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When a medical reviewer contacts the provider requesting to submit an attestation statement or signature log to authenticate a medical record, the provider must submit the attestation statement or signature log within 20-calendar days.
The MDS is a tool used for implementing standardized assessment and for facilitating care management in skilled nursing homes and non-critical access hospital swing beds.
This checklist is an aid to assist providers when responding to medical record documentation requests pertaining to community mental health centers (CMHC) or partial hospitalization program (PHP).
This questionnaire is intended to provide health care providers with a reference for use when screening a new patient for a SNF admission. This criteria is required to meet Medicare guidelines for a SNF covered stay and medical necessity.
Use the links on the left to access checklists to ensure you have met medical documentation requirements based on specific services.
CMS requires that any Medicare service provided or ordered must be authenticated by the author - the one who provided or ordered that service. This article outlines acceptable forms of authentication.
View targeted probe and educate (TPE) round results for nail cutting / pairing and debridement (CPT 11055-11057, 11719-11721 & HCPC G0127).
Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for cervical fusion with disc removal if performed in a HOPD setting and billed with the fo…
To submit a prior authorization request, complete the prior authorization coversheet. Failure to populate every field could result in delays in processing your request, a non-affirmed decision, or a determination that the request is incompl…
Facet joint interventions may be used in pain management for chronic cervical/thoracic and lumbar/sacral pain arising from the paravertebral facet joints. Imaging guidance (fluoroscopy or CT per code descriptor) is used to assure accurate p…