The Centers for Medicare and Medicaid Services (CMS) updates the National Correct Coding Initiative (NCCI) edits every quarter. Effective with dates of service on and after July 1, 2019, CMS is changing how modifier 59 is appended to a CPT code(s) on the claim form. Click below for the full webinar description, objectives and to register.
One of the most common questions I am asked via email and in-person during a seminar is “When does an order for therapy expire” or “How old can an order be before a patient starts therapy”? To answer this question, we must look in 3 places. The first is your
A question I often receive is can a new graduate physical therapist or graduate physical therapist assistant treat Medicare patients while they are waiting to take their national examination and have their services supervised by a licensed physical therapist (PT) or physical therapist assistant (PTA) and billed to the Medicare program? Does the Centers for…
There are many modifiers providers of therapy services are use to adding to CPT codes on the claim forms. Common modifiers include the KX modifier, 59-modifier and therapy specific modifiers of GN, GO and GP. But do you know the following modifiers and when to use them: GA, GX, GY and GZ? In this article,…
Lately, I have been receiving questions regarding what must a therapist or an assistant document in regards to time for patients receiving outpatient therapy services under Medicare Part B. Does the Medicare program require time in and time out? Does the Medicare program require we document the minutes spent on each individual CPT code. In…
The Centers for Medicare and Medicaid Services (CMS) has released a new booklet where they describe common outpatient rehabilitation therapy services Comprehensive Error Rate Testing (CERT) Program errors, how the CMS calculates improper payment rates, the necessary documentation to support billed Medicare claims, and managing potential overpayments. Some of the more common CERT errors include:…
Last week, the Office of the Inspector General (OIG) published 3 enforcement actions involving physical therapy. I will provide a brief summary of the 3 enforcement actions and a link to each action. In the first enforcement action, physical therapist Hatem Behiry was found guilty of participating in a $30 million scheme to defraud Medicare…
Noridian Healthcare Solutions will be hosting a free 30-minute webinar on May 21, 2019 at 1:00pm CT to discuss outpatient therapy certifications and recertifications. The webinar will include: Overview What is a Certification When to recertify Signatures Common Errors Resources For additional information and to register, click HERE.