Hip Replacement Medical Necessity

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Hip replacement - Mayo Clinic

https://www.mayoclinic.org/tests-procedures/hip-replacement/about/pac-20385042

Conditions that can damage the hip joint, sometimes making hip replacement surgery necessary, include: 1. Osteoarthritis.Commonly known as wear-and-tear arthritis, osteoarthritis damages the slick cartilage that covers the ends of bones and helps joints move smoothly. 2. Rheumatoid arthritis.Caused by an … See more

Documenting Medical Necessity for Major Joint …

https://www.hhs.gov/guidance/document/documenting-medical-necessity-major-joint-replacement-hip-and-knee

Documenting Medical Necessity for Major Joint Replacement (Hip and Knee) This MLN Matters® Special Edition (SE) is intended for physicians who …

Hip Replacement Surgery | Johns Hopkins Medicine

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hip-replacement-surgery

Your doctor may recommend hip replacement if you have significant pain, inflammation and damage to your hip joint due to conditions such as: Osteoarthritis(most common) …

Major Joint Replacement (Hip or Knee) - Centers for …

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/jointreplacement-ICN909065.pdf

Improper Payment Data shows that the Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity category represents the highest dollar amount for …

0184-Total Hip Arthroplasty: Medical Necessity and …

https://www.cms.gov/httpswwwcmsgovresearch-statistics-data-and-systemsmonitoring-programsmedicare-ffs-compliance/2a232-total-hip-arthroplasty-medical-necessity-and-documentation-requirements

For purposes of coverage under Medicare, Total Hip Arthroplasty (THA), also referred to as joint replacement, have proven to be an important medical …

Article - Billing and Coding: Total Hip Arthroplasty (A57683)

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57683&LCDId=34163&CptHcpcsCode=27130

In the instance that the patient is undergoing a bilateral hip replacement, all criteria listed above would apply to the bilateral surgery when indicated. The medical record should …

Hip Arthroplasty - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/200_299/0287.html

Revision or replacement of a THA or hip resurfacing arthroplasty is considered medically necessary for the following indications when accompanied by pain and functional …

LCD - Total Hip Arthroplasty (L34163) - Centers for …

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=34163

Pain relief not achieved by taking non-steroidal anti-inflammatory medications and failure to achieve symptom improvement with other conservative therapies such as …

Major Joint Replacement for Hip and Knee - JE Part B

https://med.noridianmedicare.com/web/jeb/cert-reviews/cert/major-joint-replacement-for-hip-and-knee-documenting-medical-necessity

Major Joint Replacement for Hip and Knee - Documenting Medical Necessity Findings by the Comprehensive Error Rate Testing (CERT) post review …

Surgery of the Hip – Commercial Medical Policy

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/surgery-hip.pdf

Surgery of the hip and surgical treatment for femoroacetabular impingement (FAI) syndrome is proven and medically necessary in certain circumstances. For medical necessity …

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