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  • Posting Date: 10/28/2021
    Other Audit Contractor ADRs

    Other Audit Contractor Additional Development Requests Origins Facts Identification Comprehensive Error Rate Testing (CERT) Office of Inspector General (OIG) Recovery Auditor Contractors (RAC) [...]

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  • Posting Date: 07/18/2023
    Medical Review: Targeted Probe and Educate Review Topics

    Jurisdiction 6 HH+H Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Home Health Services - Medical Necessity ICD-10 Z47-Z47.89 N/A 55H3V – The documentation did [...]

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  • Posting Date: 06/17/2025
    Holding MSP Claims Receiving CWF Edit 6802

    Certain MSP claims are incorrectly rejected against CWF edit 6802. On 4/24/2025, CMS directed MACs to hold all MSP claims editing with 6802 while CWF works to correct the issue.

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  • Posting Date: 06/18/2025
    MLN Connects® Newsletter: June 18, 2025

    MLN Connects® Newsletter: June 18, 2025 News 2023 Doctors & Clinicians Preview Period Open Until June 25 Hospital Price Transparency: Respond to Accuracy & Completeness RFI by July 21 Medicare Part B Discarded Drug Program: Get [...]

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  • Posting Date: 06/18/2025
    Reducing Unprocessable Claims

    When claims are submitted with invalid, incomplete or incorrect information, our claims processing system will detect these errors and will reject claims as unprocessable. Our goal is to assist our providers in submitting claims correctly the [...]

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  • Posting Date: 10/15/2021
    Home Health Referrals

    Home Health Referrals Table of Contents Home Health Referrals Order for Home Health Services Documentation to Support Homebound Status Documentation to Support the Need for Skilled Services Documentation Regarding the Face-to-Face [...]

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  • Posting Date: 01/27/2015
    Home Health Forms – Which is Required?

    Home Health Forms – Which is Required? The Advance Beneficiary Notice/Home Health Change of Care Notice/Notice of Medicare Noncoverage Scenario ABN HHHCN NOMNC Patient met goals under the POC and is being [...]

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  • Posting Date: 06/07/2021
    Eligibility Criteria for Face-to-Face Encounters

    Eligibility Criteria for Face-to-Face Encounters National Government Services is reminding home health providers that a face-to-face encounter form is not adequate documentation to support that a face-to-face encounter occurred. [...]

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