CMS develops national coverage determinations on an ongoing basis, and __________ create(s) edits for NCD rules, which are local coverage determinations.
a. BlueCross BlueShield
b. Medicaid
c. Medicare administrative contractors
d. third-party payers
Question 2
The Medicare coverage database (MCD) is used by Medicare administrative contractors,
providers, and other health care industry professionals to determine whether a procedure or service is __________ for the diagnosis or treatment of an illness or injury.
a. billed at the appropriate level
b. preauthorized by the contractor
c. reasonable and necessary
d. usual, customary, and reasonable
