Claim submission guidelines
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.
Medicare Beneficiary Identifier - get it, use it
There are three ways to obtain the Medicare Beneficiary Identifier (MBI), which is effective when the beneficiary was or is eligible for Medicare.
Medicare Beneficiary Identifier - get it, use it
There are three ways to obtain the Medicare Beneficiary Identifier (MBI), which is effective when the beneficiary was or is eligible for Medicare.
Beneficiary-submitted claim filing instructions
This article provides beneficiary guidelines for submitting claims rendered in Florida, U.S. Virgin Islands, or Puerto Rico.
Appropriate drug billing Part B
Read this article to learn more about appropriately billing Part B drugs.
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…
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…