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Billing news

Avoid the Wait
Modified: 6/24/2022
There will be a common working file (CWF) “dark day” Friday, July 1 through Sunday, July 3.
Modified: 6/22/2022
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.
Modified: 6/16/2022
Are you submitting claims with procedure codes that aren't valid for Medicare? First Coast returns these claims to providers. Read this article to learn more about unprocessable claims.
Modified: 6/15/2022
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.
Modified: 6/15/2022
Important information you should know before billing J9035 for Avastin (bevacizumab).
Modified: 6/14/2022
Important information you should know before billing the compounded form of Avastin.
Modified: 6/9/2022
How to bill for skin substitute coes A2001-A2010
Physicians and non-physician practitioners who perform procedure codes CPT 15271-15278 (application of skin substitute) may bill separately for skin substitute codes A2001-A2010.
Modified: 6/8/2022
Modified: 5/27/2022
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.
Modified: 5/26/2022
Important information you must know when billing for Prolia® (denosumab) injections, J0897.
Modified: 5/26/2022
This article will assist Medicare Part B providers with proper billing relating to COVID-19 vaccine and monoclonal antibody infusion. Beneficiary coinsurance and deductible are waived.
Modified: 5/21/2022
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.
Modified: 5/18/2022
Important reminders when billing CPT codes 0596T and 0597T to avoid claim processing delays
Modified: 5/5/2022
This information outlines the process for the 935 recoupment.
Modified: 5/5/2022
Learn how to check a patient’s eligibility prior to submitting your COVID-19 laboratory test claims. Data shows an increase in Part B denials due to a patient’s inpatient status.
Modified: 5/4/2022
CMS created the new HCPCS code C9507 for COVID-19 convalescent plasma for use in the outpatient setting. Review this article for billing information.
Modified: 5/2/2022
Review this article for guidance on billing the home administration code M0201 when administering the COVID-19 vaccine.
Modified: 5/2/2022
Are your claims being impacted because you have multiple PTANs linked to a single NPI? This article provides guidance for improving the efficiency of the NPI selection and may assist Medicare Part B providers with billing COVID-19 related services.
Modified: 5/2/2022
This article provides guidance for NPI selection on claims and how to improve the efficiency of the NPI selection.
Modified: 4/28/2022
Data indicates that many providers are not submitting proper diagnosis codes to support the medical necessity for tetanus vaccinations.
Modified: 4/28/2022
Important information you must know when billing for Eylea (aflibercept) injections, J0178
Modified: 4/19/2022
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.
Modified: 4/2/2022
This article provides information regarding unsolicited/voluntary refunds; that is, monies received by Medicare not related to an open account receivable.
Modified: 4/2/2022
Medicare providers – please view this notice concerning unsolicited/voluntary refunds for 2021
Modified: 4/1/2022
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.
Modified: 3/31/2022
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.
Modified: 1/26/2022
This article assists with billing requirements for cochlear implant batteries L8621-L8624.
Modified: 1/3/2022
The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 1.625 percent is in effect January through June 2022. [Publication 100-04, Chapter 1, Section 80.2.2]
Modified: 12/1/2021
CMS has issued the 2022 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee-for-service program. [MM12507]
Modified: 10/20/2021
Learn about First Coast's electronic submission options.
Modified: 9/24/2021
Avoid claim rejects. If you bill E/M codes within the CPT code range 99201-99239, do not report more than one unit per date of service.
Modified: 9/15/2021
CMS has identified a claims processing issue that potentially impacts all Cohort 1 Primary Care First (PCF) participants that submitted claims for flat visit fee (FVF) eligible services processed between January 1, 2021, and February 3, 2021.
Modified: 8/16/2021
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]
Modified: 7/20/2021
Documentation is required to process claims for ventricular assist device (VAD) supplies. View this article regarding how to avoid delays when billing VAD supplies.
Modified: 3/10/2021
CMS has issued the 2021 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee-for-service program. [MM12024]
Modified: 3/4/2021
Modified: 2/11/2021
There are two options for providers to find information about a beneficiary’s deductible.
Modified: 1/29/2021
Most services billed to Medicare must reflect the exact date the service was performed for or provided to the patient. This article discusses situations where there have been questions from the provider community. [SE17023]
Modified: 11/14/2020
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]
Modified: 11/14/2020
Medicare claims processing systems will accept HCPCS code U0001 on April 1, 2020, for dates of service on or after February 4, 2020.
Modified: 11/4/2020
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]
Modified: 10/28/2020
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]
Modified: 9/9/2020
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.
Part B