Medical review
Checklist: Cardiac rehabilitation services
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for cardiac rehabilitation services.
Checklist: Pulmonary rehabilitation services
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for pulmonary rehabilitation services.
Checklist: Pulmonary rehabilitation services
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for pulmonary rehabilitation services.
Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders
Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.
Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders
Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.
CBR Guide - Part B
The Comparative Billing Report (CBR) for Part B providers furnishes a detailed examination of the comparative data that Medicare considers when determining how the provider’s billing patterns…
Prior authorization program for repetitive scheduled non-emergent ambulance transports
Background
Submissions
Extended affirmation periods
Prior authorization program for certain hospital outpatient department services - claim submission guidelines
Claims submitted for a prior authorization request (PAR) that received a provisional affirmation PA decision, including any service that was part of a partially affirmed decision, must include the 14…
Prior authorization program for certain hospital outpatient department services - claim submission guidelines
Claims submitted for a prior authorization request (PAR) that received a provisional affirmation PA decision, including any service that was part of a partially affirmed decision, must include the 14…
Prior authorization: Facet joints and cervical fusion
CMS has removed CPT codes 64492 and 64495 from the listing of codes requiring prior authorization. View our article to learn more about these changes.