CBR Recommended Links
General Links
- CBR Disseminator
- Centers for Medicare & Medicaid Services (CMS) Web Site
- Medicare Quarterly Provider Compliance Newsletter
Evaluation and Management Services References
- CMS Manual System, Pub 100-04, Medicare Claims Processing Manual, Chap 12, Sec 30.6.1
- Coding Trends of Medicare Evaluation and Management Services
- Comprehensive Error Rate Testing Program Overview
- Evaluation and Management (E/M) Services Fact Sheet [PDF, 822KB]
- Evaluation and Management Services Guide [PDF, 4MB]
- Section 1833(e) of the Social Security Act
- Section 1862(a)(1)(A) of the Social Security Act
Cardiology Services References
- 42 Code of Federal Regulations (CFR), Section 410.32
- CMS Manual System, Pub 100-02, Medicare Benefits Policy Manual, Chap 15, Section 80
- Medicare and the Health Care Delivery System, Chapter 2
- Section 1862(a)(1)(A) of the Social Security Act
Pain Management Services References
- 42 Code of Federal Regulations (CFR), Section 410.32
- Inappropriate Medicare Payments for Transforaminal Epidural Injection Services
- Section 1862(a)(1)(A) of the Social Security Act
Advanced Diagnostic Imaging References
- American College of Radiology: Medical Excellence in Diagnostic Imaging Campaign
- Berenson-Eggers Type of Service (Betos) HCPCS Release and Code Sets
- CMS Manual System, Pub 100-02, Medicare Benefits Policy Manual, Chapter 15, Section 80
- Growth in Advanced Imaging Paid Under the Medicare Physician Fee Schedule
- Medicare and the Health Care Delivery System
- Section 1862(a)(1)(A) of the Social Security Act
Ordering Durable Medical Equipment: Lower Limb Orthotics References
- CMS MLN Matters Article Pertaining to Signature Guidelines
- IOM 100-04, Medicare Claims Processing, Ch 20, DME, Prosthetics, Orthotics, and Supplies (DMEPOS)
- IOM 100-08, Medicare Program Integrity, Ch 5, Items/Services - Special DME Review Considerations
- Medicare Payments for Orthotics: Inappropriate Payments
- Section 1862(a)(1)(A) of the Social Security Act
- The CMS DME Center
Electrodiagnostic Studies References
- 42 Code of Federal Regulations (CFR), Section 410.32
- CMS Manual Sys, Pub 100-03, Medicare National Coverage Determinations Manual/Chap 1/Pt 2/Sec 160.23
- CMS Manual System, Pub 100-02, Medicare Benefits Policy Manual, Chapter 15, Section 80
- Recommended Policy - Electrodiagnostic Medicine American Association of Neuromuscular Medicine
- Section 1862(a)(1)(A) of the Social Security Act
Ordering Durable Medical Equipment: Diabetic Supplies References
- Medicare Benefit Policy Manual, Pub. No. 100-02, Chapter 15, Section 110
- MLN Fact Sheet: Glucose Testing Supplies: Complying with Documentation & Coverage Requirements
- MLN Matters Number: MM6698 (Revised), Signature Guidelines for Medical Review Purposes
- MLN Matters Number: SE0738 (Rev), An Overview of Medicare Covered Diabetes Supplies and Services
- MLN Matters Number: SE1008, Medicare Coverage of Blood glucose Monitors and Testing Supplies
- Review of Medicare Claims: Home blood-glucose test strips, DME MAC, Jurisdiction B/C/D (1)
- Review of Medicare Claims: Home blood-glucose test strips, DME MAC, Jurisdiction B/C/D (2)
- Review of Medicare Claims: Home blood-glucose test strips, DME MAC, Jurisdiction B/C/D (3)
- Section 1862(a)(1)(A) of the Social Security Act
- Strengthening Medicare: Better Health, Better Care, Lower Costs
- The CMS DME Center
Ordering Durable Medical Equipment: Spinal Orthotics References
- CMS MLN Matters Article Pertaining to Signature Guidelines
- IOM 100-04, Medicare Claims Processing Manual, Chapter 20, DMEPOS
- IOM 100-08 Medicare Program Integrity Manual, Ch 5, Items/Services-Special DME Review Considerations
- Medicare Payments for Orthotics: Inappropriate Payments
- Section 1862(a)(1)(A) of the Social Security Act
- The CMS DME Center
Sleep Study References
- CMS file "2010 End of Year Zip Code"
- IOM, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 70
- IOM, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 6, Section 50
- IOM, Pub. 100-03, Medicare National Coverage Determinations Manual, C 1, Pt 4, Sect 240
- IOM, Pub. 100-03, Medicare National Coverage Determinations Manual, Chap 1, Part 4, Sections 240.
- Medicare Fee Schedule
- Section 1862(a)(1)(A) of the Social Security Act (SSA)
Podiatry References
- IOM, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 290
- Medicare Payments for Nail Debridement Services
- Section 1862(a)(13)(C) of the Social Security Act (SSA)
Hospice References
- CMS Regions
- Code of Federal Regulations (CFR) Hospice Care Guidelines
- Hospice Association of America, Hospice Facts and Statistics, September 2009
- IOM, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 9
- IOM, Pub. 100-04, Medicare Claims Processing, Chapter 11
Ambulance References
- Ambulance Services for Medicare End-Stage Renal Disease Beneficiaries: Medical Necessity
- Ambulance Services for Medicare End-Stage Renal Disease Beneficiaries: Payment Practice
- IOM, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 10 – Ambulance Services
- IOM, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 11, Section 30.1
- IOM, Pub. 100-04, Medicare Claims Processing Manual, Chapter 15
- Medicare Payments for Ambulance Transports
- Section 410.40 of the Code of Federal Regulations - Coverage of Ambulance Services
- Section 410.41 of the Code of Federal Regulations - Requirements for Ambulance Suppliers
Chiropractic Services References
- Chiropractor Service in the Medicare Program: Payment Vulnerability Analysis
- Inappropriate Medicare Payments for Chiropractic Services
- IOM, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, Sections 30.5 and 240
- IOM, Pub. 100-04, Claims Processing Manual, Chapter 12, Section 220
- Limitations on Services of a Chiropractor, Code of Federal Regulations
Physical Therapy References
- CMS Manual System Transmittal 1145 Change Request 5478
- CMS Manual System Transmittal 1414 Change Request 5871
- CMS Provider Inquiry Assistance - Therapy Caps Exception Process
- IOM, Pub. 100-02, Chapter 15, Sections 220 and 230
- IOM, Pub. 100-04, Chapter 5, Section 10
- Medicare Benefit Policy Manual Pub. No. 100-02 Chapter 15 (Section 220 and 230)
- MLN Matters Number: SE0637 (Revised)
- Questionable Billing for Medicare Outpatient Therapy Services
- The Office of Inspector General (OIG) Work Plan Fiscal Year 2009 (pg.14)
- The Office of Inspector General (OIG) Work Plan Fiscal Year 2010 (pg. 16)