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Expansion of Coverage of Chiropractic Services Demonstration
(CMS)
April 06, 2005 -
MEDICARE IMPLEMENTS DEMONSTRATION TO EXPAND COVERAGE OF
CHIROPRACTIC SERVICES
MEDICARE CHIROPRACTIC SERVICES
DEMONSTRATION
FINAL DESIGN REPORT,
Click here. (pdf. 532kb)
April 27, 2005
-
Federal Register Notice (.pdf 57 kb)
-
Press Release (.pdf 58 kb)
-
Chiropractor Medlearn Matters Article
-
Laboratory Medlearn Matters Article
-
Radiology Medlearn Matters Article
-
Chiropractor Power Point Presentation (.pdf 177 kb)
- Beneficiary Fact Sheets
- Demonstration Geographic Areas
-
Diagnosis and Procedure Codes (.pdf 135 kb)
-
Frequently Asked Questions and Answers
(pdf. 18kb)
05/06/2005
INSTRUCTIONS RELEASED -- MID-QUARTER
Transmittal 34 ... This instruction affects Comprehensive
Outpatient Rehabilitation Facilities, Outpatient
Physical
Therapy, Skilled Nursing Facilities, Physicians and
Non-Physician Practitioners.
View the complete text of Transmittal 34
(PDF - 366 KB)
MM3648 (Revisions to the Medicare Benefit Policy Manual
(Pub 100-02), Chapter 15, Sections 220 and 230 Regarding Therapy
Services)
SE0533 (Further Clarification of CR3648, Which Revised
the Medicare Benefit Policy Manual (Pub 100-02), Chapter 15,
Regarding Therapy Services)
National Correct Coding Policy Manual for Part B Medicare
Carriers -- Version 10.3
"O. Chiropractic Manipulative Treatment"
[page 14 of 18]
United States of America v. Thomas Bruce Vest,
also known as T. Bruce Vest, doing business as Doctors Clinic
"Second, the Government presented 36 patients
who testified that during their visits to the Doctors Clinic,
they did not report many of the symptoms and past conditions
that Vest recorded on their medical records."
Fraud And Abuse
Fighting Fraud & Abuse
MM3449
Revised Requirements for Chiropractic Billing of
Active/Corrective Treatment and Maintenance Therapy, Full
Replacement of CR 3063
Revised: 11/19/2004
CR3449 (10/08/2004)
CMS
Documentation Guidelines — Evaluation and Management
Services
R125PI
CR4022
"Medical
Review Additional Documentation Requests"
R123PI - CR3703
9/23/2005
"Chapter
3, MMA Section 935
I. SUMMARY OF CHANGES: This change implements
portions of Section 935 of the MMA (entitled
Recovery of Overpayments). Specifically, this CR
explains to contractors their right to
request documentation for a limited sample of submitted
claims, after overpayments have been identified,"
CMS 2004 Transmittals 90-CR3569:
Prepayment Review of Claims for MR Purposes
(pdf)
"Contractors shall not initiate non-random prepayment
medical review of a provider or supplier based on the initial
identification by that provider or supplier of an improper
billing practice unless there is a likelihood of a sustained
or high level of payment error."
CMS 2005
Transmittal 120
--
CHANGE REQUEST 3880
"Correction to Change Request (CR) 3222:
Local Medical Review Policy/ Local Coverage Determination
Medicare Summary Notice (MSN) Message Revision"
"E. Distinguishing Between
Benefit Category, Statutory Exclusion and Reasonable and
Necessary Denials"
R13SOM: Revisions to
Chapter 2, "The Certification Process," Appendix E--
"Providers of Outpatient Physical Therapy or Outpatient Speech
Language Pathology (OPT/OSP) Services," and Appendix K--
"Comprehensive Outpatient Rehabilitation Facilities"
Medicare Program Integrity Manual
Chapter 3: Verifying Potential Errors and Taking
Corrective Actions (pdf)
(Zipped Word File)
Medical Review Strategy
"In addition to carry-over of several of the
FY 2004 focuses, the new FY 2005 focus areas will be:
- Chiropractic services
- Level of consultations
- Follow-up consultations
Transmittal 34
General Coverage of Physician Services***NCP
PHYS-001
Physician Visits, Documentation and
Interpretation of Test Results***NCP
PHYS-002
Incident To a Physician's Professional Service
in the Office or Clinic***NCP
PHYS-004
Outpatient Physical
Therapy, Occupational Therapy and Speech-Language
Pathology
PHYSMED-001
Coding Guidelines:
"...7. *The date the patient was last seen and the
UPIN of the
attending physician must be listed in
Item 19 on the CMS-1500 form or the electronic
equivalent."
Physical Medicine and Rehabilitation Procedures
and Modalities
PHYSMED-009
Neuromuscular Electrical Stimulation (NMES)
PHYSMED-011
Illinois
WPS Medicare Part B - Provider Education - Claim Information
Seminar Schedule
" WPS
is frequently asked if we offer Continuing Education Units (CEUs)
for our programs. We are happy to announce that......"
Seminar Materials
CMS (HCFA) 1500 Claim Form Instructions
(pdf - 72
pages; 695KB)
Timely Filing of Claims
Unprocessable Claim Guidelines
How to Appeal a Claim Determination
Chiropractic Care Educational Guidebook
(pdf - 95
pages; 476KB)
- Jan. 2005
WPS Medicare Part B - Chiropractic
FAQs
WPS Medicare Part B - 2005 Medicare Payment Information
Available from CD-Rom
Medicare Part B WPS Search on "chiropractic care"
Teleconferences
WPS Communiqué
Virginia TrailBlazer Part BHome
Page
1500 Claim Form/Unprocessable Claim Form Instructions
Top 10 Billing Errors
General Principles of Documenting Patient's Medical Records
Provider Outreach and Education (Educational issues)
Audio Training
Chiropractic Services
CMS 1500 Claim Form Instructions
Part B Problem Solving Guide
 or the
TrailBlazer Medicare Part B Mid - Atlantic Important
Contacts .
Iowa
Noridian Medicare: Provider Homepage
Noridian Medicare: Provider: Publications: Medicare B: Medical
Policies
Chiropractic Services Policy
Chiropractic BBM July 2003
Chiropractic Care
Documentation
Diagnosis Criteria
x-ray
Advanced Beneficiary Notice
Questions and Answers
Chiropractic Demonstration Project
Appeals
Recoupment
EDI
Education
Telephone Appeals Changing Hours
5/11/2005
Medicare Part B Appeal
Documentation
Fraud and Abuse
Medicare Part B: Medicare Chiropractic Billing
Medicare Part B Workshop
Medicare B News Bulletins and LMRPs-LCDs(1994 to Current)
NM
Welcome To Arkansas Medicare Services
Fee Schedules
How to Complete the CMS-1500 Form
Helpful Hints for Filing Claims
Maine
National Heritage Insurance Company
National Heritage Insurance Company is the
Medicare Part B contractor for California,
Maine, Massachusetts, New
Hampshire, and Vermont, serving 5.5 million beneficiaries and
178,000 healthcare providers. |
