North Carolina Medicaid Therapy Visit Limits for 2018
The following is an update on NC Medicaid therapy visit limitations for patients over 20 years old. These limits are from DMA Clinical Coverage Policy No: 10A (amended 12/15/2017). Medicare Cap
Medicaid patients who are over […]
PTAs and COTAs will soon be able to treat Tricare patients.
A new law has been enacted instructing the Department of Defense to add PTAs and COTAs to its list of permitted providers. Please note that this […]
The following changes to the orthotic and prosthetic management codes will be effective as of January 1, 2018:
• Both 97760 and 97761 are revised so that they can only be used for the initial encounter. The new descriptions […]
Supervised Exercise Therapy Approved for Medicare Patients with PAD, Medicare Guidelines For Physical Therapy
CMS has recently concluded that supervised exercise therapy improves health outcomes for Medicare patients with intermittent claudication due to peripheral artery disease (PAD) and the this exercise therapy is at least […]
As we approach the latter months of this year, this is a reminder of how the Medicare therapy cap rules apply during 2017.
Regular Medicare Therapy Cap. The annual Medicare therapy cap is $1,980 for 2017. As in past years, the cap for physical and speech […]
June 2017
CMS has very specific documentation requirements that apply to typical off-the-shelf and custom orthotics and other “DME” supplied by orthopaedic groups and hand therapy practices. DME carriers are auditing claims and specifically requesting this documentation.
Whenever a Medicare provider supplies and bills for DMEPOS […]
The following is a detailed explanation of the “in-office ancillary services” exception in the Stark Rules.
Statutory Background
Section 1877 of the Social Security Act, which is commonly referred to as the “Stark Rules,” was enacted in 1989. As originally enacted, the Stark Rules […]
DMA Clinical Coverage Policy No: 10A (amended 6/1/2017)
Medicaid patients who are over 20 have visit limits that are listed below. All visit limits refer to combined PT, OT, and ST visits from all therapy providers in any outpatient setting, including hospital outpatient […]
Should we avoid using medical terminology abbreviations?
The use of abbreviations is certainly acceptable and a practice that we use to save time because our brains work faster than our hands. A “best practice” recommendation is for each clinic to compile a list of “approved” abbreviations […]
We have been made aware that there is an issue with the NCCI edits related to the new therapy evaluation codes. If the code pairs below are billed on the same day, the code edits will generate an error indicating that these codes cannot be charged on the […]
