Claim submission guidelines
Automated Process for Multiple PTAN Matches to Single NPI will Reduce Claim Processing Delays: Part A
Part A providers with multiple facility PTANs linked to a single NPI, learn about our automated process to match the most appropriate PTAN to your NPI.
Process for Supplying Invoice Amount on Certain HCPCS Codes - Avoid Rejected Claims
Please review the revised drug codes list; Q5155 has been updated.
Appropriate Drug Billing Part B
Read this article to learn more about appropriately billing Part B drugs.
Coding Guidelines: Part A Outpatient Therapy Billing at a Glance
Outpatient therapy occurrence codes assist with physical, occupational, and speech-language pathology services claims being submitted.
Hardcopy Claim Submission Exceptions and Required Cover Form
This article describes hardcopy claim submission exceptions and the required coversheet for hardcopy UB-04 form submissions.
Coding Guidelines: Part A Billing for Blood and Blood Products
The following information explains how to bill for blood and blood products paid under the outpatient prospective payment system.
Billing for Hospital Part B Inpatient Services - Ancillary Services
Inpatient Part B services include inpatient ancillary services that do not require an outpatient status and are not strictly provided in an outpatient setting.
Outpatient Prospective Payment System (OPPS) Addendums Updates A, B, D1, and E
Review to find quarterly updates related to OPPS and I/OCE and review accessing the addendums* listed below.
Private Room Billing
This article provides guidance on billing medically necessary and non-medically necessary inpatient private room accommodations.