MLN Product (New); Medicare Quarterly Provider Compliance Newsletter [Volume 11, Issue 3] – April, 2021 (ICN2020024)
This new publication comprises Subregulatory Guidance for health care professionals to help them address and avoid common billing errors and the top issues of the 2nd Quarter of 2021. This quarter's newsletter describes the following 3 Comprehensive Error Rate (CERT) and Recovery Audit findings and provides guidance and educational resources that Medicare providers and health care professionals can use to address and avoid these issues:
1. Comprehensive Error Rate Testing (CERT): Continuous Positive Airway Pressure (CPAP) Therapy for the Treatment of Obstructive Sleep Apnea (OSA)
2. Recovery Auditor Finding: 0067 – Inpatient Psychiatric Facility Services: Medical Necessity and Documentation Requirements
3. Recovery Auditor Finding: 0074 – Drugs and Biologicals: Incorrect Units Billed (Single-Dose Vials)
Our MLN Products explain national Medicare policy in an easy-to-understand format; the underlying policy is already cleared and publically available at:
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/ge101c04.pdf#page=7
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c02.pdf
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c17.pdf
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/pim83c04.pdf#page=119
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/pim83c05.pdf
https://oig.hhs.gov/oas/reports/region1/11600508.pdf
CMS policy or operation subject matter experts also reviewed/cleared this product.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: June 03, 2021
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.