Targeted probe and educate (TPE) round results: End stage renal disease (ESRD) (CPT 90999)
Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.
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Targeted probe and educate (TPE) round results: Inpatient rehabilitation facilities (IRF)
Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).
How to bill correctly for transcranial magnetic stimulation (TMS) in the treatment of adults with major depressive disorder
First Coast is receiving first-level appeals (redeterminations) based on claim denials for providers not including the ordering...
Part B service-specific review – clinical laboratory presumptive and definitive drug testing
Summary for Clinical Labs (November 2020).
Checklist: Paravertebral facet joint injection services documentation
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...
Medical necessity requirements for skilled nursing facility (SNF) admissions
This questionnaire is intended to provide health care providers with a reference for use when screening a new patient for a SNF...
Prior authorization of ambulance claims requires UTN in proper field
Repetitive, scheduled non-emergent ambulance transport (RSNAT) has been effective as of April 1, 2022. Through this program, a...
Repetitive scheduled non-emergency ambulance transport prior authorization claims submission guidelines
Follow this instructions to learn how to file a claim once you received the unique tracking number (UTN) related to the prior...
Checklist: Nursing home
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for...
Paperwork (PWK)
Learn how PWK, the paperwork segment of the X12N version 5010, allows providers to submit medical documentation with their...