Prolonged physician services: Office and other outpatient visits
Learn more about billing Medicare for prolonged office and other outpatient E/M services that exceed the maximum time by at...
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Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders
Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted...
Prolonged physician services: Hospital inpatient or observation care services
Learn more about billing Medicare for prolonged hospital inpatient or observation care E/M services exceeding the maximum time...
Prolonged physician services: Home or residence visits
Learn more about billing Medicare for prolonged home or residence E/M services that exceed the maximum time by at least 15...
Split or shared E/M guidelines: Medicare Claims Processing Manual updates
This article summarizes the Medicare E/M guidelines for split or shared E/M services effective in 2024.
Medical review activities
Service-specific reviews
First Coast is tasked with preventing inappropriate Medicare payments. One of the ways this is conducted...
Service-specific reviews
View these current post-payment service-specific reviews and available results.
Additional review programs
- Recovery audit program: Find out how the recovery audit program utilizes claim reviews to reduce the volume of improper payments...
Drugs and biologicals Part B: Using the JW and JZ modifiers
The JW and JZ modifier policy applies to all drugs separately payable under Medicare Part B described as supplied in a “single...
Coding guidelines: Part A inpatient billing for malnutrition diagnosis codes
Read this article for diagnosis coding guidelines on correctly billing malnutrition claims.