Keys to Maintaining Medicare Billing Compliance with Regard to Cardiovascular Stress Testing

Given the challenges and risks associated with billing Medicare for cardiovascular stress testing, providers that bill for these tests must take exhaustive measures to ensure compliance on an ongoing basis. This is particularly important with enforcement in this area being a top priority for CMS, the HHS OIG, and the DOJ. In order to avoid raising red flags and emerge from an audit or investigation unscathed, some of the key steps providers need to take include:

1. Identify and Apply All Relevant Medicare Billing Rules and Guidelines

It is imperative for health care providers that perform cardiovascular stress testing to identify and apply all relevant Medicare billing rules and guidelines. The rules and guidelines from LCD L34324 and LCD L38396 summarized above provide just a small sampling of what providers need to know. However, these examples illustrate the complexity and particularity of the restrictions that are in place, and providers must devote the time and resources necessary to ensure that their Medicare billing practices are fully compliant on an ongoing basis. Read more