Current processing issues
These tables display processing issues that are being worked currently or have been resolved recently.
Articles
Article Type
Category
Targeted probe and educate (TPE) round results: Evaluation and management services - outpatient office visits
View TPE round results for evaluation and management services - outpatient office visits.
Targeted probe and educate (TPE) round results: Drugs and biologicals (HCPCS J7318-J7329, J7331-J7332)
View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).
Finding fee schedule policy indicators
How to find policy indicators such as global days for a service, relative value units (RVUs) for a particular code, and more.
Hospital outpatient department (OPD) prior authorization exemption process
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to...
Prior authorization program for repetitive, scheduled non-emergent ambulance transports (RSNAT)
CMS has implemented the prior authorization program for certain repetitive, scheduled non-emergent ambulance transports in...
Tips to prevent reject reason code U5233
Read this article for tips on how to prevent reject reason code U5233.
Tips to prevent claim adjustment reason code (CARC)s 54NCD or 53NCD
Read this article for tips to prevent claim adjustment reason code (CARC)s 54NCD or 53NCD.
Modifier 66 fact sheet
Surgeons append modifier 66 to claims indicating they were on a team of surgeons performing a specific procedure on the same...
Resolution tips for overlapping claims
This job aid was prepared by the Part A/B and home health and hospice (HHH) MAC collaboration team to help providers that...