by Gina Elkins | Friday, April 19, 2013 | Compliance
I know that the mandatory ‘go live’ date isn’t until July 1st for claims to be in compliance with G-Codes and Severity Modifiers. However, why wait until the last minute? If you haven’t contacted you software vendor to discuss when they will...
by Gina Elkins | Friday, April 5, 2013 | Compliance
We have been hearing for years that therapy services must be reasonable and necessary. Now, with all Medicare Part B claims over $3,700 being reviewed by RACs, MACs conducting focused Probe audits, and don’t forget about the ZPIC audits, it is even more...
by Gina Elkins | Friday, March 22, 2013 | Compliance
CMS posted last night with final guidance on the Manual Medical Review for therapy claims above $3,700. Medicare Administrative Contractors (MACs) will conduct prepayment reviews until March 31, 2013 then beginning April 1, 2013 Recovery Audit Contractors (RACs) will...
by Gina Elkins | Wednesday, March 20, 2013 | Compliance
Functional Pathways wanted you to be aware that you might receive non-compliance alerts for outpatient therapy functional reporting G-Codes and severity modifiers from your MAC. These alerts do not apply to institutional claims. There will be no alert messaging for...
by Gina Elkins | Friday, March 8, 2013 | Compliance
In the Thursday March 7, 2013 CMS FFS Provider e-News reports problems impacting crossover of Medicare Part B Outpatient Therapy Claims. CMS reports that providers who bill Medicare for outpatient therapy may have recently noticed an increase in the frequency of...
by Gina Elkins | Friday, February 22, 2013 | Compliance
CMS posted updated information about the agency’s Manual Medical Review process. The annual Medicare Part B therapy benefit for each Medicare beneficiary is $1,900 for Occupational Therapy and $1,900 for Physical Therapy/Speech Therapy combined. There are...
