by Caroline Fife, M.D. | Mar 24, 2025 | Medicare Audits
Here’s a guest blog from Michael Crouch, following up on Martha Kelso’s post about audit requirements. I hope the information from these industry experts will help practitioners prepare themselves better for the audits that are bound to happen. If you have been...
by Caroline Fife, M.D. | Mar 18, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Medicare Audits
Here’s a guest blog from Martha Kelso, Chief Regulatory Officer at Wound Care Plus, LLC, providing a heads-up about the documentation demands for her most recent audit of CTPs/CAMPs/skin substitutes – this time a UPIC audit. According to the Medicare Program Integrity...
by Caroline Fife, M.D. | Feb 26, 2025 | Medicare Audits
Here’s another fantastic post from attorney Knicole Emanuel about the serious overreach problems inside the alphabet soup of Medicare audits. This is an issue that will get even more problematic due to the delay of the “skin substitute” LCD(s). Some auditors are...
by Caroline Fife, M.D. | Feb 11, 2025 | Fight the Good Fight, Healthcare Payment Policy, Medicare Audits
The Alliance of Wound Care Stakeholders is hosting a webinar on Wednesday, February 12, 2025, 1:00 PM – 2:00 PM EST. If you and your organization provide wound care to Medicare beneficiaries, are you prepared for the important policy updates for 2025 implemented by...
by Caroline Fife, M.D. | Dec 9, 2024 | Fight the Good Fight, Medicare Audits
Attorney Knicole Emanuel has published another fascinating blog! Check out her discussion about the Recovery Audit Contractor (RAC) and the False Claims Act (FCA). Many practitioners are undergoing the full alphabet soup of Medicare audits (TPE, UPIC, SMERC, RAC,...
by Caroline Fife, M.D. | Sep 9, 2024 | Healthcare Payment Policy, Medicare Audits
I have been posting warnings about the increase in Medicare audits, especially for CTPs/skin subs and hyperbaric oxygen therapy for many years. Because everyone was being audited, I KNEW that my hospital-based outpatient department (HOPD) was going to be audited. The...
by Caroline Fife, M.D. | Dec 8, 2023 | Fight the Good Fight, Medicare Audits
This is part of my series of articles about Useful Information on Medicare Audits. Here are the “reasons for denial” codes for hyperbaric oxygen therapy posted on the Palmetto website. Although they are posted on the Palmetto website, these come from CMS and thus are...
by Caroline Fife, M.D. | Dec 5, 2023 | Fight the Good Fight, Hyperbaric Oxygen Therapy, Medicare Audits
This is part of my series of articles about Useful Information on Medicare Audits. Noridian is the MAC for Medicare A/B of: Region E: California, Hawaii, Nevada, American Samoa, Guam, Northern Mariana Islands Region F: Alaska, Arizona, Idaho, Montana, North Dakota,...
by Caroline Fife, M.D. | Nov 27, 2023 | Featured, Medicare Audits
I am posting a series of articles with information directly from the websites of the various MACs. Anyone can access this information so I feel a little silly posting it, but several clinicians have told me about audits they are undergoing and they had not paid...
by Caroline Fife, M.D. | Nov 21, 2023 | Fight the Good Fight, Medicare Audits
This is part of my series of articles about Useful Information on Medicare Audits. 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...
