I have been posting information from the MAC websites about audits and required documentation, particularly for HBOT. The Palmetto MAC website has a lot of detailed information about certain specific HBOT indications. The website is “cute” – you hover over the indication and can briefly see the details until you move your curser and it vanishes. The cuteness of this wears off if you want to copy the information. I pasted screen shots for the information on osteomyelitis – a process which was a pain in the derriere.
There are some things worth pointing out such as the fact you need proof of osteomyelitis with a biopsy or imaging, detailed information on debridement (with dates) or the reason it wasn’t done, and specific labs for nutrition (none of which are evidence based) including albumin, prealbumin, and total protein (and what measures you took to correct these).
One colleague in this jurisdiction failed an audit for not providing protein supplementation to a patient on protein restriction. Yes folks, that’s where we are these days.
I will also add that the requirements used by an auditor in one MAC tend to show up verbatim in the audits of a different MAC. So, everyone should pay attention to the list below even if you aren’t in region J or M.
Palmetto is the MAC for:
- Region J: Alabama, Georgia, Tennessee (Region J)
- Region M: North Carolina, South Carolina, Virginia, West Virginia (excludes Part B for the counties of Arlington and Fairfax in Virginia and the city of Alexandria in Virginia)
- Home Health and Hospice for: Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, and Texas