Claim submission guidelines
Drugs and biologicals Part A: 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…
Appropriate drug billing Part A
Read this article to learn more about appropriately billing Part A drugs.
Proper reporting of condition code G0
Hospitals should report condition code G0 (zero) on Part A claims when multiple medical evaluation and management (E/M) visits occur on the same day in the same revenue center, but the visits were…
Mammography coverage and certification of mammography facilities
Read this article for information on mammography coverage and certification of mammography facilities.
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.
Avoid rejection of paper claims
First Coast made changes to how we handle paper claims marked for "other insurance". Review this article to avoid claim rejections of this kind.
Returned to provider claims affect timely filing
A claim must be submitted to Medicare no later than one year after the date of service to be considered filed timely. Claims returned to the provider have not been filed successfully.
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.
When not to show patient paid amounts on claims
First Coast has been made aware of complaints by beneficiaries being required to pay for services up front. This article explains what may occur when indicating a patient payment amount on a claim…