Changes to Amount in Controversy for Appeals in 2027
The claims value in dispute must meet the threshold for obtaining an administrative law judge (ALJ) hearing and a judicial...
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Process for Supplying Invoice Amount on Certain HCPCS Codes - Avoid Rejected Claims
The drug codes list and the radiopharmaceutical codes list have been updated.
MLN Connects for October 1, 2026
This edition includes information on laboratory testing, laboratory NCD edit software update, and more.
First Coast Supports Part A Billing Awareness During the Month of September
Thanks for joining us! As the September Medicare Navigator Part A Billing Workshop Series wraps up, we hope you found value in...
Screen Changes in Direct Data Entry
Effective October 1, screen changes in Direct Data Entry (DDE) have been made to the DRG/Pricer Inquiry (37) MAP1781.
Current Processing Issues
Incorrect duplicate denials have occurred for chronic care management (CCM) and remote physiological management (RPM) services...
Targeted Probe and Educate Round Results: Evaluation and Management Services - Outpatient Office Visits
View targeted probe and educate (TPE) round results for evaluation and management services - outpatient office visits.
Targeted Probe and Educate Round Results: Evaluation and Management Services – Initial and Subsequent Inpatient Care Visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services - initial inpatient...
Tutorial: Completing the Medicare Part B Redetermination Request Form
To avoid processing delays, complete the Prior Authorization section of the Medicare Part B Redetermination Form only when the...