tci Medicare Compliance & Reimbursement - 2017 Issue 21

Compliance: CMS: Verify Rotator Cuff Necessity or Expect MAC Takebacks

Tip: Sign your medical orders to avoid CMS scrutiny. A new report from Medicare should remind you why it's so important to maintain - and submit - complete supporting documentation for claims. If you repeatedly send CMS paperwork that lacks provider signatures, the medical orders are considered incomplete. The agency reminds practices that without thorough signed physician notes that fully detail the necessity for arthroscopic rotator cuff repair, the claim is invalid - and your Medicare pay is revoked. According to the October 2017 Medicare Quarterly Provider Compliance Newsletter, CMS's CERT contractors are reporting that they have seen this...

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