Comprehensive Error Rate Testing (CERT)

Centers for Medicare & Medicaid Services (CMS) established the Comprehensive Error Rate Testing (CERT) program to monitor and report the accuracy of Medicare fee-for-service (FFS) payments. The CERT program measures the error rate for claims submitted to Medicare contractors. Palmetto GBA uses CERT reports to identify areas of focus for our Provider Outreach and Education efforts. One of the major outcomes of these CERT reports is the paid claims error rate (percentage of dollars paid incorrectly).

From this web page, you may view CERT error rates by code group and provider type (specialty), articles about specific areas of concern as a result of CERT review findings, and newsletters from the CERT documentation contractor (CERT DC).

More Information About CERT

Also, providers may designate a specific point of contact to receive CERT information in your billing or medical records office. Please click on the link below and update the point of contact information for your facility. This is important in ensuring that the correct CERT request is received as soon as possible by the contact person to avoid the CERT review from being routed to various departments within each Part A facility.

Establish a CERT contact person for your practice at the CERT provider website.

Comprehensive Error Rate Testing (CERT) Articles

CERT: Part A ChecklistCERT Ambulance ChecklistPatient Discharge Status Codes MatterCERT: Inpatient Psychiatric Facility ChecklistCERT Provider Sample LettersDRG 207 - Respiratory System Diagnoses with Ventilator SupportProvider Minute: Physician Orders/Intent to Order Laboratory Services and Other Diagnostic ServicesOutpatient Therapy and Rehabilitation Services Documentation ChecklistCERT: Skilled Nursing Facility ChecklistComprehensive Error Rate Testing (CERT) Teaching and Instruction for Providers (TIP) Letters from Medical ReviewInpatient Admission Documentation ChecklistCERT Contractor Email AddressesDRG 517 - Other Musculoskeletal System and Connective Tissue O.R. ProceduresDRG 193, 194 and 195 - Simple Pneumonia and PleurisyDRG 312 - Syncope and CollapseDRG 493 - Lower Extremity and Humerus ProceduresCERT Error: Insufficient DocumentationSouth Carolina Part A CERT InformationDRG 313 - Chest PainDRG 627 - Thyroid, Parathyroid and Thyroglossal procedureDRG 981, 982 and 983Do You Know What Your Comprehensive Error Rate Testing (CERT) Contractor Is Looking For?CERT Appeals: Providing DocumentationDRG 056 - Degenerative Nervous System Disorders with MCC and DRG 057 - Degenerative Nervous System Disorders without MCCDRG 092 - Other Disorders of Nervous System with Complication Or Comorbidity W/CCHEAT Provider Compliance Training VideosDRG 518 - Back and Neck ProceduresDRG 460 - Spinal FusionMS-DRG 552 - Medical Back Problems without MCCAppeal Errors Identified by the Comprehensive Error Rate Testing (CERT) ProgramInpatient Rehab Facilities (IRFs) Common CERT Error CodesMedicare Providers: What You Need to Know About Signatures & DocumentationVirginia/West Virginia Part A CERT InformationDRG 556 - Signs and Symptoms of Musculoskeletal System and Connective TissueDRG 003 - Mechanical VentilationDRG 266 and DRG 267 - Endovascular Cardiac Valve ReplacementVerify Your CERT Contact InformationDRG 227 - Cardiac Defibrillator Implant without Cardiac Catheterization without MCCDRG 560 - Aftercare, Musculoskeletal System and Connective Tissue with Complication or Comorbidity (CC)Comprehensive Error Rate Testing (CERT) Identified Errors for TelehealthCERT Documentation Request ListingsComprehensive Error Rate Testing (CERT) Question and Answer Fact SheetMedicare Part A Payments for End-Stage Renal Disease Dialysis Services and Comprehensive Error Rate Testing (CERT)What is a Comparative Billing Report?DRG 453, 454 and 455 - Combined Anterior/Posterior Spinal FusionDRG 948 - Signs and Symptoms w/o MCCCERT Error: Incorrect CodingStamped Signatures Not Acceptable!Do you know if the CERT Contractor differs from the Medicare Administrative Contractor?Additional Guidance on Electronic Signatures Is AvailableRequested CERT Documentation Located at Another FacilityRespond to All CERT RequestsCERT Decisions May be AppealedDocumenting the Patient's Progress in the Medical RecordOrders for Tests Must Be SignedTop CERT ErrorsSignatures, Credentials and Dates: They Are ImportantCreate a Signature LogPhysician Signatures Missing on Medical Records: CERT TipMedicare Does Not Accept Retroactive OrdersKnow the Purpose of the CERT ContractorBe Sure to Keep the CERT Contractor's Website UpdatedCMS Contractors Verify ComplianceLack of Signature Could Affect Provider ReimbursementDocumenting Specific Services in the Medical RecordSubmitting Complete and Legible Medical Records is Key!CERT Follow-up Record RequestsDiagnostic Test Order Needed to Support a Service for the Interpretation of a Diagnostic TestAsk Questions, Be InformedLack of Documentation Affects Provider ReimbursementWhat Can You Expect to Receive from the CERT Contractor?A Legible Medical Record MattersDocumenting Is Critical!Authentication Matters!How to Avoid Denials for Inpatient Transcatheter Aortic Valve Replacement (TAVR) ServicesHow to Avoid Denials for Inpatient Transcatheter Aortic Valve Replacement (TAVR) ServicesDRG 682 - Renal Failure with Major Complication or Comorbidity (MCC)From the Desk of the MAC Medical Directors: Caring for Medicare Patients is a PartnershipComplying with Medicare Signature RequirementsComplying with Documentation Requirements for Laboratory ServicesCaring for Medicare Patients is a PartnershipComplying with Medicare Signature RequirementsCaring for Medicare Patients is a PartnershipOutpatient Rehabilitation Therapy Services: Complying with Documentation RequirementsCERT A/B MAC Outreach & Education Task Force: Emphasis on Outreach & Education to Reduce ErrorsCMS Provider Minute: The Importance of Proper Documentation VideoComplying With Medical Record Documentation RequirementsCMS Provider Minute: The Importance of Proper Documentation VideoProvider Minute: Utilizing Your MACEntries in Medical Records: Amendments, Corrections and AddendaIntroduction to CERT Web Based TrainingComprehensive Error Rate Testing (CERT) Errors : Critical Access Hospitals (CAH)DRG 884-Organic Disturbances and Mental Retardation / 885-Psychoses