Dollars and Documentation Q: Does Medicare require specific certification for the performance of specified types of treatment? A: The national Medicare guidelines, “Special Instructions for Medical Review of Dysphagia Claims,” section 6.10.K, states that intermediaries should assume that the professional rendering care has the necessary specialized training and experience. The intermediary is ... Article
Article  |   June 01, 2003
Dollars and Documentation
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  • Nancy B. SwigertColumn Editor
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Swallowing, Dysphagia & Feeding Disorders / Special Populations / Genetic & Congenital Disorders / Practice Management / Professional Issues & Training / Regulatory, Legislative & Advocacy / ASHA News & Member Stories / Dollars and Documentation
Article   |   June 01, 2003
Dollars and Documentation
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), June 2003, Vol. 12, 32. doi:10.1044/sasd12.2.32
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), June 2003, Vol. 12, 32. doi:10.1044/sasd12.2.32
Q: Does Medicare require specific certification for the performance of specified types of treatment?
A: The national Medicare guidelines, “Special Instructions for Medical Review of Dysphagia Claims,” section 6.10.K, states that intermediaries should assume that the professional rendering care has the necessary specialized training and experience. The intermediary is instructed to “refer any suspected patterns of poor quality to the CMS Regional Office.” Some Local Medical Review Policies (LMRPs) for dysphagia services include the statement “specially trained and credentialed speech-language pathologists” in reference to the FEES or FEESST procedures. One LMRP states that the speech-language pathologist “is prepared to produce evidence of special preparation in the field of dysphagia.” However, it is unlikely that an LMRP would specify an entity that may certify the qualifications of a practitioner unless the organization is identified in federal regulations as a nationally recognized certifying body. New procedures and techniques are sometimes taught in continuing education courses and the instructor informs the participants that only individuals “certified” by the instructor will be able to perform the procedure and be reimbursed by third-party payers. As stated above, requiring such certification from a CE provider is not the practice of CMS nor of LMRPs.
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