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08/05/15

WPS to Host Several Therapy Seminars

Wisconsin Physician Services (WPS) will be hosting several in-person half-day seminars for outpatient rehabilitation therapy. The morning session will consist of billing and payment and will include the following: CMS regulations and coverage, resources to understand the billing and payment, Advance Beneficiary Notice of Non-coverage, and functional reporting criteria. The afternoon session will explore the coverage criteria and documentation requirements for physical therapy, occupational therapy, and speech language pathology. In this interactive session we will review the coverage criteria as well as actual documentation examples. Seminar locations include: Coralville, IA on October 7th, Overland Park, KS on November 11th, and Saint

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08/03/15

UnitedHealthcare Community Plan SLP Updated

UnitedHealthcare (UHC) Community Plan has revised their speech-language pathology (SLP) coverage determination guideline with an effective date of August 1, 2015. To view the revised SLP coverage determination guideline, click

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08/03/15

ICD-10 Transition Update

With the transition to ICD-10 less than 2 months away, providers still have questions concerning ICD-10 and how to use the codes in their outpatient therapy practice and/or department. Worse yet, some providers have yet to start their ICD-10 training and education as they were hoping for a delay in the implementation date. For those that waited, start your training and education now. The Centers for Medicare and Medicaid Services (CMS) has no plans to delay the implementation date and you must be ready to begin using ICD-10 codes for dates of service on or after October 1, 2015. To

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07/22/15

Recovery Audit Program Recent Updates

Effective June 4, 2015, The Centers for Medicare and Medicaid Services (CMS) has withdrawn the Requests for Quotes for the next round of Recovery Auditor contracts. CMS plans to update the Statement of Work and release new Requests for Proposals shortly. In the meantime, the current Recovery Auditors will continue active recovery auditing through at least December 31, 2015. In addition, in mid-January 2015, CMS approved the Recovery Auditors to begin reviewing Outpatient Therapy Threshold claims (those over the $3700 threshold) that were paid March 1, 2014 through December 31, 2014. In an effort to minimize provider burden, CMS set restrictions

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07/17/15

Signature Requirements Workshop

Noridian Healthcare Solutions will be hosting a workshop on August 25, 2015 on signature requirements under the Medicare program. The workshop will include: Overiew and Purpose Valid Signatures Signature Guidelines Attestation Form and Signature Log Comprehensive Error Rate Testing (CERT) Resources Questions For additional information and to register, click HERE.

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07/17/15

Therapy Cap Exception Process Workshop

Noridian Healthcare Solutions will be hosting a workshop on the Medicare therapy cap exception process on August 6, 2015. The workshop will include: Therapy Cap Exception Process Accessing Therapy Limits Required Documentation Claim Submission KX Modifier Overview For additional information and to register, click HERE.

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07/15/15

CMS Releases 2016 Proposed Rule for Services Reimbursed Under the MPFS

On July 15, 2015, the Centers for Medicare and Medicaid Services (CMS) released the 2016 proposed rule for services reimbursed under the Medicare Physician Fee Schedule (MPFS). This proposed rule does impact outpatient therapy services provided in the following settings: Private Practice Skilled Nursing Facilities Outpatient Rehabilitation Facilities Comprehensive Outpatient Rehabilitation Facilities Home Health Agencies providing Part B Therapy Services Hospital Outpatient Departments (excludes critical access hospitals) Highlights of the proposed rule include the 2016 payment rate, 2016 PQRS program, and CPT codes used by PT and OT that CMS wants to review to see if they are “misvalued” and

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07/09/15

CMS and AMA Announce Efforts to Help Providers Get Ready For ICD-10

With less than three months remaining until the nation switches from ICD-9 to ICD-10 coding for medical diagnoses and inpatient hospital procedures, The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) are announcing efforts to continue to help physicians get ready ahead of the October 1 deadline. In response to requests from the provider community, CMS is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD- 10 code set. To read the additional guidance that does include an

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