tci Part B Insider - 2003 Issue 31

Physician Notes: Physicians Get a Break on Beneficiary Appeals Documentation

Long-delayed coverage appeal rule at last in final form Burdensome physician certification rules that could have derailed beneficiary appeals of Medicare coverage decisions have been stripped from the books.   In a final rule governing beneficiary appeals of national and local coverage determinations, the Centers for Medicare & Medicaid Services relented on stringent certification requirements contained in its Aug. 22, 2002, proposal. Those rules have been relaxed in the final rule: Now, certification that a service is necessary can simply be in the form of a written order or another component of the medical record. And physicians won't be...

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