Medicare Audits & Documentation
More Details About Audit Requirements: Guest Blog from Michael Crouch
Here’s a guest blog from Michael Crouch, following up on Martha Kelso’s post about audit requirements.
UPIC Auditors Demand Skin Substitute Invoices & Rebate Agreements – Guest Blog by Martha Kelso
A heads-up about the documentation demands for a recent audit of CTPs/CAMPs/skin substitutes – this time a UPIC audit.
Overzealous Medicare Audits
The companies contracted by CMS to perform Medicare audits get a percentage of the money “recuperated,” so they have a monetary incentive to ensure that doctors fail.
Don’t Miss the Alliance of Wound Care Stakeholders Webinar Feb 12th on the 2025 Medicare Final Rules!
If you and your organization provide wound care to Medicare beneficiaries, are you prepared for the important policy updates for 2025 implemented by CMS?
RAC Overpayment Allegations Versus FCA Accusations
Many practitioners are undergoing the full alphabet soup of Medicare audits (TPE, UPIC, SMERC, RAC, etc.).
You Only THINK You Aren’t Being Audited by Medicare… Check Again
I am not trying to fearmonger. I am trying to make sure that people know what they need to do to get ready.
CMS Reasons for Denial of Hyperbaric Oxygen Therapy – Check Out What’s Required in Your Medical Record
Here are the “reasons for denial” codes for hyperbaric oxygen therapy posted on the Palmetto website.
Noridian: Here’s Their Hyperbaric Oxygen Checklist
Here is the Hyperbaric Oxygen Therapy (HBOT) checklist for Noridian. Later I will post information about their TPE results.
Palmetto Results for Provider Specific Probe: July Through September 2022
Here’s more information from Palmetto about the Targeted Probe and Educate (TPE) audit process from July through September 2022.
Palmetto and Hyperbaric Oxygen Therapy – Educational Materials
Here are links to useful materials about Hyperbaric Oxygen Therapy (HBOT) on the Palmetto website.
Palmetto Part B: Reasons for Denial of HBOT on TPE audit
Apparently, all of the reasons for denial are “minor”? Does that make it better? If you know, contact me.
Noridian TPE results
Here is the Hyperbaric Oxygen Therapy (HBOT) checklist for Noridian. Later I will post information about their TPE results.
Have you watched the Noridian HBOT TPE Tutorial? It is 9 minutes.
Here is the Hyperbaric Oxygen Therapy (HBOT) checklist for Noridian. Later I will post information about their TPE results.
Palmetto & Hyperbaric Oxygen Therapy Covered Indications – Check out the Links to Failing Flaps
I laboriously pasted screen shots of the information on failing flaps. There are some fascinating things.
Palmetto and Hyperbaric Oxygen Therapy Covered indications – Check out the Links to Soft Tissue Radionecrosis
If I am in a patient mood, I will go through this ridiculous screen capture process for some of the other HBOT indications.
Palmetto & Hyperbaric Oxygen Therapy Covered Indications – Check out the Links to Osteomyelitis
One colleague in this jurisdiction failed an audit for not providing protein supplementation to a patient on protein restriction.
Medicare Audit Info: Palmetto TPE on Hyperbaric Oxygen Therapy (HBOT)
This information would be more helpful if they explained what the major and minor risk categories were!
Useful Information on Medicare Audits: First Coast Wound Care Checklist for TPE
Here’s the checklist First Coast used for a Targeted Probe and Educate (TPE) audit. Checklist looks the same for the Part B.
Useful Materials for Responding to a Medicare Audit: Part 1
For this first post, I will provide links to the basics. Next I will start posting information from specific MACs.
The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.