Palmetto GBA E-mail Update: Friday, April 24, 2015

The following are the most recent updates from Palmetto GBA:

Requested CERT Documentation Located at Another Facility
If the requested CERT documentation is located at another facility (ex. hospital, nursing home, referring physician’s office, etc.) as the billing provider, it is your responsibility to obtain the medical records to support services billed to Medicare, regardless of where the records are housed. Please share with appropriate staff.

Applies to:

  • Jurisdiction 11 Home Health and Hospice//General
  • Jurisdiction 11 Part A//General
  • Jurisdiction 11 Part B//General

Five Facts about ICD-10
To help dispel some of the myths surrounding ICD-10, the Centers for Medicare & Medicaid Services (CMS) recently talked with providers to identify common misperceptions about the transition to ICD-10. These five facts, in this article, address some of the common questions and concerns CMS has heard about ICD-10. Remember, your practice or clearinghouse can conduct acknowledgement testing at any time with Palmetto GBA. Testing will ensure you can submit claims with ICD-10 codes. During a special ‘acknowledgement testing’ week to be held in June 2015, you will have access to real-time help desk support. Please share with appropriate staff.

Applies to:

  • Jurisdiction 11 Home Health and Hospice//General
  • Jurisdiction 11 Part A//General
  • Jurisdiction 11 Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

May 2015 Medicare Advisory
The May 2015 Medicare Advisory is now available. Please review this issue for Medicare policy and coverage updates as well as announcements for upcoming provider education opport unities. Please remember to share this information with your staff.

Applies to:

  • Jurisdiction 11 Part B//General

E/M Weekly Tip: Brief and Extended History of Present Illness (HPI)
Brief and extended HPIs are distinguished by the amount of detail needed to accurately characterize the clinical problem(s). A brief HPI includes documentation of one to three HPI elements (for both 1995 and 1997 documentation guidelines). An extended HPI includes documentation for at least four HPI elements or the status of at least three chronic or inactive conditions (for both 1995 and 1997 guidelines). Please share with appropriate staff.

Applies to:

  • Jurisdiction 11 Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

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