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Review information from CMS about its action regarding recently expired Medicare legislative provisions.
The 2018 updated list of healthcare common procedure coding system (HCPCS) codes for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) jurisdictions is now available. [MM10416]
Learn which modifier to use when you expect Medicare will deny a claim that does not meet medical necessity criteria and whether you have or do not have an advanced beneficiary notice (ABN) signed by the beneficiary.
This article provides information regarding unsolicited/voluntary refunds; that is, monies received by Medicare not related to an open account receivable.
This article reviews specific points that providers should consider regarding CCM guidelines, along with a link to a Medicare Learning Network® (MLN®) article that outlines the CCM guidelines in more detail.
The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 2.625 percent is in effect, from January 1, 2018, through June 30, 2018. [Publication 100-04, Chapter 1, Section 80.2.2]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2016 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM9410]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2017 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM9902]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2018 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM10405]
By billing place of service code 02 with a covered telehealth procedure code, this certifies that the beneficiary was present at an eligible originating site when the telehealth service was furnished. Therefore, the GT modifier is being eliminated. [MM10152]
All Medicare physicians, providers, and suppliers who offer services and supplies to qualified Medicare beneficiaries (QMB) may not bill QMBs for Medicare cost-sharing. This article was revised to indicate that December 8 CMS will suspend modifications to the provider remittance advice and the Medicare summary notice for QMB claims made October 2. The article was also revised to show the HETS QMB release was implemented in November 2017. Finally, the article was changed to clarify that QMBs cannot elect to pay Medicare cost-sharing but may need to pay a small Medicaid copay in certain circumstances. All other information remains the same. [SE1128]
Change request (CR) 10374 provides the quarterly update of healthcare common procedure coding system (HCPCS) codes used for home health (HH) consolidated billing (CB) effective April 1, 2018. [MM10374]
To correct claims returned for beneficiary name and number mismatch, take the following action. [CR 7260]
This information outlines the process for the 935 recoupment.
To determine if a claim was medically reviewed, providers should look at certain fields on the claim screen. [Provider Outreach and Education]
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.