Medicare Compliance
Our Hard-Stop Compliance prevents the #1 reason for denied Medicare claims – errors or incomplete patient treatment records. S4PT ensures your patient’s records are up-to-date with appointment schedules, automatically adding the KX modifier when necessary to avoid claim denials.
What do you need to comply with Medicare guidelines?
- Current Plan of Care signed by a physician or nurse practitioner in a timely manner
- Progress reports every 10 visits or 30 days
- Proper code for electrical stimulation
- Correct NCCI edits
- Correct modifiers for your area of practice
- Correct modifiers for certain CPT codes used together
- Correct CQ/CO modifiers
- Follow 8-minute rule
- Track Medicare reimbursement/apply KX modifier at right time
We offer tools that streamline documentation, making it easy to capture all necessary information in line with Medicare requirements. Our system automatically checks for incomplete or missing data, helping your clinic maintain accurate and up-to-date patient records. Systems4PT also ensures that claims are correctly coded and necessary modifiers, such as the KX modifier, are properly added to reduce the risk of denials or audits.
What does Systems4PT do to ensure you are compliant?
-
Tracking of Medicare Kx modifier Threshold
- Hard-Stop on 10-day visit/30-day Progress Note requirement.
- Hard-Stop on POC/Prescription Expiration
- Hard-Stop to correct G0283 coding requirement.
- NCCI coding alert with appropriate modifier application if therapist approved.
- Effortless MIPS participation through a QCDR
- 150 – 500 words of required MIPS-specific defensive documentation recommended, touch free
- 80 – 200+ words of compliant, defensive, evaluation code rationale documentation recommended, touch free
