Process for supplying invoice amount on certain HCPCS codes - avoid rejected claims
The code list for drugs has been updated.
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New high-cost cell-based gene therapy drug Encelto approved for use in the ambulatory surgical center (ASC) setting
Medicare approved the groundbreaking new cell-based gene therapy drug, Encelto, for use in the ambulatory surgical center...
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 supervision of diagnostic tests
The Code of Federal Regulations requires that, with certain exceptions, diagnostic tests covered under the Social Security Act...
Multiple procedure payment reduction on the professional component and technical component of certain diagnostic imaging procedures
The MPPR on diagnostic imaging applies when multiple services are furnished by the same physician to the same patient in the...
Long term care facility prospective payment system standard versus site neutral payment
For discharges on or after October 1, 2015, there are two separate payment categories for long term care hospital (LTCH)...
Use of JW and JZ Modifiers when Billing for Separately Payable Incident-to Supplies
Effective January 1, 2026, the application of the JW and JZ modifiers has changed for certain skin substitutes per the calendar...
Avoiding MSP claim rejects
Providers billing Medicare must determine if Medicare is the primary payer or not. This article has tips on checking MSP...
Medicare coverage of driveline kits for ventricular assist devices (VADs)
Documentation is required to process claims for ventricular assist device (VAD) supplies. View this article regarding coverage...
2026 influenza, pneumococcal, and hepatitis B vaccine reimbursement
Read this article for information on vaccine fees for calendar year 2026.