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Advocacy


Coding & Billing

2010 Coding and Compliance Seminars

Managing Your Reimbursement and Regulatory Risks

January 8-9 - Cincinnati, OH (Register by December 21)
February 26-27 - Dallas, TX (Register by February 12)
March 19-20 - Arlington, VA (Register by March 5)
April 9-10 - Las Vegas, NV (Register by March 26)


Coding
Canalith Repositioning Coding Guidance
CMS Transmittal Explaining 8-Minute Rule (.pdf)
Group Therapy and Medicare
ICD-10 Resources Restricted
The Correct Coding Initiative

Billing
"Incident to" Services
Advanced Beneficiary Notices
Beneficiary Responsibilities
Claim Adjustment Reason Codes
Common Errors to Avoid when Billing Medicare Carriers (.pdf) - 5/10/07
Federal Payment Levy Program
Guidance for Submission of Claim Forms
IRS Payment Withholding for Medicare Claims (.pdf) - 8/15/08
Medicare Denial Modifiers
Medicare Parts A and B Preauthorization Requirements (.pdf) - 9/1/09
Medicare Remittance Advice
MLN Article: Billing for Services by SLPs in Private Practice (.pdf) - 5/4/09

Documentation
CMS Clarifies Signature Requirements for Medicare Documentation (.pdf) - 8/5/08
Medicare Manual Revisions Effective Jan. 1, 2008 (.pdf) - 5/7/08
Medicare Documentation and Coverage Guidelines (.pdf) - 5/7/08
FAQs: 90 Day Recertification Requirement (.pdf) - 1/10/08 Restricted
Medicare Manual Revisions June 2005: Transmittal 36 (.pdf)
APTA Summary of Revisions to the Medicare Benefit Policy Manual - June 2005 (.pdf) Restricted
Information Regarding Discontinuation of the 700 & 701 Forms

Quality Reporting Program (includes PQRI)

PQRI establishes a financial incentive for eligible professionals, including physical therapists, to participate in a voluntary quality reporting program. PTs who successfully report on at least three quality measures on claims for dates of service from January 1 to December 31, 2010, may earn a bonus payment of 2% of total allowed charges for covered Medicare Physician Fee Schedule services. Many of the 2010 resources have not been issued at this point. When they become available, we will post them on our Web site.

Click here to access our PQRI resources.


Coordination of Benefits
If a Medicare beneficiary is also covered under another health plan such as a workers' compensation plan or Medicaid, CMS refers to the effort to reconcile the claims received for services provided as "coordination of benefits." The documents below describe how a physical therapist should submit claims for Medicare beneficiaries also eligible for other health coverage.

CMS Brochure: The Medicare-Medicaid Relationship (.pdf) - 9/1/06
CMS Coordination of Benefits FAQs (.pdf) - 6/8/07
CMS Fact Sheet: Medicare Secondary Payer (.pdf) - 5/13/09
Medicare and Worker's Compensation (.pdf) Restricted
MLN Article: Medicare Claims Crossover & Balance Billing (.pdf) - 5/5/09
Regulations Regarding Individuals That Qualify For Medicare and Medicaid (.pdf) Restricted

 
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