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Regulatory Compliance Support policies and procedures

If you have questions about regulatory compliance, you can review HCA Healthcare's documentation on issues related to coding, billing, lab testing and more.

Regulatory Compliance Support (APS) policies and procedures

Policy Reference Number
Certification and Recertification for Post Acute Services REGS.APS.001
Outpatient Rehabilitation Therapy Services REGS.APS.002

Regulatory Compliance Support (BILL) policies and procedures

Policy Reference Number
Outpatient Self-Administered Drugs REGS.BILL.003
Stat, Call Back, Stand-by and Handling Charges REGS.BILL.006
Billing for Investigational Devices REGS.BILL.007

Regulatory Compliance Support (COD) policies and procedures

Policy Reference Number
Coding Documentation for Inpatient Services REGS.COD.001
Coding Documentation for Outpatient Services REGS.COD.002
Coding References and Tools REGS.COD.003
Coding Help Line REGS.COD.004
Coding Orientation and Training REGS.COD.005
Coding Continuing Education Requirements REGS.COD.006
Reimbursement of Professional Exam Fee to Obtain Credentials REGS.COD.007
Prohibition of Contingency-Based Coding Arrangements REGS.COD.009
Coding Documentation for Rehabilitation Facilities/Units REGS.COD.013
External Coding Vendors for Coding Services, Reviews and Related Education REGS.COD.017
Inpatient and Outpatient Coding Compliance Monitoring and Auditing REGS.COD.018

Regulatory Compliance Support (DOC) policies and procedures

Policy Reference Number
Clinical Documentation Improvement (CDI) - Implementation Requirements REGS.DOC.001
Query Documentation for Clinical Documentation Improvement (CDI) & Coding - Compliance Requirements REGS.DOC.002
CDI Orientation and Training REGS.DOC.003
CDI Continuing Education Requirements REGS.DOC.004

Regulatory Compliance Support (GEN) policies and procedures

Policy Reference Number
Advance Beneficiary Notice of Non-coverage Outpatient Services REGS.GEN.003
Billing - Orders for Hospital Outpatient Tests and Services REGS.GEN.004
Billing & Billing Related Continuing Education Requirement REGS.GEN.007
Hospital Evaluation and Management Services REGS.GEN.008
Outpatient Services and Medicare Three Day Window REGS.GEN.009
Medicare - Hospital Issued Notice of Non-Coverage REGS.GEN.010
Medicare - National and Local Coverage Determinations REGS.GEN.011
Refunds for Medically Unnecessary Services for Federal Payers REGS.GEN.012
Responding to Governmental Requests for Claims Reviews or Surveys REGS.GEN.013
Medicare Order Form for Patient Status REGS.GEN.014
Correction of Errors Related to Federal and State Healthcare Program FFS Reimbursement REGS.GEN.015

Regulatory Compliance Support (HHA) policies and procedures

Policy Reference Number
Advance Beneficiary Notice of Non-Coverage – Home Health and Hospice Services REGS.HHA.001
Responding to Governmental Requests for Home Health or Hospice Agencies Claims Reviews or Surveys REGS.HHA.002
Correction of Errors Related to Federal and State Healthcare Program FFS Reimbursement for Home Health and Hospice Agencies REGS.HHA.003
Medicare – National and Local Coverage Determinations for Home Health and Hospice Services REGS.HHA.004

Regulatory Compliance Support (LAB) policies and procedures

Policy Reference Number
Billing - Outpatient Specimen Collection REGS.LAB.006
Billing - Custom Profiles REGS.LAB.007
Referred Laboratory Testing REGS.LAB.009
Laboratory - Reflex Tests REGS.LAB.010
Laboratory - Client Billing Practices REGS.LAB.023
Maintenance of Company Standard Laboratory Chargemaster REGS.LAB.025
Hematology Procedures, Urinalysis Procedures, and Organ or Disease-Oriented Panels REGS.LAB.026

Regulatory Compliance Support (OSG) policies and procedures

Policy Reference Number
Coding Documentation for Non-Hospital Entities REGS.OSG.001
Advance Beneficiary Notice of Non-coverage for Physician Professional Services and Non-Hospital Entities REGS.OSG.002
Coding Reference and Tools for Non-Hospital Entities REGS.OSG.003
Coding and Billing Help Line for Non-Hospital Entities REGS.OSG.004
Coding Orientation and Training for Non-Hospital Entities REGS.OSG.005
Coding Continuing Education Requirements for Non-Hospital Entities REGS.OSG.006
Medicare-National and Local Coverage Determinations for Physician Professional Services and Non-Hospital Entities REGS.OSG.007
Coding: Additional Compensation Plans for Coding Services Submitted on 1500 Claim Forms REGS.OSG.008
Prohibition of Contingency-Based Coding Arrangements for Non-Hospital Entities REGS.OSG.009
Physician Supervision Requirements for Diagnostic Tests Performed in Freestanding Entities REGS.OSG.010
Certified External Vendors for Coding Related Education for OSG Entities REGS.OSG.011
Responding to Governmental Requests for Non-Hospital Entities Claims Reviews or Surveys Policy REGS.OSG.012
Billing Continuing Education Requirements for Professional Services REGS.OSG.BILL.001

Regulatory Compliance Support (PROF) policies and procedure

Policy Reference Number
Provider Coding/Billing Continuing Education Requirements for Professional Services REGS.PROF.006