Effective June 20, 2013, Cigna Government Services, Medicare Administrative Contractor in the states of Kentucky and Ohio, will require additional documentation be included with all Reopening request that are being submitted for the purpose of adding a KX modifier to a therapy claim. The documentation may include but is not limited to: treatment plans, history and physicals, progress notes, consult notes and reports. After this date, if the documentation is not included with the reopening request, the claim cannot be processed for an adjustment.

Cigna Government Services (CGS) invites you to participate in an Ask-the-Contractor Teleconference (ACT) specifically focused on the new claims-based data collection reporting requirement and changes to the manual medical review process for outpatient therapy services. The teleconference is scheduled for Thursday, May 23, 2013, from 9-10:30 a.m. CT/10-11:30 a.m. ET. Please mark your calendar and plan to participate in this call. No pre-registration is necessary. To join the teleconference, please click HERE and follow the instructions.

Effective today, May 13, Noridian Administrative Services (NAS) has officially changed its name to Noridian Healthcare Solutions (Noridian) to better reflect the scope of capabilities that have grown from our core business.

First Coast Service Options, Inc., a Medicare Administrative Contractor, has put together a nice summary of the 5 different levels of the appeal process, time limit for filing the request, and where to file the appeal. This site even has an option where the provider can submit the date of the denial or decision of an appeal, and the system will tell the provider the date of when they must appeal to the next level. Even though this is on the First Coast Service Options website, this would be the same process for all Medicare Administrative Contractors, hence, would be

Novitas Solutions, J12/JH Medicare Administrative Contractor, has posted updated FAQs on outpatient therapy services regarding billing. To view the FAQs, click HERE.

Novitas Solutions, J12/JH Medicare Administrative contractor, has posted updated FAQs on outpatient rehabilitation documentation. To view the FAQs, click HERE.

Novitas Solutions, J12/JH Medicare Administrative contractor, has posted updated FAQs on SNF rehabilitation as of April 30, 2013. To view the FAQs, click HERE.

Novitas Solutions, the J12/JH Medicare Administrative Contractor, has updated PT FAQs on their website as of April 30, 2013. To access the FAQs, click HERE.