CIGNA Government Services is proud to launch their new Part B Facebook page, dedicated to educating the Provider communities in North Carolina and Idaho. Experience the newest way to get updates from CGS! The new CIGNA Government Services Part B Facebook page will be a constant source of current and relevant information, from workshop event listings and Webinar signups, to other helpful tools...
Medicare requires that medical record entries for services provided/ordered be authenticated by the author. The method used shall be a hand written or an electronic signature. Stamp signatures are not acceptable. Patient identification, date of service, and provider of the service should be clearly identified on the submitted documentation. (Medicare Internet Only Manual 100-8, Ch 3, sect 3.4.1.1...
To best facilitate payment for an unlisted CPT code, please include in the claim’s narrative section what specific procedure is being linked to the unlisted code.
During reviews performed by the Comprehensive Error Rate Testing ( CERT ) contractor, concerns have emerged involving physician signatures. A few simple steps to remember: ALWAYS sign your notes/orders - submitted records with just a typed signature/signature line with no handwritten or electronic signature is not acceptable Signatures must be legible - a...
This notice is intended to help providers understand that an error will be assessed when a medical record does not include a LEGIBLE IDENTIFIER (signature) of the author (initials are not acceptable). This error will cause an overpayment and a recoupment of funds. Through audits conducted by the Office of Inspector General (OIG) and CERT (Comprehensive Error Rate Testing) there appears to be...
March 30, 2009 CMS issued the following Joint Signature Memorandum (JSM) (JSM/TDL-09225, 03-26-09): Recently the Department of Health and Human Services' Office of Inspector General (OIG) conducted an evaluation of the Comprehensive Error Rate Testing (CERT) Review Contractor. As a result of this OIG review, we have concluded that the provision in the Program Integrity Manual (PIM) that has...
The CERT review process is now strictly enforcing a long standing rule that requires a legible signature on all clinic notes, orders and other documentation (e.g. procedure notes) used to substantiate a claim billed to Medicare. Section 1833(e) of the Social Security Act states that contractors must be able to identify the provider who performed the service in order to pay. CMS defines a...
Recently CIGNA Government Services has noticed an increase in the number of insufficient documentation and medical necessity errors received as a result of CERT claim reviews. This increase in the number of insufficient documentation and medically unnecessary claims seems to correlate with the regulations in the Medicare Benefit Policy Manual, Chapter 15, Section 80.6.1. This regulation...
CIGNA Government Services will allow KRAS Gene Mutation Testing in the care of patients with metastatic colon cancer who are being considered for an Epidermal Growth Factor Receptor inhibitor as second line therapy effective October 1, 2008. Generally these are billed by the reference lab performing the test for Medicare beneficiaries. The allowed CPT codes are 83890, 83892(2), 83898,...
Cigna – Medicare Tennessee will retire LMRPs: 85651 - Sedimentation Rate, Erythrocyte; Non-automated 85652 - Sedimentation Rate, Erythrocyte; Automated