I receive many questions regarding Medicare Part B certifications and recertifications as they pertain to outpatient physical, occupational and speech therapy services. In this article, I will answer the following questions: 1. How long is a certification and recertification valid for under Medicare Part B outpatient therapy services? 2. How soon must a plan of care be signed by a physician or NPP to be considered timely under Medicare Part B rules and regulations? 3. What is delayed certification and recertification?  4. What are some possible justifications to support delayed certification or recertification? 5. If I only do an evaluation

The Centers for Medicare and Medicaid National Correct Coding Initiative (NCCI) edits effective with dates of service July 1, 2018 – September 30, 2018 is now available for my Gold Members. The outpatient therapy specific NCCI edit “cheat sheet” is available HERE. Please make sure to log into your account to access the “cheat sheet”.

The American Hospital Association (AHA) has submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the 2019 Skilled Nursing Facility (SNF) proposed rule and 2019 Inpatient Rehabilitation Facility (IRF) proposed rule. To read the AHA comments regarding the SNF proposed rule, click HERE. To read the AHA comments regarding the IRF proposed rule, click HERE.

The June 2018 quarterly Long-term Care Hospital (LTCH) and Inpatient Rehabilitation Facility (IRF) Compare refresh, including quality measure results based on data submitted to CMS between Q3 2016 – Q2 2017, is now available. To view the LTCH data, click HERE. To view the IRF data, click HERE.

Long-term Care Hospital (LTCH) and Inpatient Rehabilitation Facility (IRF) Provider Preview Reports have been updated and are now available. Providers have until July 1, 2018 to review their performance data on quality measures based on Quarter 4 -2016 to Quarter 3 – 2017 data, prior to the September 2018 LTCH Compare and IRF Compare site refreshes, during which this data will be publicly displayed. To access the LTCH Compare, click HERE. Click HERE to access the LTCH Provider Preview Report Access To access the IRF Compare, click HERE. Click HERE to access the IRF Provider Preview Report Access

As more and more therapists are getting trained in dry needling, I receive more questions on what CPT code do I bill for the dry needling techniques? According to APTA, “Dry needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments. It is a technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue, and to diminish persistent peripheral nociceptive input, and reduce or restore impairments in body structure and function, leading to improved

The Centers for Medicare and Medicaid Services (CMS) will be hosting a teleconference on June 27, 2018 from 2:00pm – 3:0pm eastern time. During this call, learn about proposed modifications to the way CMS calculates Home Health Quality of Patient Care star ratings, including: Removal of the Drug Education on All Medications Provided to Patient/Caregiver during All Episodes of Care measure Addition of the Improvement in Oral Medications measure CMS presents the rationale, proposed timing, and impact of these changes. A question and answer session follows the presentation. For additional information and to register, click HERE.

Documentation must meet Medicare’s signature requirements. If Medicare claims reviewers cannot validate the signatures, Medicare Administrative Contractors (MACs) deny the claim, assess an error, and begin recouping overpayments. Questions I receive regarding signatures include the following: How does CMS define a handwritten signature? What if I use a scribe when documenting medical record entries? What is required for a valid signature? What should I do if I did not sign a medical record? What if I signed the order or progress note but my signature is not legible? What is a signature log? Am I able to attest to my