tci Part B Insider - 2012 Issue 28

In other news…

Don't submit a hospice claim with one of these diagnoses, unless your documentation thoroughly backs it up -- Debility, Alzheimer's disease, and Chronic Airway Obstructions. Medicare Administrative Contractor CGS is continuing a widespread review of hospice claims with these diagnoses, it says on its website. In a probe review that ran from October 2011 through March 2012, CGS denied most claims for failing to show the terminal prognosis or for certifications that were missing, incomplete or not timely, the MAC says. Hospices also failed to submit documentation at all in response to the ADR. Reminder: \"The patient's appropriateness for...

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