Adding a New Diagnosis to an Existing Plan of Care

You are treating a patient for one condition (e.g., neck pain) and when they come in for a follow-up visit, they now present with a physician order for their right shoulder. What do you do? In this article, I will answer the following questions:

UnitedHealthcare Updates Outpatient Therapy Medical Policy: August 2023

UnitedHealthcare (UHC) has once again revised their Habilitation and Rehabilitation Therapy (Occupational, Physical and Speech) revised medical policy with an effective date of August 1, 2023. The revised policy impacts all UHC Commercial plans and UHC Oxford. The only revision to this revised policy compared to the July 1, 2023 revision is UHC has

Can a Resident Certify a Therapy Plan of Care

QuestionCan a resident physician certify and recertify a plan of care for outpatient therapy services under the Medicare program? Answer If you have other questions about Medicare Part B and outpatient therapy plans of care, click HERE. If you have questions about Medicare Part B outpatient therapy certifications and recertifications, click Here.

Identifying the Certifying Physician(s) on a Claim Form

I am often asked by providers of outpatient therapy services how to identify who the certifying physician/non-physician practitioner (NPP) or physicians/NPPs are on the claim form. The answer depends on whether you are a private practice submitting claims on the paper 1500 claim form or the electronic equivalent (i.e. 837P) or you are an institutional provider (i.e. skilled nursing facility, rehabilitation agency, CORF, or hospital outpatient department) submitting claims on the UB-04 electronic claim form (837I). In this article, I will provide the answers to the above including how to identify multiple physicians/NPPs on the claim form when one physician/NPP … Read More