Skip to Main Content

Print | Bookmark | Email | Font Size: + |

January 12, 2016

Progressive Corrective Action (PCA) Review: Home Visits

The J15 Part B Medical Review department performed Progressive Corrective Action (PCA) reviews on home visits throughout the year. The findings from PCA reviews occurring over 2015 are as follows:

  • Failure to support the medical need for a home visit in lieu of an office visit
  • Failure to meet the key component levels required for the code billed,
  • Medical necessity was not supported,

For more information on Medicare guidelines, including documentation required to process a claim, please refer to:

CMS Internet Only Manual

Social Security Act

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved