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A hospital’s discharge plan shall not specify or limit access to qualified HHAs and it must identify any provider or...
Providers should review these instructions and make the necessary changes to their operations to be compliant.
This edition includes information on how to determine the reasonable cost of ambulance services furnished by a provider.
Numerous research studies have demonstrated the correlation between adequacy of dialysis and health care outcomes.
Medicare will cover colorectal cancer screening test/procedures for the early detection of colorectal cancer.
The HCFA has announced the new deductible and coinsurance amounts for calendar year 1998.
This edition includes updates regarding medical review initiatives.
The purpose of this bulletin is to clarify Health Care Financing Administration (HCFA) regulations with regard to billing of contrast material.
The Office of the Inspector General (OIG) keeps public records of individuals/entities that are excluded from reimbursement under Medicare (Title XVIII of the Social Security Act).
HCFA requires fiscal intermediaries to review 100% of all SNF demand bills.
This edition includes final LMRPs A80162, A83036, and A87086, and revisions to A99183.
Extension of the limitation on payment for services to individuals entitled to benefits on the basis of end stage renal disease (ESRD) who are covered by group health plans (GHP).
HCFA’s instructions signified that reporting code G0051 plus code G0052 would be equal to the reporting of the destruction of 14 lesions.
This edition focuses on the high denial rate for diagnostic mammography services despite a lower claim submission total.
Medicare Part A, Blue Cross and Blue Shield of Florida, Inc., is pleased to announce that we acquired AFLAC as a new trading partner under the COB process.
The purpose of this bulletin to reiterate instructions requiring CMHC providers to utilize TOB 76X, effective April 1, 1997.
The purpose of this bulletin is to clarify billing by certified independent dialysis facilities for separately billable laboratory test.
The purpose of this bulletin is to clarify information regarding the reporting of outpatient ASC procedures and...
The ARU will allow our provider customers to obtain information via the ARU without speaking directly to a Customer Service Representative (CSR).
Medicare Part A, Blue Cross and Blue Shield of Florida, Inc., is pleased to announce that we acquired Pioneer Life Insurance Co. as a new trading partner under the COB process.
In the spirit of continuous improvement, and with a need to involve more providers, we have redesigned our provider communication process.
In accordance with HCFA instructions, the intermediary begins its count on the day after the day of receipt.
The purpose of this bulletin is to advise providers that HCFA has delayed the implementation of codes until January 1, 1998.
The purpose of this bulletin is to ensure providers are aware of these Medicare coverage issue regulations.
One of these revised procedures resulted in the establishment of a new report relative to your claim adjustment/cancel processing.
The purpose of this bulletin is to ensure that all Medicare hospital providers are aware of the repeal of the Pacemaker Registry.
Subsequent to the release of the revised instructions, HCFA has received numerous contacts requesting clarification of the medical review...
HCFA has placed strict limits on the amount of hours a beneficiary can be placed in outpatient observation.
The new value code (A4) is reported via the HCFA-1450 (UB-92) billing format, in form locators 39-41, when providers report...
The Medicare Part A fee schedules for drugs and/or pharmacy services are provided via this bulletin.
The OIG fraud alert (OIG 96-18) details fraud and abuse in the provision of services in nursing services.
This section is revised to indicate that reconstruction of the affected breast and the contralateral unaffected breast following a medically necessary mastectomy.
The purpose of this bulletin is to ensure that all Medicare hospital providers reporting outpatient PHP services are aware of revised reporting requirements.
The purpose of this bulletin is notify providers of payment calculation changes to EPO for ESRD patients.
Although this Fraud Alert has been widely circulated by the Fraud Unit, this bulletin distribution is an attempt to ensure that all Medicare Part A providers are aware of this potential fraud situation.
The purpose of this bulletin is to ensure providers are aware that Modified Barium Swallow studies are not covered when...
Considerable attention has been focused recently on treatments for breast cancer.
This edition includes revised instruction relating to billing for electrical nerve stimulation.
Effective March 1, 1997, the HCFA has revised the regulations regarding surgical dressings to reflect a change in billing and payment.
Medical review policy is a composite of statutory provisions, regulations, nationally published Medicare coverage policies, and LMRPs.
General Medicare Bulletin G-230, dated August 30, 1996, informed Medicare participating providers of the HCFA’s instructions pertaining to laboratory tests that are frequently...
This edition includes an update regarding a revised schedule for the customer contact center beginning March 3, 1997.
This section is revised to eliminate certain tests from the list of separately billable laboratory tests that...
The purpose of this bulletin is to ensure that all ESRD customers are aware that only the current versions of HCFA-382 should be used, and...
The purpose of this bulletin is to provide additional billing instructions for ambulance services.
General Medicare Bulletin G-253, published December 20, 1996, advised providers of specific revisions for radiology and other diagnostic changes.
The new non-medical AI applications, will eliminate the manual review of claims that suspend for specific claim edits within the FSS.
The purpose of this bulletin to is make providers aware that an additional outcome of the MSN implementation is the elimination of the...
Reason codes, and the text messages that define those codes, are used to explain why a claim may not have been paid in full.
The purpose of this bulletin is to ensure that all Medicare hospital and CMHC providers are aware of HCFA’s manualized instructions.
This provision requires Medicare participating Rural Health Clinics to have a quality assessment and performance improvement program (QAPI), effective January 1, 1998.
HCFA is proposing to implement PAYERID for Medicare only, on a voluntary basis for providers.
The purpose of this bulletin is to share HCFA’s information, in that HCFA has determined that an initial evaluation by a CMHC on-site at a SNF.
A study of elderly nursing home residents vaccinated with Fluogen from the recalled lots has shown that because of the reduced potency of the...
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.