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Last Modified: 4/15/2019 Location: FL, PR, USVI Business: Part A, Part B
Current processing issues for Part A and Part B
The table below provides an at-a-glance look at processing issues being worked currently or resolved recently. To sort by line of business (LOB), status, or date last updated, click on that column's header. Click again to change between ascending or descending order.
LOB
Issue
Resolution
Status
Provider Action
Last Updated
Part A, Part B
CMS published a final decision memorandum for vagus nerve stimulation (VNS) for treatment-resistant depression (TRD) on February 15, 2019. MACs will adjust claims brought to their attention.
Open.
Beginning July 25, 2019, providers may contact First Coast for adjustments on claims from February 15, 2019, to present.
7/16/2019
Part B
Due to a system error, some claims for nonparticipating providers were paid incorrectly resulting in overpayments. These claims will be reprocessed and overpayment letters will be issued.
Open.
Providers who receive overpayment letters shall refund the overpaid amounts to First Coast’s debt recovery area as directed in the letters.
6/18/2019
Part B
Due to a system error, some claims for nonparticipating providers were paid incorrectly resulting in overpayments. These claims will be reprocessed and overpayment letters will be issued.
Open.
Providers who receive overpayment letters shall refund the overpaid amounts to First Coast’s debt recovery area as directed in the letters.
6/18/2019
Part B
A system edit erroneously excluded covered diagnosis codes for Mohs surgery with no separate excision. MACs will adjust claims beginning no later than March 29.
Open.
None.
3/4/2019
Part B
An error in the implementation of the 2019 Merit-based Incentive Payment System (MIPS) payment adjustment has been discovered. Medicare administrative contractors (MACs) will adjust claims as needed.
Open.
None.
2/6/2019
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.