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Tag Archives: tka

Letter to CMS: 5 insights on what orthopedic surgeons think about removing TKA from the Medicare Inpatient Only list

Posted on March 30, 2018 by Webmaster

5 insights on what orthopedic surgeons think about removing TKA from the Medicare Inpatient Only list Continue reading →

Posted in Industry News | Tagged inpatient only list, IPOL, tka | Leave a comment

Study: More ‘Collaboration and Consistency’ Needed Between PTs and Surgeons in TKA, THA Measures

Posted on March 30, 2018 by Webmaster

More ‘Collaboration and Consistency’ Needed Between PTs and Surgeons in TKA, THA Measures Continue reading →

Posted in Industry News | Tagged tha, tka | Leave a comment

The CMS Open Door Forum of Feb 27 2018 – Audio only

Posted on February 28, 2018 by Webmaster

The most interesting exchange is at 44:00 in…

Posted in Academy Blog | Tagged odf, tka | Leave a comment

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The CMS Open Door Forum of Feb 27 2018 – Audio only
The most interesting exchange is at 44:00 in…

CMS limits of scope of MAC/QIO review for appeals
“Scope Creep” in Appeals is Dead CMS has instructed MACs and QICs to limit their review to the reason(s) the claim or line item at issue was initially denied. For redeterminations and reconsiderations of claims denied following a complex prepayment review, a complex post-payment review, or an automated post-payment review by a contractor, Limiting the scope of review on redeterminations and reconsiderations of certain claims. MLN Matters Number SE1521.

NEWS POLL Friday February 17 2017
Nominee Tom Price Wants Shift Away from Medical Necessity Audits To Anti-Fraud Audits
CMS should focus its billing audits less on verifying medical necessity and more on rooting out blatant fraud, the agency’s likely next secretary said Tuesday. Rep. Tom Price, R-Ga.

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