What's the Latest Medicare Documentation & Coverage Requirements

Program ID :IC30.2019
Webinar Length of Time: 1.0 Hour

Link to view the lecture presentation:

Resources:

None

Presenters

Claudia Amortegui, MBA
The Orion Consulting Group, Inc., United States

Claudia Amortegui is president of The Orion Group, a consulting company specializing in the reimbursement of rehab equipment. Her extensive and diverse experience comes from consulting for over 20 years, and from working on all sides of the industry, with Medicare, a manufacturer, and a provider. She has been published numerous times in national industry publications and has conducted education programs throughout the United States and Canada. Her clients consist of manufacturers, providers, referrals and funding sources.

Presented at the 35th International Seating Symposium, Pittsburgh, PA USA

Note: Faculty for this activity have been required to disclose all relationships with any proprietary entity producing health care goods or services, with the exemption of nonprofit or government organizations and non-healthcare related companies.

Claudia Amortegui disclosed the following conflict:

Financial interests with the following proprietary entity producing healthcare goods or services as indicated below:

Consultant for:

National Seating & Mobility

Sunrise Medical

Ride Designs

Ki Mobility

LiveWell Medical

Monroe Wheelchair

Description

Medicare always keeps us on our toes, whether you are a provider, clinician or manufacturer there always seems to be something new when it comes to Medicare reimbursement. Some of the changes should actually be beneficial, but others seem to limit access even more. Where do these changes leave us today when it comes to ordering and providing the proper wheelchair and making sure the suppliers are properly paid? Are clients still having to rent some of their CRT wheelchair bases? Do they have to rent the separate options? How does competitive bidding affect CRT? Is my client required to use a specific supplier? Is a therapist required to complete an evaluation and write an LMN? What is the time frame to have all documentation completed? Is prior authorization available for all CRT wheelchair orders, including the options/accessories? What are the requirements for the Home Assessments & ATP "Involvement"? These are just some of the questions that will be addressed during the session. This session will provide the latest Medicare updates as they relate to complex rehab technology (CRT). We will also discuss the most current coverage policies and documentation requirements. Whether you are a clinician ordering equipment or a supplier providing equipment, you must be up to date with all the details to ensure the best service for your client.

Learning Objectives

Upon viewing this webinar, participants will be able to:

Discuss two different types of upgrades and which one is considered to be allowed by Medicare
Describe four key requirements in documentation as they relate to proper Medicare funding
Describe three key elements of documentation needed to complete a Medicare upgrade

References

Social Security Act, Special Payment Rules for Particular Items and Services, Section 1834 [42 U.S.C. 1395m]
CGS DME MAC Jurisdiction C Supplier Manual (2018). Chapter 3 (Supplier Documentation), Section 11 (Evidence of Medical Necessity: Power Mobility Devices), Spring 2018
Medicare Claims Processing Manual, Publication 100-4, Chapters 20 (DMEPOS) (3/30/18) and Chapter 30 (Financial Liability Protections) (1/28/17)
CMS Medicare Program Integrity Manual (Pub. 100-8), Chapter 5 (Evidence of Medical Necessity: Wheelchair and Power Operated Vehicle Claims)
CGS & Noridian Jurisdiction C & D Supplier Manuals, Chapter 6 (Claims Submission), Spring 2018
CMS Local Coverage Determinations (LCDs) and Policy Articles: Manual Wheelchairs (L33788 & A52497), Power Mobility Devices (L33789 & A52498), Wheelchair Options/Accessories (L33792 & A52504), Wheelchair Seating (L33312 & A52505)

CEU Registration and Cost

0.100 Continuing Education Units (CEUs) will be awarded to individuals for viewing 1.0 hours of instruction.
The cost for the webinar is $59.00

Instructions to Obtain CEUs

go to the RSTCE web site at: www.rstce.org

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IC30.2019 What's the Latest Medicare Documentation & Coverage Requirements
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You will receive your CEU Certificate via e-mailed as a PDF file (Please allow 10 minutes for the database to process your certificate and send it to your e-mail)

The University of Pittsburgh, School of Health and Rehabilitation Sciences awards Continuing Education Units to individuals who enroll in certain educational activities. The CEU is designated to give recognition to individuals who continue their education in order to keep up-to-date in their profession. (One CEU is equivalent to 10 hours of participation in an organized continuing education activity). Each person should claim only those hours of credit that he or she actually spent in the educational activity.
The University of Pittsburgh is certifying the educational contact hours of this program and by doing so is in no way endorsing any specific content, company, or product. The information presented in this program may represent only a sample of appropriate interventions.

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Updated | 07.25.2019