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Change request (CR) 10374 provides the quarterly update of healthcare common procedure coding system (HCPCS) codes used for home health (HH) consolidated billing (CB) effective April 1, 2018. [MM10374]
Change request 10319 announces and explains the use of two new not otherwise classified codes that may be used when a required tracer code is not available. [MM10319]
Change request (CR) 9911 releases information regarding the qualified Medicare beneficiary (QMB) indicator that modifies the Medicare claim processing systems to help providers more readily identify the QMB status of each patient. The article was revised November 16 to reflect a revised CR 9911 issued November 15. In the article, the CR release date, transmittal number, and the web address of CR 9911 are revised. All other information remains the same. [MM9911]
The Centers for Medicare & Medicaid Services (CMS) recently released the annual home health (HH) consolidated billing updates. The new consolidated billing codes take effect January 1, 2018. [MM10308]
All Medicare physicians, providers, and suppliers who offer services and supplies to qualified Medicare beneficiaries (QMB) may not bill QMBs for Medicare cost-sharing. The article was revised to show the HETS QMB release will be in November 2017. Previously, the article was revised October 18 to indicate that the provider remittance advice and the Medicare summary notice for beneficiaries identifies the QMB status of beneficiaries and exemption from cost-sharing for Part A and B claims processed on or after October 2, 2017, and to recommend how providers can use these and other upcoming system changes to promote compliance with QMB billing requirements. All other information remains the same. [SE1128]
This article has been rescinded. [MM9893]
This article reviews specific points that providers should consider regarding CCM guidelines, along with a link to a Medicare Learning Network® (MLN®) article that outlines the CCM guidelines in more detail.
Learn which modifier to use when you expect Medicare will deny a claim that does not meet medical necessity criteria and whether you have or do not have an advanced beneficiary notice (ABN) signed by the beneficiary.
To correct claims returned for beneficiary name and number mismatch, take the following action. [CR 7260]
This information outlines the process for the 935 recoupment.
This article provides information regarding unsolicited/voluntary refunds; that is, monies received by Medicare not related to an open account receivable.
To determine if a claim was medically reviewed, providers should look at certain fields on the claim screen. [Provider Outreach and Education]
The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 2.375 percent is in effect, from July 1, 2017, through December 31, 2017. [Publication 100-04, Chapter 1, Section 80.2.2]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2016 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM9410]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2017 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM9902]
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.