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

Cataract Removal, CPT® 66984

  • Active
Hyperbaric Oxygen (HBO) Therapy, HCPCS G0277
Inpatient Rehab Facility (IRF)
  • Active
Intravenous Hydration, CPT® 96360/96361
Outpatient Rehab Facility (ORF) Physical Therapy, Revenue Code 042X
Polysomnography CPT® 95810-95811
Total Knee Arthroplasty, CPT® 27447
  • Active

 

Last Updated Thu, 23 Sep 2021 17:41:55 +0000