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...
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Returned to provider (RTP)
A claim on status T (RTP) was returned to provider for corrections. The assigned reason code will provide you instructions for...
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.
Ambulatory surgical center (ASC) prior authorization request (PAR) submission guidelines
View these submission guidelines for ASC prior authorization requests.
Ambulatory surgical center (ASC) prior authorization (PA) claim submission guidelines
Prior authorization (PA) for the ASC prior authorization demonstration is voluntary. However, if a provider elects to bypass PA...
Critical access hospital (CAH) method II professional reassignment deadline is January 1
Beginning January 2, 2026, CAH Part A Method II claims for professional services will return to provider (RTP) if a reassignment...
Prior authorization request (PAR) ambulatory surgical center (ASC) procedures Medicare Part B fax/mail coversheet
The PAR fax/mail coversheet for ASCs is now available for Florida ASCs participating in the ASC PA demonstration. ASCs in...
Medical documentation checklists
Use the links on the left to access checklists to ensure you have met medical documentation requirements based on specific...
Critical access hospital (CAH) method II professional reassignments
CMS has issued new instructions concerning the Fiscal Intermediary Shared System (FISS) reason codes 31006 and 31007 for Method...
Targeted probe and educate round results: Annual wellness visits (AWV)
Top denial / partial denial reasons and high-level results are listed below from each round of annual wellness visits (AWV)...