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This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. For the most comprehensive experience, we encourage you to visit Medicare.gov or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
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Answers

Modified: 9/21/2022
Modified: 9/2/2022
Modified: 9/3/2022
Modified: 9/22/2022
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 9/11/2022
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 8/18/2022
Modified: 8/29/2022
Modified: 9/9/2022
Question relating to CMS guidelines regarding use of ABN in relation to ambulance services.
Modified: 9/8/2022
FAQ regarding signature requirements on ambulance claims
Modified: 9/8/2022
The AMA – CPT E/M Office Revisions – Level of medical decision making table indicates *Each unique test, order, or document contributes to the combination of two or combination of three in Category 1.
Modified: 7/13/2022
Questions and answers pertaining to Medicare Part A/B appeals and redeterminations.
Modified: 7/28/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 7/21/2022
Modified: 7/21/2022
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 7/21/2022
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 6/14/2022
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 7/13/2022
Modified: 9/8/2022
This field is not required to use the score sheet. It was added to allow the user to enter the patient name, or any other patient-specific identifying information for printing and/or filing purposes only.
Modified: 7/28/2022
Question and answer pertaining to services which can be billed "incident to" another provider's service.
Modified: 7/28/2022
Modified: 8/23/2022
Question and answer pertaining to services which can be billed "incident to" another provider's service.
Modified: 7/7/2022
Question and answer referencing mailing address for CMS-1500 paper claim form.
Modified: 7/29/2022
Question and answer pertaining to Medicare enrollment applications.
Modified: 7/8/2022
Question and answer pertaining to early offset of a demanded debt.
Modified: 7/8/2022
Modified: 8/3/2022
Questions and answers pertaining to Medicare Part B appeals and redeterminations.
Modified: 8/9/2022
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 8/9/2022
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 7/8/2022
Modified: 7/8/2022
Question and answer pertaining to entering place of service (POS) codes on claims.
Modified: 7/8/2022
Question and answer regarding the indication of an anti-markup diagnostic service on a claim.
Modified: 8/5/2022
Question and answer pertaining to indicating provider numbers on claims.
Modified: 8/5/2022
Question and answer regarding the indication of rendering physician billing numbers on claims.
Modified: 7/8/2022
Question and answer about reporting service facility location information on a claim.
Modified: 7/13/2022
Modified: 8/29/2022
How to avoid RUCs [First Coast Education Action Team]
Modified: 9/27/2022
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims were rejected as unprocessable with tips and resources to help you avoid many of these errors. [First Coast Education Action Team]
Modified: 9/20/2022
Modified: 9/7/2022
Modified: 9/2/2022
Modified: 7/8/2022
Question and answer pertaining to timely filing of claims.
Modified: 6/14/2022
Modified: 6/14/2022
Modified: 7/8/2022
Modified: 6/14/2022
Modified: 6/14/2022
Modified: 6/14/2022
Modified: 6/14/2022
Modified: 7/13/2022
Questions and answers pertaining to ambulance services.
Modified: 7/21/2022
Modified: 9/30/2022
Question and answer regarding denial reason code 54MUE.
Modified: 8/25/2022
Modified: 7/21/2022
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims denied with tips and resources to help you avoid many of these errors.
Modified: 7/21/2022
[First Coast Education Action Team]
Modified: 7/22/2022
[First Coast Education Action Team]
Modified: 7/22/2022
[First Coast Education Action Team]
Modified: 7/21/2022
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims denied with tips and resources to help you avoid many of these errors.
Modified: 8/6/2022
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims denied with tips and resources to help you avoid many of these errors.
Modified: 6/14/2022
Question and answer pertaining to ANSI code OA-18.
Modified: 7/22/2022
[First Coast Education Action Team]
Modified: 8/18/2022
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims denied with tips and resources to help you avoid many of these errors.
Modified: 9/28/2022
Modified: 8/9/2022
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 7/29/2022
Modified: 8/26/2022
Modified: 8/30/2022
Modified: 7/21/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 8/5/2022
Submitted in response to provider E/M inquiries
Modified: 8/23/2022
Submitted in response to provider E/M inquiries
Modified: 7/13/2022
Submitted in response to provider E/M inquiries
Modified: 7/8/2022
Submitted in response to provider E/M inquiries
Modified: 8/9/2022
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 6/16/2022
Modified: 9/3/2022
Modified: 8/4/2022
[CR 6417]
Modified: 7/27/2022
Questions and answers pertaining to the 2% reduction in Medicare payments due to federal sequestration.
