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Category Archives: CERT
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
Documentation Guidelines Interpreted Differently Based on your MAC
There are two sets of E/M documentation guidelines. In 1995, CMS released the first set of guidelines that were tailored more towards primary care. The specialists soon spoke up, stating that under the 1995 guidelines, system-focused examinations were under-represented. Responding to … Continue reading
Posted in CERT, Coding, Documentation, Medicare
Tagged CERT, CMS, Documentation, E/M, guidelines, HPI, MAC, WPS
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