-
Posting Date: 01/29/2021
Stereotactic Body Radiation Therapy
Stereotactic Body Radiation Therapy Insufficient documentation means that something was missing from the medical records. Below are the most common reasons CERT determined there was insufficient documentation that caused improper payments for [...]
Read More -
Posting Date: 01/29/2021
Anesthesia Services
Anesthesia Services Insufficient documentation means something was missing from the medical records. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for [...]
Read More -
Posting Date: 01/29/2021
Diagnostic Testing Services
Diagnostic Testing Services Insufficient documentation means something was missing from the medical records. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for [...]
Read More -
Posting Date: 01/29/2021
Transcatheter Aortic Valve Replacement
Transcatheter Aortic Valve Replacement The CMS CERT program produces a national Medicare FFS error rate, as required by the Improper Payments Information Act. CMS strives to eliminate improper payments in the Medicare Program to maintain the [...]
Read More -
Posting Date: 01/29/2021
Part A to Part B Claims (Rebilling) Submissions
Submitting Part A to Part B Claims (Rebilling) Submissions Administrator’s Ruling CMS 1455-R The Administrator’s Ruling CMS 1455-R, issued on 3/13/2013 established an interim process for hospitals to use to submit claims for Part B [...]
Read More -
Posting Date: 01/29/2021
Inpatient Hospital Surgery
Inpatient Hospital Surgery National Government Services would like to alert providers on one of the highest dollar and most avoidable denials from the CERT contractor: submitting documentation relating to inpatient hospital surgeries. [...]
Read More -
Posting Date: 01/29/2021
Redetermination/Reopening Requests Online with NGSConnex
Redetermination/Reopening Requests Online with NGSConnex The NGSConnex web application allows providers/suppliers the ability to electronically submit and check the status of all redeterminations and/or reopenings requests online with no costs [...]
Read More -
Posting Date: 10/07/2010
Selecting the Appropriate Principal Diagnosis for Inpatient Services
Selecting the Appropriate Principal Diagnosis for Inpatient Services CERT analysis indicates providers are not coding the principal diagnosis to the highest level of specificity and/or selecting the most appropriate code for the inpatient [...]
Read More