Claim submission guidelines
CMS-1500 (02/12) data element requirements
This document discusses the conditions and requirements of the Item fields within the revised CMS-1500 (02/12) paper claim form and the electronic equivalent elements.
YouTube video: Avoid Medicare claim rejects that should be submitted to a Medicare Advantage plan
Want to learn the key differences between original Medicare and a Medicare Advantage plan? Take a look at our YouTube video.
YouTube video: Avoid Medicare claim rejects that should be submitted to a Medicare Advantage plan
Want to learn the key differences between original Medicare and a Medicare Advantage plan? Take a look at our YouTube video.
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…
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…
Automated process for multiple PTAN matches to single NPI will reduce claim processing delays: Part A
For 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.
Important instructions for paper claim form CMS-1500 (version 02/12)
This article addresses important submission instructions for Optical Character Recognition (OCR) processing.
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.
Automated process for multiple PTAN matches to single NPI will reduce claim processing delays: Part B
For Part B providers with multiple billing 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
The drug codes list and radiopharmaceutical codes lists have been updated.