Institutional billing resources (Addendums A, B, D1 and E*)
To bill correctly under the Outpatient Prospective Payment System (OPPS), please review the addendums* listed below.
Articles
Article Type
Category
Proper reporting of condition code G0
Hospitals should report condition code G0 (zero) on Part A claims when multiple medical evaluation and management (E/M) visits...
Submitting high dollar claims for single use vials
Read this article to learn more about submitting high dollar claims for single use vials.
Reimbursement guidelines for radiopharmaceutical procedure codes -- Avoid rejected claims
We created this article to educate on billing certain contractor-priced codes, including radiopharmaceuticals. Code list was...
Avoid negative impacts to your claims: Review policies on genetic testing for cardiovascular disease
View this important information you must know if you bill for genetic testing for cardiovascular disease, effective January 30.
Avoid negative impacts to your claims -- review LCD L39073 and billing and coding article A58812 pharmacogenomics testing
Important information you must know if you bill for pharmacogenomics testing.
YouTube video: Avoid Medicare claim rejects that should be submitted to a Medicare Advantage plan
Want to learn the key differences between original Medicare and a Medicare Advantage plan? Take a look at our YouTube video.
New coversheet for hardcopy UB-04 submissions
This article describes First Coast’s new coversheet for hardcopy UB-04 form submissions.
Returned to provider claims affect timely filing
A claim must be submitted to Medicare no later than one year after the date of service to be considered filed timely. Claims...
Returned or rejected as unprocessable claims affect timely filing
A claim must be submitted to Medicare no later than one year after the date of service to be considered filed timely. Claims...