Article of the week: Ensure outpatient cardiac rehab billing compliance
Rehab Regs, February 8, 2008
Make sure that all outpatient cardiac rehabilitation (OCR) services your hospital provides meet Medicare's standards. The following are a few of the steps that the Office of Inspector General (OIG) uses when it audits outpatient cardiac rehabilitation:
- Compare the hospital's policies and procedures for OCR to national Medicare coverage requirements and fiscal intermediary (FI) local medical review policies. Identify any differences.
- Verify that the hospital's cardiac rehabilitation program personnel are qualified in accordance with Medicare requirements. Ensure that nonphysician personnel have received training in both basic and advanced life support techniques, as well as in exercise therapy for coronary disease.
- Verify the accuracy of the diagnoses identified on the Medicare claims against each beneficiary's inpatient medical record, the prescribing physician's referral form, and the hospital's OCR medical record.
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