Introducing the new Medicare Provider Compliance Newsletter
October 11, 2010
Medicare has started a new "educational tool" they are calling the Medicare Quarterly Provider Compliance Newsletter. The first issue was released October 1, 2010.
The purpose behind the newsletter is to assist providers by identifying common billing problems and addressing the ways that providers can avoid these problems.
This inaugural newsletter includes the following topics:
Inpatient Hospital and Skilled Nursing Facilities Fail to Submit Requested Documentation
Other Services with Excessive Units - Units Billed Exceeded the Number Approved per Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) Code Descriptions
Inpatient Hospital Services - Respiratory System Diagnosis with Ventilator Support: Principal Diagnosis on the Claim Did Not Match the Principal Diagnosis in the Medical Record
Other Cardiac Pacemaker Implantation (DRG 116) - Not Medically Necessary to Receive Care in Inpatient Setting
Inpatient Hospital Services - Heart Failure and Shock (DRG 127) Criteria for Inpatient Care Not Met
Other Drug Codes - Incorrect Number of Units Billed
Inpatient Hospital Services - Medical Record Did Not Include Sufficient Documentation
Physician Pharmaceutical Injectables - Incorrect Procedure Codes and/or Number of Units Billed
Click here to view the new Medicare Quarterly Provider Compliance Newsletter.