Part B billing, payment methodology and documentation requirements for non-sheet skin substitute products
This article outlines billing, payment methodology, and documentation requirements for non-sheet skin substitute products. It...
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Anatomical modifiers
Procedures performed during separate patient encounters, at separate anatomic sites, or on separate specimens, may require that...
Process for CPT category III T codes
Review the revised listing of CPT category III T codes that require documentation to avoid negative impacts to your claims.
Process for pathology, laboratory, and other codes
Avoid negative impacts to your claims by providing the medical records for the laboratory, pathology and other codes claims...
Physician billing for procedures performed in an ASC
Physicians and practitioners performing services in Medicare-participating ambulatory surgical centers (ASCs) are reporting an...
Referring and reference laboratories
View this outline of key definitions, billing responsibilities, and claim submission requirements for referred laboratory...
Process for supplying invoice amount on certain HCPCS codes - avoid rejected claims
The drug codes list and radiopharmaceutical codes lists have been updated.
Hospital off-campus outpatient department reporting requirements
Effective July 6, 2026, outpatient claims with type of bills (TOB) 13X or 14X will be returned to provider (RTP) for reason code...
Understanding radiopharmaceutical fee schedule amounts and billing expectations
Read this clarification regarding how radiopharmaceutical payment limits should be interpreted and how providers are expected to...