340B drug payment policy remedy payment for calendar year (CY) 2018 to CY 2022
View information related to the 340B drug payment policy remedy.
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Drugs and biologicals
View this page to easily locate information related to drugs and biologicals, such as billing and coding guidelines, related...
Billing for vein ablation services? Access our LCD guidelines
Based on claims reviewed by the recovery audit contractor (RAC), First Coast has identified top denials for services within the...
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...
End stage renal disease (ESRD): Payment for phosphate binders effective January 1
Effective January 1, phosphate binders are paid as a renal dialysis service under Medicare Part B. Read this article to learn...
Syfovre (J2781) removed from injection frequencies system editing
Read this article to learn more about J2781 being removed from injection frequency editing.
Reporting manifestation diagnosis codes
The January Integrated Outpatient Code Editor (IOCE) expands editing related to manifestation diagnosis codes. Read this article...
Prohibition on billing dually eligible individuals enrolled in the Qualified Medicare Beneficiary (QMB) program
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost...
Kisunla for monoclonal antibodies directed against amyloid for the treatment of Alzheimer's disease
Effective July 2, Medicare will pay for Kisunla for monoclonal antibodies directed against amyloid for the treatment of...
Payment of codes for chemotherapy administration and nonchemotherapy injections and infusion
CMS provided clarification regarding the Medicare guidance relating to complex administration CPT codes 96401-96549. Please read...