RAC AUDIT ALERT: VENTILATORS SUBJECT TO DWO REQUIREMENTS

On January 11, 2018, Performant Recovery, the National DMEPOS RAC, added ventilators to their approved issues list. According to their website, Performant Recovery will perform complex reviews on ventilator claims subject to DWO requirements on or after January 1, 2016 to determine if coverage criteria and/or medical necessity requirements were met. Codes included in the audit:

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RAC AUDIT ALERT: Respiratory Assist Devices

On December 17, 2017, Performant Recovery, the National DMEPOS RAC, added Respiratory Assist Devices (RADs) to their approved issues list. According to their website, Performant Recovery will perform complex reviews of these claims to determine if coverage criteria and/or medical necessity requirements were met. Codes included in the audit are: E0470, E0471 Performant will review

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Same or Similar Denials: How to avoid it?

By Donna Youngblood, RN Same or similar denials occur when claims information is checked against the patient’s CMN history. This will indicate when equipment is “same or similar” to that piece of equipment being billed on the claim. An example of same and similar items includes a K0800 (power operated vehicle) and a K0823 (Group

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Signatures from representatives still needed for H.R. 3730

Kay Koch, OTR/L,ATP The holiday season is upon us and while this may not be on your holiday wish list many people who use complex rehab wheelchairs would like it to be. HR 3730 has still not gotten the signatures needed to exempt Complex Rehab Manual Wheelchair Accessories from Competitive Bidding. Introduced in the house

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Understanding the HIPAA Training Requirements

Do you understand the HIPAA training requirements? If you don’t, you’re not alone. HIPAA regulations concerning training can become a little vague and some people are unsure what they’re required to have training on or what it even entails. To help, we’re breaking down some of the confusion when it comes to HIPAA training requirements.

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OIG Hospice Report

Written by Lisa Eick RN CMS recently re-published an article regarding the OIG report from September 2016 that found more than one third of Hospice election statements and certification of terminal illness documents were found to be non-compliant. The sample included only General Inpatient stays (GIP), however the article is a great reminder for all

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Quick Facts about the HITECH and Omnibus Rule

Have you heard the terms HITECH and Omnibus Rule tossed around, but you aren’t entirely sure what they are? You aren’t alone. Here are fast facts about the HITECH and Omnibus Rule. What are they? HITECH: This is a provision to the American Recovery and Reinvestment Act of 2009, which provided incentives to physicians and

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