tci Medicare Compliance & Reimbursement - 2011 Issue 16

Industry Notes: CMS Identifies the 4 Biggest Errors among Therapy Claims

When it comes to Medicare's Comprehensive Error Rate Testing (CERT) reports, the agency tells it like it is -- and CMS found four major errors among outpatient rehabilitation therapy service claims. According to the new fact sheet entitled, "Comprehensive Error Rate Testing (CERT) -- Outpatient Rehabilitation Therapy Services," the main issues found among these claims are the following: Missing/incomplete plan of care/treatment plan Missing physician/non-physician practitioner (NPP) signature and dates Missing modality time Missing certification and recertification.Tip: When you report a CPT® code for therapy services, double-check to determine whether CPT® classifies it as a time-based code...

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