Mandatory self-service clerical error reopening requests
Effective October 1 for all JN providers, Part B clerical error reopening (CERs) requests must be submitted using the SPOT...
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High-cost cell-based gene therapy drug Encelto approved
This article outlines billing and claim submission requirements for providers administering Medicare-approved Encelto™, a cell...
Part B billing, payment methodology and documentation requirements for non-sheet skin substitute products
This article outlines billing, payment methodology, and documentation requirements for non-sheet skin substitute products. It...
Limitation of recoupment process (Medicare Modernization Act [MMA] 935)
Read this article to learn more about the 935 recoupment process.
Federally qualified health center (FQHC): Non-FQHC services, laboratory services and technical component services
Certain services are not considered FQHC services because they are not included in the FQHC benefit or are not a Medicare...
Advanced care planning (ACP)
Advanced care planning (ACP) is a separate Part B service enabling Medicare patients to make important decisions over the type...
Medicare Secondary Payer (MSP) Educational Series -- Questions and Answers
The following questions originated from the "Medicare Secondary Payer (MSP) Educational Series." The questions are followed by...
Process for CPT category III T codes
Review the revised listing of CPT category III T codes that require documentation to avoid negative impacts to your claims.
Process for pathology, laboratory, and other codes
Avoid negative impacts to your claims by providing the medical records for the laboratory, pathology and other codes claims...
End-stage renal disease (ESRD) monthly capitation payment (MCP) claims
Billing ESRD monthly capitation payment claims correctly is important. Read this article to learn more about billing these...