Note These Additional CERT Areas of Concern

Subscribe or sign in to view the full article.

Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article summarizes additional areas of concern identified in CMS’s Medicare Fee-for-Service 2013 Improper Payment Report. It is aimed at coders, billing staff, compliance teams, and providers who want a high-level view of where Medicare claim errors were concentrated and what broad documentation or setting-related issues were associated with those errors. The discussion covers joint replacements, cardiovascular stenting, cardiac pacemakers, and chiropractic services in the context of Medicare Part B compliance.

Why This Topic Matters

Understanding where CMS identified elevated error rates helps practices focus review efforts on documentation, medical necessity, and site-of-service compliance in high-risk service areas.

Article Sections

  1. Additional CERT Areas of Concern

    Introduces additional Medicare Fee-for-Service improper payment topics highlighted by CMS and frames the article around common sources of claim errors.

  2. Joint replacements

    Discusses Medicare error findings related to major joint replacement services and the broad documentation issues associated with those claims.

  3. Cardiovascular stenting

    Summarizes CMS findings involving cardiovascular stent placement and the service-setting issues noted in the report.

  4. Cardiac pacemakers

    Reviews pacemaker-related error findings and the general mismatch between service selection and patient eligibility noted in the report.

  5. Chiropractic services

    Covers chiropractic claim errors and the broader documentation elements CMS identified as frequently missing.

What You Will Learn

  • Which Medicare service categories were highlighted as problematic in the CERT report
  • What broad documentation concerns were associated with several of the service areas
  • How CMS framed error patterns across procedures and provider services
  • Why medical-necessity and site-of-service review can matter in Medicare compliance

Who Should Read This

  • Medical coders
  • Billing staff
  • Compliance professionals
  • Physicians and nonphysician practitioners
  • Practice managers

Subscribe or sign in to view the full article.

Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles

This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.

Related Articles

Articles are listed in order of calculated relevance.

demo
request yours today
subscribe
start today
newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.

Aimee- AI -powered coding assistant - Try it now for Free Would you like Aimee - AI
to help you with this?