Latest updates: Billing and coding
Part B billing, payment methodology and documentation requirements for non-sheet skin substitute products
This article outlines billing, payment methodology, and documentation requirements for non-sheet skin substitute products. It clarifies that the appropriate application codes must be submitted on the…
Anatomical modifiers
Procedures performed during separate patient encounters, at separate anatomic sites, or on separate specimens, may require that a modifier be reported. Avoid claim denials or appeals due to incorrect…
Process for CPT category III T codes
Review the revised listing of CPT category III T codes that require documentation to avoid negative impacts to your claims.
Process for CPT category III T codes
Review the revised listing of CPT category III T codes that require documentation to avoid negative impacts to your claims.
Process for pathology, laboratory, and other codes
Avoid negative impacts to your claims by providing the medical records for the laboratory, pathology and other codes claims submissions indicated in this article. First Coast requests specific…
Physician billing for procedures performed in an ASC
Physicians and practitioners performing services in Medicare-participating ambulatory surgical centers (ASCs) are reporting an incorrect place of service (POS) code.
Referring and reference laboratories
View this outline of key definitions, billing responsibilities, and claim submission requirements for referred laboratory services to ensure correct reporting, avoid duplicate billing, and maintain…
Referring and reference laboratories
View this outline of key definitions, billing responsibilities, and claim submission requirements for referred laboratory services to ensure correct reporting, avoid duplicate billing, and maintain…
Process for supplying invoice amount on certain HCPCS codes - avoid rejected claims
The drug codes list and radiopharmaceutical codes lists have been updated.
Hospital off-campus outpatient department reporting requirements
Effective July 6, 2026, outpatient claims with type of bills (TOB) 13X or 14X will be returned to provider (RTP) for reason code 34554 if modifier ER, PO, or PN is billed on all service lines, and…