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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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]
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.
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]
Documentation is required to process claims for ventricular assist device (VAD) supplies. View this article regarding how to avoid delays when billing VAD supplies.
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]
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.
