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2015 Therapy Cap Values

November 26, 2014 1 Comment
2015 Therapy Cap Values

CMS has announced the 2015 Therapy Cap values for 2015 for physical therapy and speech-language pathology combined and occupational therapy.    The therapy caps were initiated under the Balanced Budget Act of 1997 (P.L. 105-33, Section 4541(c)) to implement a per beneficiary annual cap (financial limitation) on the amount of therapy services under Medicare Part B.  The original […]

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Keep Using 59 Modifier

November 25, 2014 1 Comment
Keep Using 59 Modifier

 CMS issued MM 8863 on Modifiers for Distinct Procedural Services in August leaving the therapy community wondering how to best use the new subset of the 59 modifier.  The subset, referred to as  X{EPSU}, was established to further define those “distinct  procedural services” identified as: XE – Separate Encounter XS – Separate Structure XP – Separate Practitioner XU […]

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Risky Business: Outsourcing SNF Therapy

October 26, 2014 1 Comment
Risky Business: Outsourcing SNF Therapy

Risky business in outsourcing SNF therapy you say?  A few weeks ago a news article was delivered to my inbox that might as well have been accompanied by alarm bells. Before you read the headline and consider yourself exempt, the startling aspect of the case is that it involves a SNF being held liable for […]

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Top 3 Essential Compliance Components

July 31, 2014 3 Comments
Top 3 Essential Compliance Components

Do you have the top 3 essential compliance components in your therapy program or practice?   You may have a compliance plan that you wrote, or purchased a compliance program off the shelf, or maybe your compliance program consists of chart audits and quality reviews.  The Office of the Inspector General (OIG) has provided Compliance Guidances […]

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Medical Record Corrections and Amendments

July 24, 2014 3 Comments
Medical Record Corrections and Amendments

Do you know how to make medical record corrections and amendments?  CMS refers to information that occurs following the visit documentation as “amendments”.  Did you ever finish a note only to discover several days later that you forgot to add something?  Whether on a paper and pencil system or electronic medical record system (EMR) there is specific guidance on […]

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Three Tips When Converting to A Therapy EMR

July 22, 2014 0 Comments
Three Tips When Converting to A Therapy EMR

Are you in the process of converting to a therapy electronic medical record (EMR)?  Or perhaps you are still considering which EMR program you will select?  Regardless of where you are in the process, you will need these three tips when converting to a therapy EMR.  But first, before I share three tips when converting to […]

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New Option in Medicare Appeals

July 17, 2014 1 Comment
New Option in Medicare Appeals

Do you have appeals pending in the Medicare appeals process?  Are you aware there is a new option in Medicare Appeals if you meet certain criteria?  There is a good possibility that many therapy providers that went over the $3700 therapy thresholds and  were denied have reviewed their medical documentation and made a decision regarding appeals.  […]

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Rehab Agency Fire Standards

July 16, 2014 0 Comments
Rehab Agency Fire Standards

CMS has released updated interpretive guidelines specifically addressing rehab agency fire standards.  Rehab Agencies are also known as ORFs (Outpatient Rehabilitation Facilities) and are referred to as OPTs, (physical therapy) or OSTs (Speech Language Pathology) in various CMS guidelines.  Rehab Agencies are subject to Survey and Certification according to the Rehab Agency Conditions of Participation […]

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Medicare Electronic Signature Requirements

July 15, 2014 1 Comment
Medicare Electronic Signature Requirements

Did you know that there are Medicare electronic signature requirements?   CMS has specific guidance on the use of electronic signatures which is applicable to not only therapy notes in your own EMR, but electronic signatures for certification of the plan of care. The following guidelines for electronic signature are found in the Medicare Program Integrity […]

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Medicare Signature Requirements

July 12, 2014 7 Comments
Medicare Signature Requirements

When is a signature, not a signature?  Did you know that Medicare has signature requirements? Judging from the number of emails that I have received from the MACs over the past few weeks, it would appear that Medicare’s long standing signature requirement is not being observed.  A number of years ago, prompted in large part by […]

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