The rules did not change, but there has been a recent increase in Pre-Claim Review (PCR) non-affirmations when wound measurements and other clinical documentation is not submitted. In order for the wound care to be considered reasonable and necessary, the Medicare Benefit Policy Manual Chapter 7 – 40.1.2.8 Wound Care states, “the size, depth, nature…
Tag: PCR
Review Choice Demonstration
The Review Choice Demonstration (RCD) selection period is currently open for Illinois (Cycle 5) and Texas (Cycle 4) from March 1, 2022 through March 16, 2022. Selections made during this time will go into effect on April 1, 2022. Providers that DO NOT MAKE A SELECTION will automatically be placed in a default category based…
Review Choice Demonstration
The Review Choice Demonstration continues for Medicare home health services in selected states–specifically, Illinois, Ohio, Texas, Florida, and North Carolina. Here’s some of the latest news of RCD: Due to the lingering public health emergency, CMS has extended the phased-in participation for Florida and North Carolina until July 31, 2021. This allows the agencies in…
