The J15 Part A Medical Review department performed a service-specific probe review on inpatient services relating to hospital admissions which resulted in admission to skilled nursing facilities, bill type 11X, in Kentucky. Based on the results summarized below, this edit was discontinued in Kentucky. To view the results of the probe review, click HERE.

The J15 Part A Medical Review department performed a service-specific probe review on inpatient services relating to hospital admissions which resulted in admission to skilled nursing facilities, bill type 11X, in Ohio. Although results demonstrated that additional medical review efforts may be indicated, due to a change in the medical review strategy, CGS will not advance this probe edit to ongoing complex review at this time. We may conduct additional reviews related to these services in the future. To read the results of the review, click HERE.

Wisconsin Physician Services (WPS) will host an onsite seminar on May 21, 2014 in Seattle, WA focused on documentation. During this seminar, WPS will review sample documentation and see how it stacks up against medical necessity criteria. This is a must attend session for any clinician hoping to gain additional insight into the medical review process for skilled nursing facilities. For additional information and to register, click HERE.

Wisconsin Physician Services (WPS), Medicare Administrative Contractor for the states of Indiana and Michigan, will host an onsite seminar focused on outpatient therapy services in Traverse City, MI on August 20, 2014 from 1:00pm – 4:00pm. The seminar is designed for those who provide or bill physical therapy, occupational therapy, or speech language pathology to Medicare beneficiaries.  Topics covered in the program include the following: Requirements for a Plan of Care Certifications and Recertifications Evaluations and Reevaluations Therapy Caps Advanced Beneficary Notice of Noncoverage Documentation Requirements Functional Reporting Requirements For additional information, including how to register, click HERE.

Wisconsin Physician Services (WPS), the Medicare Administrative Contractor in the states of Indiana, Iowa, Kansas, Michigan, Missouri, and Nebraska, has developed an online tool to assist providers in selecting the correct form to submit and the correct department and address to submit your appeal request. If WPS is your Medicare Administrative Contractor, check out this online tool. Private practices in Iowa, Kansas, Missouri and Nebraska,

First Coast Service Options, Medicare Administrative Contractor for the state of Florida, has published a guide to educate providers on common documentation errors for outpatient rehabilitation therapy services. The leading cause of payment errors for therapy is insufficient documentation in the medical records. In the guide, First Coast discusses issues with the contents of the plan of care, signature and certification requirements for the plan of care, daily note documentation, and functional limitation reporting. Even though this guide was published by First Coast for the state of Florida, the guide would be beneficial to all therapists who treat Medicare outpatients

The MIST Therapy System, CPT Code 97610, consists of an equipment component (an ultrasonic generator and transducer) and a disposable component (sterile applicator). The sterile disposable applicator is attached to the generator’s transducer and has been designed to accept a pre-packaged sterile bottle of saline. Generally, treatment consists of three sessions per week, during which time the nurse or therapist holds the device near the wound while ultrasonic energy generated by the device atomizes the saline and delivers a continuous mist to the treatment site. The disposable applicator contains an on/off valve that controls the flow of sterile saline to

National Government Services (NGS) will be hosting 3 webinars specific for their therapy providers and the webinars will review the local coverage determination, supplemental instructions article and important information for their therapy providers for 2014. The webinars will take place on April 22, May 15, and June 11.