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DOCUMENTATION / CODING / BILLING / COMPLIANCE May 19, 2012 Welcome, Guest!
Frequently Asked Questions
Topic:

New Item Q: What is the difference between codes 64550, Application of surface (transcutaneous) neurostimulator, and 97014, Application of a modality to one or more areas; electrical stimulation (unattended)?

New Item Q: What is the therapy cap amount for 2012?

New Item Q: What is Medicare's Common Working File (CWF)?

New Item Q: What Place of Service (POS) code should I use for out-patient Medicare Part B therapy services provided in the home that are not provided by a Home Health Agency (HHA) under Part A?

New Item Q: Can a physical therapy student write in the medical record?

New Item Q: When will the therapy cap be applied to the hospital outpatient departments?

New Item Q: Will all hospital outpatient departments be subject to the therapy cap starting October 1, 2012?

New Item Q: Will therapy services provided in a hospital outpatient department (excluding Critical Access Hospitals) between January 1 - September 30, 2012 count towards the therapy cap?

New Item Q: What is the best way to prepare for an audit?

New Item Q: What is a "Corporate Integrity Agreement" (CIA)?

New Item Q: Do I have to include the NPI of the physician who certified the Medicare plan of care on the claim form?

New Item Q: Why should I begin to report quality measures in Medicare's Physician Quality Reporting System (PQRS) program now if the penalties are not scheduled to be imposed until 2015?

New Item Q: If an exception to the therapy cap is not granted, is the patient financially liable for the remaining balance?

New Item Q: Where can I locate the 2012 Physician Quality Reporting System (PQRS) Measure Specifications?

New Item Q: Is it important to keep records of staff education related to compliance training?

New Item Q: How can I determine which Medicare beneficiaries are eligible for certain PQRS measures?

New Item Q: Should an attorney draft a compliance plan and how long should it be?

New Item Q: What is expected to happen to the therapy cap in 2013?

New Item Q: Should all staff members be given a copy of the clinic's compliance plan?

New Item Q: Do Medicare Advantage plans utilize a financial cap on therapy services?

New Item Q: What are the requirements for successful claims-based reporting in the 2012 Physician Quality Reporting System (PQRS) program?

New Item Q: What are the requirements for successful registry reporting of Physician Quality Reporting System (PQRS) quality measures in 2012?

New Item Q: What is a "manual medical review" of therapy services for Medicare beneficiaries?

New Item Q: How do I find out information about how many dollars have been utilized towards my patient's therapy cap?

New Item Q: If the therapy cap exceptions process ends, can I utilize the GA/GY/GX codes and subsequently submit a bill to the patient’s secondary insurance for reimbursement?

Q: Do I have to obtain a physician recertification on a Medicare Plan of Care (POC) if the duration of the episode changes due to patient attendance issues?

Q: When will CMS begin to accept Version 5010 claims?

Q: Are non-covered entities under HIPAA such as Workers Compensation and automobile insurance payers required to convert to ICD-10?

Q: What is "version 5010"?

Q: Will the ICD-9 code set be continually updated prior to the ICD-10 implementation date of October 1, 2013?

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Frequently Asked Questions
Fearon & Levine receives hundreds of questions a month from therapists around the country regarding coding, billing, documentation, payment policy, regulatory compliance, audit activity, and more. This section of the website posts answers to frequently asked questions on these topics and many others.
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