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Category Archives: MAC
Full Implementation of Ordering/Referring Edits
Starting May 1, 2013 CMS will deny Part B, DME and Home Health Agency claims where physicians who order or refer items or services for Medicare beneficiaries, on the claim didn’t have an enrollment record in the provider enrollment, chain and … Continue reading
Service Wide Review Results for IPPS Claims for DRG 311: Angina Pectoris
Novitas Solutions conducted a 50 claim service wide post pay probe review for Diagnostic Related Grouping (DRG) 311: Angina Pectoris. The review ensures that services billed to Medicare are covered, are correctly coded, and are reasonable and necessary. This review … Continue reading
EHRs: Friend or Foe?
As coders and auditors, Cheryl and I have been forever warning our clients moving over to EHR (electronic health record) about cloned visit documentation for quite some time. We now have a Medicare Administrative Contractor (MAC) that has issued a … Continue reading
Posted in CMS, documentation, Documentation, EHR, Healthcare, MAC, Medicare, Practice Management, Uncategorized
Tagged CMS, EHR, electronic health record, MAC
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PECOS surrogate program – how you can legally enroll on behalf of providers
Your longstanding but technically illegal habit of allowing non-physician staff to log into CMS’ web-based Provider Enrollment Chain and Ownership System (PECOS) using the physician’s username and password soon will become legal under a new surrogate program. But you must … Continue reading
Posted in CMS, Credentialing, Healthcare, MAC, Medicare, PECOS, Practice Management, Regulatory, Revalidation, Uncategorized
Tagged AO, CMS, EHR, NPPES, PECOS, surrogate
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CMS Increases Enrollment Submission Window
CMS is making enrollment easier. This has nothing to do with the 60 days you have to complete a revalidation after you receive the revalidation notice in the mail.
Posted in CMS, Credentialing, MAC, Medicare, PECOS, Revalidation, Uncategorized
Tagged 855, CMS, enrollment, PECOS
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WPS: Status of 3 chronic conditions accepted with 97 guidelines only
E/M documentation Here is a follow-up article, to a prior blog post, that was reported by Karen Long of Part B News Practices that followed WPS carrier instructions to document extended history of present illness (HPI) with three or more … Continue reading
Posted in Coding, CPT, documentation, E/M, MAC, Medicare
Tagged 97 Guidelines, Chronic Conditions, E/M, HPI, Part B News, WPS
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