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]
Based on change request (CR) 10901, the local coverage determination for treatment of varicose veins of the lower extremity was revised to remove all current procedural terminology (CPT®) and ICD-10–CM diagnosis codes and place them into a newly created billing and coding article.
Based on change request (CR) 10901, the local coverage determination for independent diagnostic testing facility (IDTF) was revised to remove all current procedural terminology (CPT®) and ICD-10–CM diagnosis codes and place them into a newly created billing and coding article.
Based on change request (CR) 10901, the local coverage determination for noncovered services was revised to remove all billing and coding and all language not related to reasonable and necessary provisions and place them into a newly created billing and coding article.
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.
Based on change request (CR) 10901, multiple local coverage determinations (LCDs) were revised to remove all current procedural terminology (CPT®) and ICD-10–CM diagnosis codes and place them into newly created billing and coding articles.
Based on re-analysis of data and supporting literature, the local coverage determination (LCD) and billing and coding article for 4Kscore test algorithm were revised to provide limited coverage for Current Procedural Terminology (CPT®) code 81539.
This new local coverage determination (LCD) addresses "Coverage Indications, Limitations, and/or Medical Necessity," "Place of Service," and "Provider Qualifications" requirements for endovenous stenting.
This new local coverage determination (LCD) addresses "Coverage Indications, Limitations, and/or Medical Necessity," "Place of Service," and "Provider Qualifications" requirements for gastrointestinal pathogen (GIP) panels utilizing multiplex nucleic acid amplification techniques (NAATs).
This new local coverage determination (LCD) addresses "Coverage Indications, Limitations, and/or Medical Necessity," "Place of Service," and "Provider Qualifications" requirements for micro-invasive glaucoma surgery (MIGS).
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.
Based on change request (CR) 10901, the local coverage determination for proton beam radiotherapy was revised to remove all current procedural terminology (CPT®) and ICD-10–CM diagnosis codes and place them into a newly created billing and coding article.
Based on change request (CR) 10901, the local coverage determination for bisphosphonates (intravenous [IV]) and monoclonal antibodies in the treatment of osteoporosis and their other indications was revised to remove all current procedural terminology (CPT®) and ICD-10–CM diagnosis codes and place them into a newly created billing and coding article.
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.
Please review this article from the durable medical equipment Medicare administrative contractors (DME MACs) about ordering lower limb orthoses (LLO) for your Medicare patients.
Please review this article from the durable medical equipment Medicare administrative contractors (DME MACs) about ordering spinal orthoses for your Medicare patients.
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.
