Claims

Displaying 1 - 10 of 139

Appropriate drug billing Part B

Read this article to learn more about appropriately billing Part B drugs.

Fast Facts: Skilled Nursing Facility (SNF) Helpful Hints

Read this article for helpful hints for SNF claim reviews by CERT.

Fast Facts: Skilled Nursing Facility (SNF) Helpful Hints

Read this article for helpful hints for SNF claim reviews by CERT.

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.

Process for Supplying Invoice Amount on Certain HCPCS Codes - Avoid Rejected Claims

The radiopharmaceutical codes list has been updated for code A9521.

Resolution Tips for Overlapping Claims

This job aid was prepared by the Part A/B and home health and hospice (HHH) MAC collaboration team to help providers that experience claim rejections for overlapping dates of service.

Avoiding Hospice Claim Rejects

Determine if a patient is enrolled in hospice before billing Medicare. This article has tips on checking patient eligibility and avoiding hospice claim rejects.

No Reimbursement Claims: Reason Codes 39910 and 37187

Commonly received reason codes when the Medicare deductible amount matches the full payment amount on the claim.

Private Room Billing

This article provides guidance on billing medically necessary and non-medically necessary inpatient private room accommodations.

DMEPOS HCPCS codes jurisdiction list

CMS quarterly updates the durable medical equipment prosthetics, orthotic, and supplies (DMEPOS) for DME MAC and Part B MAC jurisdictions list.