Tidbits
Medical Doc.
BILLING
Smorgasbord
SALES
100
The types of letters Medicare sends out when requesting additional documentation.
What are CERT Requests?
100
Activities such as toileting, feeding, dressing, grooming,and bathing in customary locations within the home.
What are MRADL'S?
100
Means specific documentation is on file.
What is the KX modifier?
100
This is the best place to have a patient sit when measuring them during the home assessment.
What is a solid surface?
100
This company produces a PMD with weight capacity of 301-450 in the form of an 1170 XL
What is Pride Mobility?
200
The name of the email group to send all pmd documentaion to corporate.
What is the Power Mobility Dept?
200
This documentation requirement (from the physician's medical record) states that the MAJOR reason for the patient's visit is for a power mobility evaluation.
What is the initial face to face evaluation?
200
THE HCPCS CODE THAT IS USED FOR A POWER WHEELCHAIR, GROUP 2 STANDARD, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS.
What is the K0822?
200
An upgradable billable accessory (E0990) for a patient that has edema in their lower extremities.
What are Elevating Leg Rests?
200
The upgradable billable accessory, Height Adjustable Armrests (E0973), needs this medical justification.
What is Positioning and Support?
300
Name of certification need to bill Group 3 Rehab to Medicare.
What is ATP?
300
This needs to be signed by the physician after the in-person visit and medical evaluation, and received within 45 days after completion of the face to face exam and prior to delivering PWC to patient.
What is the 7 element order (PMD Prescription)?
300
The description of the denial given by Medicare if a skin protection and/or positioning seat or back cushion that meets coverage criteria is provided with a POV or a power wheelchair with Captain's Chair.
What is not medically necessary?
300
The FINAL form that needs to be signed by the physician that lists all billable items including HCPCs Code, billable amount, and Medicare Allowable.
What is Detailed Product Description?
300
Name the company that mass markets PMD's, delivers them to the patient's front door step without ever seeing them, and you cannot turn on the TV without seeing their commercial.
What is the Scooter Store?
400
This is the other name for a scooter.
What is a POV?
400
Name 3 forms of MAE's (Mobility Assistive Equipment) that must be ruled out before patient will qualify for a PMD.
What are cane, walker, and manual wheelchair?
400
This is needed when billing in order for replacement parts to be covered by Medicare to describe the type of PMD, labor, and repair that was done.
What is a cert note?
400
Past or present decubitis skin ulcers must be located in these 3 areas of contact in order to qualify for an adjustable skin protection cushion (K0734).
What are buttock, hip, and lower back?
400
Name of the company that has the 5 star service plan that offers 1 year guaranteed service.
What is Invacare?
500
Kelly McCloud's favorite NBA team
What is Cleveland Cavaliers?
500
The 7 elements needed for the 7 element written order (PMD Prescription).
What are beneficiary name, date of the face to face, description of the item ordered, length of need, diagnosis codes, physician's signature, and date of physician's signature?
500
If the PWC is only to be used for mobility outside the home this modifier must be added to the HCPCS code when billing.
What is the GY modifier?
500
True or False: Home Health PT's, under the "umbrella" of MSA, can submit Face to Face Evaluations as medical records to Medicare.
What is False?
500
This company produces items such as the Mosaic which is billable with the K0822.
What is the Roho Group?
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