Modified: 9/23/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 7/24/2022
Here is a question relating to use of GY modifier on ambulance claims, if dual diagnosis requirement still applies.
Modified: 8/5/2022
Modifier 24 FAQ #6
Modified: 9/8/2022
Modified: 7/14/2022
Experiencing issues when logging into your First Coast University training account? This FAQ will help get you logged in.
Modified: 7/24/2022
Question and answer pertaining to services which can be billed incident to another provider's service.
Modified: 7/25/2022
Modified: 9/21/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 7/25/2022
Modified: 9/2/2022
Modified: 7/5/2022
return documentation, medical records
Modified: 7/25/2022
Modified: 9/3/2022
Modified: 7/14/2022
Question and answer pertaining to how providers can determine when Medciare is the secondary payer. [CMS website]
Modified: 10/4/2022
TPE selection process
Modified: 10/4/2022
return documentation, medical records
Modified: 7/25/2022
Modified: 7/23/2022
Question and answer pertaining to how Medicare secondary payment is determined.
Modified: 7/5/2022
error rate
Modified: 9/2/2022
Modified: 9/9/2022
Question and answer pertaining to Internet-based PECOS.
Modified: 7/14/2022
Modified: 9/3/2022
Modified: 9/2/2022
Modified: 9/9/2022
Modified: 10/4/2022
review results
Modified: 7/25/2022
Modified: 9/3/2022
Modified: 9/2/2022
Modified: 8/19/2022
Modified: 8/19/2022
Modified: 10/4/2022
education call attempts
Modified: 9/21/2022
Modified: 8/29/2022
Changed year of service for the example to 2022. Also changed the link for the source SE1117. Document was moved to the CMS archives
Modified: 9/20/2022
Modified: 7/14/2022
Modified: 7/21/2022
Answer to the question regarding a timetable for coding inpatient cost outlier claims.
Modified: 7/25/2022
Modified: 7/22/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 9/2/2022
Learn how easy it is to search for a beneficiary's Medicare Beneficiary Identifier (MBI) in SPOT.
Modified: 9/2/2022
Modified: 9/3/2022
Modified: 9/2/2022
Modified: 9/2/2022
Modified: 7/13/2022
Question regarding changes made to consolidated billing for ambulance transport for skilled nursing facility residents according to transmittal MM10550.
Modified: 8/5/2022
Modified: 9/3/2022
Modified: 7/17/2022
Questions and answers pertaining to Medicare secondary payer claims.
Modified: 7/13/2022
Questions and answers pertaining to specific modifiers.
Modified: 7/13/2022
Questions and answers pertaining to specific modifiers.
Modified: 7/13/2022
Questions and answers pertaining to specific modifiers.
Modified: 7/13/2022
Modifier 24 FAQ #2
Modified: 9/2/2022
Modified: 9/2/2022
Modified: 9/4/2022
Modified: 7/8/2022
Modified: 8/5/2022
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 7/24/2022
E/M FAQ question number 13
Modified: 7/29/2022
Modified: 8/26/2022
Modified: 8/26/2022
Modified: 7/22/2022
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims were returned as unprocessable (RUC) with tips and resources to help you avoid many of these errors.
Modified: 9/3/2022
Modified: 7/8/2022
Modified: 9/8/2022
The worksheet will only provide a suggested code for the E/M level of service. A note will populate alerting you that the service may qualify for additional prolonged services with a link to the prolonged service information.
Modified: 9/28/2022
Question and answer pertaining to Medicare enrollment applications.
Modified: 9/28/2022
Question and answer pertaining to Internet-based PECOS.
Modified: 8/25/2022
Questions and answers pertaining to Part A provider enrollment issues, including electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 8/9/2022
Question and answer pertaining to providers that need to enroll in a different state using Internet-based PECOS.
Modified: 8/25/2022
Modified: 9/3/2022
Modified: 9/2/2022
Modified: 7/13/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 9/5/2022
Modified: 7/19/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 6/14/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 8/4/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 8/6/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims. [First Coast's Education Action Team]
Modified: 9/9/2022
[First Coast Provider Outreach and Education]
Modified: 8/18/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 7/22/2022
Modified: 7/17/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 9/23/2022
Question and answer pertaining to CARC CO 144
Modified: 7/17/2022
When responding to a CERT request for medical records, can records from a referring or consulting physician be included? [First Coast Provider Outreach and Education]
Modified: 7/28/2022
Modified: 7/22/2022
Revised, no comments
Modified: 7/13/2022
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 8/5/2022
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 8/29/2022
To help you increase the number of claims that pass through edits and into processing, here are the top reasons for rejected claims as well as tips and resources to help you avoid many of these errors.
Modified: 8/30/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 8/5/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 8/18/2022
Questions and answers pertaining to hospice.
Modified: 8/30/2022
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 9/2/2022
Modified: 9/2/2022
Modified: 9/23/2022
Question and answer pertaining to Medicare enrollment applications.
Modified: 9/9/2022
Some modifiers, procedure codes, and denial codes are ineligible for clerical claim reopenings in SPOT. This article provides specifics.
Modified: 9/21/2022
Modified: 6/30/2022
changed the question to We received a claim rejected as unprocessable (RUC) with claim adjustment reason code (CARC) CO 16. What steps can we take to avoid this RUC code? Also changed the word return for the word rejected in the third paragraph
Modified: 8/6/2022
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 7/17/2022
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims were returned as unprocessable (RUC) with tips and resources to help you avoid many of these errors.
Modified: 7/17/2022
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims were returned as unprocessable (RUC) with tips and resources to help you avoid many of these errors.
Modified: 9/2/2022
Modified: 9/2/2022
SPOT users who are receiving an error message upon login should follow these steps to resolve access issues.
Modified: 9/2/2022
Modified: 9/3/2022
If SPOT users become inactive, they risk losing their access. Be sure to log in to SPOT at least once every 30 days.
Modified: 9/3/2022
Modified: 9/3/2022
Modified: 7/21/2022
Question and answer cost outlier claims.
Modified: 7/5/2022
Modified: 9/8/2022
Modified: 7/24/2022
Modified: 7/29/2022
Modified: 8/25/2022
Modified: 9/8/2022
It is suggested to score both the time and medical decision making to allow billing of the highest scoring component.
Modified: 9/8/2022
The worksheet allows for multiple start and end times to be entered. The worksheet will calculate the total time. Be sure to click “add” to enter multiple start and end times.
Modified: 9/8/2022
The office/outpatient scoring allows you to enter the total time or start and end times.
Modified: 7/8/2022
Modified: 7/29/2022
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 7/19/2022
Modified: 9/22/2022
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 8/12/2022
Question and answer pertaining to what actions providers take to appeal an overpayment for an MSP claim and stop the AR offset.
Modified: 8/3/2022
Question and answer pertaining to what actions providers take to appeal an overpayment for an MSP claim and stop the AR offset.
Modified: 7/14/2022
Question and answer pertaining to a duplicate primary payment.
Modified: 7/14/2022
Question and answer pertaining to an overpaid claim.
Modified: 7/8/2022
Question and answer pertaining to receiving an overpayment letter.
Modified: 7/14/2022
Question and answer pertaining to what form providers use to notify Medicare of a MSP overpayment.
Modified: 9/16/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 8/17/2022
Question and answer pertaining to a redetermination or reconsideration appeal requested.
Modified: 7/25/2022
TPE appeals
Modified: 7/25/2022
Modified: 7/14/2022
Question and answer pertaining to what if an MSP refund is made but the other insurer’s EOB is not sent with the payment.
Modified: 7/14/2022
Question and answer pertaining to what providers must do when refund is not made when notifying Medicare of a DPP.
Modified: 7/8/2022
Question and answer pertaining to an overpayment refund that cannot be made at one time.
Modified: 7/14/2022
Question and answer pertaining to what MSP is.
Modified: 10/4/2022
Modified: 7/25/2022
Modified: 7/8/2022
Question and answer pertaining to what providers must do when a duplicate primary payment is received.
Modified: 7/25/2022
Modified: 9/14/2022
Modified: 10/4/2022
resources, policies, references
Modified: 9/2/2022
Modified: 7/21/2022
Question and answer to cost outlier claims.
Modified: 7/21/2022
Answer to the question of when OSC 70 should be used for cost outlier claims.
Modified: 4/24/2022
LCD, NCD
Modified: 9/23/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 9/22/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 9/22/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 7/28/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 9/21/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 7/28/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 7/28/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 9/22/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 9/23/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 9/22/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 9/22/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 7/22/2022
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 10/4/2022
additional documentation request
Modified: 8/4/2022
Question and answer regarding the indication of referring provider information on claims.
Modified: 7/14/2022
Question and answer pertaining to what the BCRC is.
Modified: 9/8/2022
The icons are clickable informational links to assist you with understanding the term used in the score sheet.
Modified: 9/2/2022
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.