Be sure you know how to handle the situation The latest round of National Correct Coding Initiative (CCI) edits went into effect July 1, 2018, with many new additions including some common codes for pain management injections. Watch for Edits [...]
Plus: FBI knows how much money your patient’s PHI is worth. Keep your eyes peeled this autumn for a notification and data request from the HHS Office for Civil Rights (OCR). If you receive these communications, your practice is one [...]
MACs will continue to review claims on a post-payment basis. Don’t think scrutiny of your Medicare outpatient therapy claims is going to just simply stop. In fact, the Medicare Administrative Contractor can still review your claim even if it’s been [...]
A claim could still be reviewed even if it has been paid. Nursing home providers are in for a disappointment. The manual medical review of Medicare Part B therapy claims did not end on Dec.31st, 2012. If your claims have [...]
Don’t rely on MACs to let up on reviews while Congress decides next actions. The end’s not in sight after all for the manual medical review of Medicare Part B therapy claims. Nursing home providers hoping Dec. 31st was the [...]
Don’t expect MACs to cease reviews while awaiting further Congressional action. If you’ve been counting down the days till December 31st eager for the manual medical review of Medicare Part B therapy claims over $3,700 to come to an end, you [...]
Good news: Functional status reporting requirements improved from proposed rule. It's that time of year again: CMS has released its Final 2013 Physician Fee Schedule Rule. As to be expected, the therapy cap exceptions process expires at the end of [...]
Get advanced approval if patient nears $3,700, or wait up to 60 days for CMS payment. If your ASC provides therapy services, get ready for closer scrutiny. All therapy payments are subject to CMS manual medical review after the patient [...]
Get advanced approval, or wait up to 60 days to get high-dollar claims reviewed.CMS has finally revealed details about the manual medical review process for therapy dollar amounts exceeding $3,700. Last February, the Middle Class Tax Relief and Job Creation [...]
Plus: Hospices must keep promises, one MAC says.CMS has finally revealed details about the manual medical review process for outpatient therapy dollar amounts exceeding $3,700 with the release of MLN Matters article MM8036, effective Oct. 1Background: Last February, the Middle [...]
