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  • 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 [...]

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  • 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 [...]

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  • 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 [...]

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  • 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.  [...]

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