Implantable Neurostimulator (L8679) Documentation Requirements - JF Part B
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Implantable Neurostimulator (L8679) Documentation Requirements
It is expected that patient's medical records reflect the need for care/services provided. The listing of records is not all inclusive. Providers must ensure all necessary records are submitted to support services rendered. They may include:
| Check box if submitted | Brief Description |
|---|---|
| Operative / procedure report | |
| Practitioner, nurse, and ancillary progress notes | |
| Documentation of presurgical conservative measures/treatments | |
| Physician / Non Physician (NPP) order or evidence of intent to order | |
| Documentation of the devices, implants, biological products used | |
| Beneficiary name and date of service on all documentation | |
| Documentation as required in LCD or NCD | |
| Any additional documentation to support the reasonable necessity of the service(s) performed | |
| Advance Beneficiary Notice | |
| Signature log or signature attestation for any missing or illegible signatures within the medical record (all personnel providing services) | |
| Signature attestation and credentials of all personnel providing services | |
| If an electronic health record is utilized, include your facility’s process of how the electronic signature is created. Include an example of how the electronic signature displays once signed by the physician |
Multiple CMS contractors are charged with completing reviews of medical records. See Identifying Which Entity Completed a Part B Claim Review for detailed information about each of these contractors.
Documentation Submission
Once a provider/supplier compiles all the necessary documentation, it is important to submit them to the appropriate contractor according to the request received. Select the request below to view the appropriate submission instructions.
- Noridian Medical Review - Automated Development System (ADS) Letter
- Comprehensive Error Rate Testing (CERT) - CID Request
- Level One Appeal - Redetermination Request
Last Updated Tue, 26 Oct 2021 15:13:58 +0000