decisionhealth Newsletters, Answer Books - 2009 Issue 9 (September)
Carrier Responsibilities / Penalties can be waived if CMS or carriers give bad advice
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Article Overview
This short Medicare compliance article discusses a policy change affecting billing and coding advice from CMS and Medicare carriers. It focuses on the circumstances under which written guidance can affect penalty liability, the types of communications that may count as documentation, and the manual reference where the policy appears. It is relevant to coders, billers, compliance staff, and providers working with Medicare claims guidance.
Why This Topic Matters
It helps Medicare billing professionals understand where to look for official written guidance and why documentation of that guidance can matter in penalty disputes.
What You Will Learn
- How Medicare addresses reliance on written guidance from CMS or a carrier
- What kinds of written communications may be documented for this purpose
- Where the policy is referenced in the Medicare Claims Processing Manual
- The effective timing noted for the policy
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Revenue cycle professionals
- Healthcare providers billing Medicare
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