Prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services
CMS is implementing a five-year demonstration project for the prior authorization of certain services provided in Ambulatory...
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Understanding the prior authorization (PA) demonstration for ambulatory surgical center (ASC) services
This document was developed based on questions and answers posed during our webinars on the PA demonstration for ASC services.
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient (KX modifier)
View TPE round results for rehabilitation services outpatient (KX modifier).
Targeted probe and educate (TPE) round results: Evaluation and management services – initial inpatient care visits and subsequent inpatient care visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services - initial inpatient...
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.
Documentation requirements to support medical necessity for Inpatient Rehabilitation Facility (IRF) stay
First Coast has compiled a list of questions on specific topics that are listed in the CMS IRF RCD Medical Records Review...
Payment issue affecting end stage renal dialysis services on type of bill 72X
Payment issue affecting end stage renal dialysis services on type of bill 72X.
Provider documentation tool for non-emergent ambulance transportation
This article is designed to assist medical providers with documenting the beneficiary’s medical condition supporting coverage...
Attention exempt hospital outpatient departments (OPDs): Revised additional documentation request (ADR) letters
Due to a claim issue identified, exempt hospital OPDs will be receiving a revised exemption ADR letter with a revised letter fax...