Fast facts: Appealing a CERT review decision
The Comprehensive Error Rate Testing (CERT) review contractor conducts a medical review of randomly sampled post-payment claims...
The Comprehensive Error Rate Testing (CERT) review contractor conducts a medical review of randomly sampled post-payment claims...
To use the SPOT, you must complete the full new user registration process through the IDM website. If you have your IDM account and attempt to log on to SPOT before the role request has been approved (i.e., no request submitted, request in pending status, or request in denied status), a permission error message will be returned.
Read this article for tips on how to prevent reject reason code 31997.
When evaluation and management services are furnished incident-to a physician's service by a nonphysician practitioner, the physician may bill the CPT code that describes the evaluation and management service furnished. CPT code 99211 is an established patient office or other outpatient visit that may not require the presence of a physician or other qualified health care professional. To bill incident to, the incident to rules must be met.
Read this article for tips on how to prevent reject reason code 76474.