Claim submission guidelines
Tips to prevent reason code 326x4
Review this article if your claim is returning for reason code 326x4.
Submitting claims when the dollar amount exceeds $99,999.99
First Coast has seen an increase in claims for drugs, hemophilia clotting factors, and skin substitutes that exceed the dollar amounts above $99,999.99. Effective for claims received on or after…
Hospital off-campus outpatient department reporting requirements
Read this article to learn more about hospital off-campus outpatient department reporting requirements.
Medically Unlikely Edits: Avoid denials and appeals by properly coding the first time
First Coast wants you to prevent claim denials or appeals by coding the appropriate number of units correctly the first time.
Medically Unlikely Edits: Avoid denials and appeals by properly coding the first time
First Coast wants you to prevent claim denials or appeals by coding the appropriate number of units correctly the first time.
Institutional billing resources (Addendums A, B, D1 and E*)
To bill correctly under the Outpatient Prospective Payment System (OPPS), please review the addendums* listed below.
Submitting high dollar claims for single use vials
Read this article to learn more about submitting high dollar claims for single use vials.
Submitting high dollar claims for single use vials
Read this article to learn more about submitting high dollar claims for single use vials.
EDI: CMS-1450 paper claim to electronic claim crosswalk (5010)
The following article provides the requirements of the form locators within the CMS-1450 (UB-04) paper claim form and their electronic equivalents.