Claim submission guidelines

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.

Review this article if your claim is returning for reason code 326x4.

First Coast has noticed an increase in errors on the CMS-1500 (02/12) claim form. This article addresses important instructions regarding completion of the paper claim form.

A claim must be submitted to Medicare no later than one year after the date of service to be considered filed timely. Claims returned or rejected as unprocessable have not been filed successfully.

This article provides guidance for billing provider-liable acute inpatient non-covered and acute partial inpatient non-covered days, and acute inpatient non-covered beneficiary-liable days.

This article provides guidance for billing provider-liable acute inpatient non-covered and acute partial inpatient non-covered days, and acute inpatient non-covered beneficiary-liable days.

View these guidelines for a beneficiary who is incarcerated or in custody at the time items and services are furnished.

View these guidelines for a beneficiary who is incarcerated or in custody at the time items and services are furnished.

New section, Emergency department procedure codes for Method II CAH, added to the Medicare Claims Processing Manual Pub.100-04, chapter 4, section 250.18.

The following article provides the requirements of the form locators within the CMS-1450 (UB-04) paper claim form and their electronic equivalents.