This article was revised August 3 to reflect a revised CR 12206. The CR release date, transmittal number, and the web address of the CR were changed; all other information is the same. [MM12206]
This article was revised August 2 to reflect a revised CR 12254. The CR release date, transmittal number, and web address of the CR were changed; all other information is the same. [MM12254]
This article was revised July 21 to reflect a revised CR that added CPT code C9076 (Breyanzi). You’ll find the substantive content update in dark red font on Page 3. The implementation date, CR release date, transmittal number, and the web address of the transmittal were revised. All other information is the same. [MM12134]
This article tells you that there are changes in the October quarterly release of the edit module for clinical diagnostic laboratory services. [MM12384]
This article tells you about Medicare system updates based on the committee on operating rules for information exchange (CORE) 360 uniform use of claim adjustment reason codes (CARC), remittance advice remark codes (RARC), and claim adjustment group code (CAGC) rule publications. [MM12302]
This article reorganizes, makes edits and other changes to the advance beneficiary notice of noncoverage (ABN) section in the Medicare claims processing manual, chapter 30, section 50. [MM12242]
This article tells you about the ASP methodology, which is based on quarterly data manufacturers submit to CMS. CMS gives the MACs ASP and not otherwise classified (NOC) drug pricing files for Medicare Part B drugs on a quarterly basis [MM12342]
This article describes changes to, and billing instructions for, various payment policies CMS is making in the July 2021 ASC payment system update. CR 12341 also includes HCPCS updates. [MM12341]
This article informs you of the July 2021 updates of the 2021 MPFS. CR 12289 was revised June 21 to delete code J9314 from the table on Page 4. The CR release date, transmittal number, and the web address of the CR were also revised. All other information is the same. [MM12289]
This article announces the changes in the July 2021 quarterly release of the edit module for clinical diagnostic laboratory services. The article was revised June 16 due to a revised CR 12171. The CR release date, transmittal number, and the web address of the CR were changed; all other information remains the same. [MM12171]
This article tells you that, effective December 1, 2020, CMS covers VADs under certain criteria. CR 12290 revises some relevant sections of Medicare manuals. [MM12290]
This article tells you about changes to and billing instructions for various payment policies CMS is implementing in the July 2021 OPPS update. The July 2021 Integrated Outpatient Code Editor (I/OCE) will reflect the HCPCS, ambulatory payment classification (APC), HCPCS modifier, and revenue code additions, changes, and deletions in CR 12316. [MM12316]
This article tells you about the new HCPCS codes for 2021 that are subject to and excluded from clinical laboratory improvement amendments (CLIA) edits. The article was revised June 3 to reflect a revised CR 12131. The CR revision added important information about the use of the QW modifier. [MM12131]
This article informs you about the average sales price (ASP) methodology, which is based on quarterly data manufacturers submit to CMS. CMS gives the MACs ASP and not otherwise classified (NOC) drug pricing files for Medicare Part B drugs on a quarterly basis. This article was revised June 8 to reflect a revised CR 12244, which added language regarding Section 405 of the Consolidated Appropriations Act, 2021. [MM12244]
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.
