Claim submission guidelines
Process for pathology, laboratory, and other codes
Avoid negative impacts to your claims by providing the medical records for the laboratory, pathology and other codes claims submissions indicated in this article. First Coast requests specific…
Process for supplying invoice amount on certain HCPCS codes - avoid rejected claims
The ASC device codes list has been updated.
Appropriate use of not otherwise classified codes
Correct coding requires the most specific code available describing a service to be reported. Not otherwise classified (NOC) codes must only be used when a more specific HCPCS or CPT code is not…
Appropriate use of not otherwise classified codes when billing drugs and biologicals
Correct coding requires the most specific code available describing a service to be reported. Not otherwise classified (NOC) codes must only be used when a more specific HCPCS or CPT code is not…
Hospital off-campus outpatient department reporting requirements
Effective July 6, 2026, outpatient claims with type of bills (TOB) 13X or 14X will be returned to provider (RTP) for reason code 34554 if modifier ER, PO, or PN is billed on all service lines, and…
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-dose” containers. Read this article to understand how these modifiers…
Providers billing for drug Octagam HCPCS code J1568
Did you know the leading reason why the Recovery Audit Contractor denies the drug Octagam during a medical review is for lack of documentation? Learn more about preventing unnecessary denials.
Prevent errors on your OTP claims
Learn about the top errors First Coast has identified for Opioid Treatment Program (OTP) claims and how you can prevent the errors on your claims.
Prevent errors on your OTP claims
Learn about the top errors First Coast has identified for Opioid Treatment Program (OTP) claims and how you can prevent the errors on your claims.