Change request 10901 updates the "Medicare Program Integrity Manual" with detailed changes to the local coverage determination (LCD) process, which will help to increase transparency, clarity, consistency, reduce provider burden, and enhance public relations while retaining the ability to be responsive to local clinical and coverage policy concerns. [MM10901]
So coding changes can be made more efficiently without requiring reconsideration of an LCD, CPT and ICD-10 codes are being relocated from LCDs to associated billing and coding articles or policy articles. [CR10901]
A revised Provider Compliance Tips for Nebulizers and Related Drugs Medicare Learning Network Fact Sheet is available. Learn about coverage requirements, documentation, and how to prevent claim denials
Based on change request (CR) 11392 (ICD-10 and Other Coding Revisions to National Coverage Determinations [NCDs] - January 2020 Update), the billing and coding article was revised.
Based on the 2020 Healthcare Common Procedure Coding System (HCPCS) Update, the national noncovered services billing and coding article was revised to add Current Procedural Terminology (CPT) codes 0567T and 0568T to the “Article Text:” section for Part B only.
The noncovered services billing and coding article for noncovered services was revised to remove Current Procedural Terminology (CPT) codes 0253T and 0450T from the “CPT/HCPCS Codes/Group 1 Codes:” section and place them in the related billing and coding article for the new MIGS LCD under the Group 3 Codes section.
Please review this article from the durable medical equipment Medicare administrative contractors (DME MACs) about ordering spinal orthoses for your Medicare patients.
Please review this article from the durable medical equipment Medicare administrative contractors (DME MACs) about ordering lower limb orthoses (LLO) for your Medicare patients.
First Coast has implemented a new process to reduce provider burden and process claims more efficiently. If you submit claims for skin substitutes or radiopharmaceutical codes, learn how this new process will benefit you.
Please review this article from the durable medical equipment Medicare administrative contractors (DME MACs) about ordering surgical dressings for your Medicare patients.
Please review these quick tips from the durable medical equipment Medicare administrative contractor (DME MAC) about ordering oxygen and oxygen equipment for your Medicare patients.
This calculator will assist you in determining when additional documentation requested by First Coast Service Options Inc. (First Coast) must be received.
The Centers for Medicare & Medicaid Services (CMS) requires that any Medicare service provided or ordered must be authenticated by the author -- the one who provided or ordered that service. This article outlines acceptable forms of authentication.
When a medical reviewer contacts the provider requesting to submit an attestation statement or signature log to authenticate a medical record, the provider must submit the attestation statement or signature log within the following 20 calendar days. [CR 6698]
Payment will be considered for unused and discarded portions of a single-use drug/biological product. The JW modifier is not permitted when the actual dose of the drug or biological administered is less than the billing unit.
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.
