Knee Pain in Older Adults

The knee is the largest and most complex joint in the body.  The number of moving parts in the knee that make it so useful also render it vulnerable to injury.  Incidence of knee pain increases with age and is a very common occurrence in older adults.  Home remedies to treat knee pain include: rest, ice, heat, anti-inflammatory medications, weight loss and low impact exercise. Read more

Change to Payment Liability for Therapy Cap Denials – CMS UPDATE: 5-23-13

Section 603(c) of the American Taxpayer Relief Act of 2012 (ATRA) changed the payment liability for denials resulting from the outpatient therapy caps from beneficiaries to providers effective January 1, 2013. Medicare systems were not updated in time to accurately represent this change on provider remittance advices (RAs). Medicare contractors may have already processed therapy cap denials for services provided in 2013. These denials incorrectly report on RAs beneficiary liability (Group Code “PR”) when liability legally rests with the provider (Group Code “CO”). Read more

Skilled Nursing Facility (SNF) Alert Update – WPS Medicare eNews 5-23-13

This is an update to the issue identified where some SNF claims (type of bill 21x) were being cancelled erroneously for not meeting the three day qualifying hospital stay requirement when in fact the requirement was met. After further analysis by the Common Working File (CWF), it was determined that this only impacted SNF claims where the inpatient claim (type of bill 11x) posted on CWF contained dates of service less then four calendar days and the discharge date was equal to the SNF claim admission date. Read more

Therapy’s Role in Arthritis

While arthritis is a progressive condition, physical and occupational therapy can help to manage the symptoms of arthritis to allow people to live pain free and productive lives. Therapy performs an assessment by highly trained clinicians who are the experts at treating musculoskeletal conditions affecting adults.   A full evaluation is performed to assess the severity, progression and symptoms of arthritis. Read more