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Posting Date: 09/20/2022
Physical Therapy Services
Physical Therapy Services Insufficient Documentation Causes Most Improper Payments. Insufficient documentation means something was missing from the medical records. Below is a list of the most common reasons CERT determined there was [...]
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Posting Date: 05/18/2020
Home Prothrombin Time International Normalized Ratio Monitoring for Anticoagulation Management
Home Prothrombin Time International Normalized Ratio Monitoring for Anticoagulation Management Insufficient Documentation Causes Most Improper Payments. Insufficient documentation means that something was missing from the medical records. [...]
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Posting Date: 08/23/2021
Psychological and Neuropsychological Testing
Psychological and Neuropsychological Testing Insufficient Documentation Causes Most Improper Payments. Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT [...]
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Posting Date: 05/11/2021
Pulmonary Rehabilitation Program Services
Pulmonary Rehabilitation Program Services Insufficient Documentation Causes Most Improper Payments Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT [...]
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Posting Date: 11/04/2020
Patient Discharge Disposition Code
Patient Discharge Disposition Code Improper payments due to discharge disposition codes are costly to the Medicare Program and are easily preventable. The CERT contractor has issued errors related to the discharge disposition codes that may [...]
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Posting Date: 09/29/2020
Debridement Services
Debridement Services Insufficient documentation causes most improper payments. Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined there was [...]
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Posting Date: 09/24/2020
Chronic Care Management
Chronic Care Management Insufficient documentation causes most improper payments. Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined there was [...]
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Posting Date: 07/09/2020
Total Joint Arthroplasty
Total Joint Arthroplasty Insufficient documentation causes most improper payments. Insufficient documentation means that something was missing from the medical records. Providers can help prevent CERT errors on total joint arthroplasty by [...]
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Posting Date: 05/12/2020
Botulinum Toxin Injections for Chronic Headaches
Botulinum Toxin Injections for Chronic Headaches Insufficient documentation causes most improper payments. Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT [...]
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Posting Date: 05/05/2020
Home Health Care Requirements for a Plan of Care
Home Health Care Requirements for a Plan of Care The HHA must be acting upon a physician plan of care that meets the requirements of this section for HHA services to be covered. For HHA services to be covered, the individualized plan of care [...]
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Posting Date: 03/30/2020
Chiropractic Services
Chiropractic Services Insufficient Documentation Causes Most Improper Payments. Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined there was [...]
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Posting Date: 05/18/2020
Amending Medical Records
Amending Medical Records Amendments, Corrections and Delayed Entries in Medical Documentation All services provided to beneficiaries are expected to be documented in the medical record at the time they are rendered. [...]
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Posting Date: 12/17/2019
Continuous Cycling Peritoneal Dialysis
Continuous Cycling Peritoneal Dialysis We have experienced an increasing number of CERT errors due to documentation requirements not being met. Below is a list of the most common reasons CERT determined there was insufficient documentation [...]
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Posting Date: 11/01/2019
Cologuard TM Multitarget Stool DNA Test
CologuardTM Multitarget Stool DNA Test Insufficient Documentation Causes Most Improper Payments. Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined [...]
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Posting Date: 01/29/2021
Hemodialysis Treatment
Hemodialysis Treatment Insufficient documentation means that 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 [...]
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Posting Date: 01/29/2021
Psychiatry and Psychology Services
Psychiatry and Psychology Services CERT has determined that insufficient documentation caused improper payments for psychiatry and psychotherapy; insufficient documentation means that information was missing from the medical [...]
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Posting Date: 05/28/2020
Hospital Discharge Summary: Insufficient Documentation Causes Most Improper Payments
Hospital Discharge Summary: Insufficient Documentation Causes Most Improper Payments Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined there [...]
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Posting Date: 01/29/2021
Bill Inpatient or Outpatient Services
Bill Inpatient or Outpatient Services To help avoid denials, National Government Services has compiled information regarding references that will aid in determining whether to bill inpatient or outpatient services. CMS Medicare Learning [...]
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Posting Date: 01/29/2021
Process for Requesting Medical Records
Process for Requesting Medical Records Additional Documentation Requests INITIAL ADR letters for CERT are sent to the address on file with the NSC for DMEPOS suppliers, or the MAC for the provider/supplier that billed/submitted the [...]
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Posting Date: 01/29/2021
Inpatient Psychiatric Certification/Recertification/Delayed Certification
Inpatient Psychiatric Certification/Recertification/Delayed Certification Physicians are required to certify the medical necessity of inpatient services. This is required on admission and if the service is needed for an extended period of [...]
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