The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 4.00 percent is in effect July through December 2022. [Publication 100-04, Chapter 1, Section 80.2.2]
This article will assist Medicare Part A providers with proper billing relating to COVID-19 vaccine and monoclonal antibody infusion. Beneficiary coinsurance and deductible are waived.
Based on claims reviewed by the recovery audit contractor (RAC), First Coast has identified top denials for services within the category of vein ablation (codes 36475 and 36478) relating to endovenous radiofrequency ablation and laser treatment for lower extremity varicose veins. Common findings indicate that medical necessity and documentation requirements are often not supported within the medical records submitted.
Effective June 21, 2022, both the standard and expedited PAR coversheets are updated with new fields to improve the prior authorization request (PAR) process. The new fields include the facility fax number, the physician fax number, and a field relating to the implanted spinal neurostimulator.
Based on claims reviewed by the recovery audit contractor (RAC), First Coast has identified top denials for services within the category of vein ablation (codes 36475 and 36478) relating to endovenous radiofrequency ablation and laser treatment for lower extremity varicose veins. Common findings indicate that medical necessity and documentation requirements are often not supported within the medical records submitted.
First Coast would like to ensure providers performing biopsy services understand how to properly bill and code for these procedures. Recent data indicates improper billing so we want to provide clarification of top issues we identified.
First Coast reminds providers that CMS updated MLN12124, which was initially released in March 2021, addressing NCD 90.2, Next Generation Sequencing (NGS), and the expiration of certain ICD-10 codes.
Please review this reminder for billing the new condition codes (CCs) 90 and 91 issued by CMS under MM12049. First Coast revised this article to correctly reflect the effective date as claims received on or after February 1, 2021.
Last year, we implemented new P.O. Box addresses for mailing correspondence to First Coast. Make sure you are mailing to our current addresses as we’re no longer forwarding mail received at the old addresses. Visit our website for the new addresses.
This article provides information regarding unsolicited/voluntary refunds; that is, monies received by Medicare not related to an open account receivable.
Review our series on billing alerts for the COVID-19 related services. This article was modified January 5 to address claim submission in 2022 for Medicare Advantage beneficiaries.
Are you sending hardcopy mail to submit your requests to First Coast? Avoid the wait. There are faster and easier ways to send your requests to us. Learn about the electronic options available for you.
Effective October 1, First Coast will reject claims returned to a provider more than three times with reason code 70RTP. Read this article to learn more about this new reason code. Effective October 1, First Coast will reject claims returned to a provider more than three times with reason code 70RTP. Read this article to learn more about this new reason code.
Providers billing Medicare should determine if a patient is enrolled in hospice before billing Medicare Part A. This article has tips on checking patient eligibility and avoiding hospice claim rejects.
Effective for dates of service (DOS) on/after August 7, 2019, Medicare will pay claims from approved providers for administration of autologous T-cells expressing at least one CAR for the treatment for cancer using administration HCPCS code 0540T. [MM12177]
Transmittal 10486, dated November 19, 2020, is being rescinded and replaced by transmittal 10520, dated December 14, 2020, to revise the implementation date from December 14, 2020, to December 21, 2020. All other information remains the same. [CR11642]
The Centers for Medicare & Medicaid Services (CMS) issued the 2019 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM11025]
The Centers for Medicare & Medicaid Services (CMS) has issued the 2020 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee-for-service program. [MM11542]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2019 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM11025]
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.
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.
