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.

First Coast Service Options, Inc., a Medicare Administrative Contractor, has put together a nice slide presentation on appropriate physician signatures in the medical records. This would also be applicable for therapists and assistants. Even though this was done by First Coast, the requirements are CMS requirements, hence, this presentation would be applicable for all providers in all states.

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

During the week of May 6, 2013, the Centers for Medicare & Medicaid Services (CMS) issued 2 proposed rules. On May 6, 2103, CMS released the proposed rule for Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2014. On May 8, 2013, CMS released the proposed rule for Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2014.

UnitedHealthcare (UHC) has announced changes to its speech therapy policy and which CPT codes they will reimburse if performed under a sppech-language pathology plan of care. In its

UnitedHealthcare (UHC) has announced further reductions in payments to its providers of outpatient therapy services for its traditional UHC plans as well as all Medicare Advantage plans offered by UHC and its affiliates. Effective April 1, 2013, CMS increased the reduction rate of duplicated practice expense components from 20 to 50 percent as part of the American Taxpayer Relief Act of 2012. To align with CMS reimbursement for these types of therapy services,