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You Only THINK You Aren’t Being Audited by Medicare… Check Again

You Only THINK You Aren’t Being Audited by Medicare… Check Again

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...
CMS Reasons for Denial of Hyperbaric Oxygen Therapy – Check Out What’s Required in Your Medical Record

CMS Reasons for Denial of Hyperbaric Oxygen Therapy – Check Out What’s Required in Your Medical Record

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...
Noridian: Here’s Their Hyperbaric Oxygen Checklist

Noridian: Here’s Their Hyperbaric Oxygen Checklist

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,...
Palmetto Results for Provider Specific Probe: July Through September 2022

Palmetto Results for Provider Specific Probe: July Through September 2022

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...
Palmetto and Hyperbaric Oxygen Therapy – Educational Materials

Palmetto and Hyperbaric Oxygen Therapy – Educational Materials

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...
Palmetto Part B: Reasons for Denial of HBOT on TPE audit

Palmetto Part B: Reasons for Denial of HBOT on TPE audit

by Caroline Fife, M.D. | Nov 20, 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...
Noridian: Here’s Their Hyperbaric Oxygen Checklist

Noridian TPE results

by Caroline Fife, M.D. | Nov 20, 2023 | Fight the Good Fight, Hyperbaric Oxygen Therapy, Medicare Audits

I am posting a series of articles with information directly from the websites of the various MACs. Anyone can access this and I feel a little silly posting it, but several clinicians have told me about audits they are undergoing and they had not paid attention either...
Noridian: Here’s Their Hyperbaric Oxygen Checklist

Have you watched the Noridian HBOT TPE Tutorial? It is 9 minutes.

by Caroline Fife, M.D. | Nov 9, 2023 | Fight the Good Fight, Hyperbaric Oxygen Therapy, Medicare Audits

This is part of my series of articles about Useful Information on Medicare Audits. I am posting a series of blogs with information directly from the websites of the various MACs. Anyone can access this and I feel a little silly posting it, but several clinicians have...
Palmetto & Hyperbaric Oxygen Therapy Covered Indications – Check out the Links to Failing Flaps

Palmetto & Hyperbaric Oxygen Therapy Covered Indications – Check out the Links to Failing Flaps

by Caroline Fife, M.D. | Nov 7, 2023 | Healthcare Payment Policy, Hyperbaric Oxygen Therapy, Medicare Audits

I have been posting information from the MAC websites about audits and required documentation, particularly for HBOT. The Palmetto MAC website has detailed information about certain specific HBOT indications if you sufficiently medicated to manage the intense...
Palmetto and Hyperbaric Oxygen Therapy Covered indications – Check out the Links to Soft Tissue Radionecrosis

Palmetto and Hyperbaric Oxygen Therapy Covered indications – Check out the Links to Soft Tissue Radionecrosis

by Caroline Fife, M.D. | Nov 6, 2023 | Fight the Good Fight, Medicare Audits

I have been posting information from the MAC websites about audits and required documentation, particularly for HBOT since that’s a huge audit focus. I got an email from a colleague in the Palmetto jurisdiction who for many months has been fighting denials for HBOT in...
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