Method II critical access hospital: Professional billing requirements for emergency department services
New section, Emergency department procedure codes for Method II CAH, added to the Medicare Claims Processing Manual Pub.100-04...
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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...
Cognitive assessment and care plan services
If your patient shows signs of cognitive impairment during a routine visit, Medicare covers a separate visit to more thoroughly...
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...
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.
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...
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)...
Process for Supplying Invoice Amount on Certain HCPCS Codes - Avoid Rejected Claims
The radiopharmaceutical codes list has been updated for code A9521.