Post-Pay Reviews - JE Part A
Post-Pay Reviews
The Centers for Medicare & Medicaid Services (CMS) is required to protect the Medicare Trust Fund against inappropriate payments which pose a risk to the Trust Fund. Noridian’s focus includes performing post-payment service specific reviews identified by vulnerabilities that indicate questionable billing patterns.
Information below provides a global notice of what post-payment service topic reviews are currently in process, required documentation, resources used in reviews, and any current findings if the service topic review is completed.
Review Criteria | Service Specific Review Notification | Current Review Status |
---|---|---|
Comprehensive Metabolic Panel (CMP), CPT® 80053 | ||
Darbepoetin Alfa, Non-ESRD, HCPCS J0881 | ||
Ferric Carboxymaltose, HCPCS J1439 | ||
Inpatient Rehab Facility (IRF) | ||
Intravenous Hydration, CPT® 96360/96361 | ||
Outpatient Rehab Facility (ORF) Physical Therapy, Revenue Code 042X | ||
Pembrolizumab, HCPCS J9271 | ||
Polysomnography CPT® 95810-95811 | ||
Thyroid Stimulating Hormone (TSH) Assay, CPT® 84443 |
Last Updated Dec 09 , 2023