Post-Pay Reviews - JF Part A
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.
|Service Specific Review Notification
|Current Review Status
Cataract Removal, CPT® 66984
|Hyperbaric Oxygen (HBO) Therapy, HCPCS G0277
|Inpatient Rehab Facility (IRF)
|Intravenous Hydration, CPT® 96360/96361
|Outpatient Rehab Facility (ORF) Physical Therapy, Revenue Code 042X
|Polysomnography CPT® 95810-95811
|Total Knee Arthroplasty, CPT® 27447