Claims
Current processing issues
An update was made to a Part B issue reflecting pending claims are now finalized and payments started with the May 11 cycle.
DMEPOS HCPCS codes jurisdiction list
CMS annually updates the durable medical equipment prosthetics, orthotic, and supplies (DMEPOS) for DME MAC and Part B MAC jurisdictions list.
Duplicate reject/return to provider (RTP) reason code
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Avoid negative impacts to your claims: Review policies on genetic testing for cardiovascular disease
View this important information you must know if you bill for genetic testing for cardiovascular disease.
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…
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…
Credit balance reporting
Details on submitting the credit balance report, submission deadlines, and a tool to check credit balance status.
Tips to prevent claim adjustment reason code (CARC) 54MUE
Read this article for tips on how to prevent claim adjustment reason code (CARC) 54MUE.
Ambulance modifiers
Ambulance modifiers identify the place of origin and destination of the ambulance trip and must be included on all ambulance claims.
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.