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Linda Collins Blogger

Review of Documentation for Spinal Orthoses Claims

Posted by Linda Collins | May 08, 2018

CGS Medicare, Jurisdiction B and Jurisdiction C, announced a CGS Connect, a new program to offer review of documentation for Lumbral Sacral Orthoses billed using HCPCS L0450 and L0640.

CGS Connect is a new program offered in Jurisdiction B and Jurisdiction C which enables suppliers to submit documentation on certain claims for review prior to claims submission. This is a voluntary program which may provide a level of confidence that your documentation meets the requirements for claim payment. You are encouraged to submit all medical records including those from physicians, physical therapists, and other healthcare providers. The documentation is reviewed by clinicians, who will provide feedback if the documentation is not sufficient. The purpose of the education is to provide education to suppliers.

To get started you complete the CGS Connect Request Form and submit it to the appropriate MAC. The medical reviewers will provide detailed feedback on the documentation, typically within ten business days.

What does this mean for you?

The next time you provide an LSO to a Medicare beneficiary, consider using the CGS Connect service for pre-review of your documentation. The program is for claims billed with HCPCS L0450 and L0640 only.  You may benefit by:

  • A reduction in claim denials related to documentation errors
  • A reduced need to appeal claim payment decisions
  • One-on-one education on the correct way to submit required documentation

 

You can learn more about the CGS Connect program here.

 


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