Process for supplying invoice amount on certain HCPCS codes - avoid rejected claims
The code list for drugs has been updated.
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Modifier 57 flowchart
Use this decision flowchart to assist in correctly applying the 57 modifier.
Modifier 25 flowchart
Use this decision flowchart to assist in correctly applying the 25 modifier.
Revision to social determinants of health risk assessment (HCPCS code G0136)
CMS recently revised the code descriptor for HCPCS code G0136 to remove the social determinants of health risk (SDOH) assessment...
Medicare Diabetes Prevention Program (MDPP) changes for calendar year 2026
Read this article for important changes and revisions to the MDPP program for calendar year 2026.
Medicare & Veteran Affairs: Adjustments for duplicate claims
CMS entered into an agreement with the Department of Veterans Affairs (VA), which allows First Coast to recover duplicate...
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...
Radioactive diagnostic agents for positron emission tomography of prostate-specific membrane antigen positive lesions in men with prostate cancer
Read this article to learn more about radioactive diagnostic agents for positron emission tomography of prostate-specific...
Physician supervision of diagnostic tests
The Code of Federal Regulations requires that, with certain exceptions, diagnostic tests covered under the Social Security Act...