Latest updates: Claims
Use of JW and JZ Modifiers when Billing for Separately Payable Incident-to Supplies
Effective January 1, 2026, the application of the JW and JZ modifiers has changed for certain skin substitutes per the calendar year (CY) 2026 final rule. This article describes the changes.
Method II critical access hospital: Professional billing requirements for emergency department services
New section, Emergency department procedure codes for Method II CAH, added to the Medicare Claims Processing Manual Pub.100-04, chapter 4, section 250.18.
Avoiding hospice claim rejects
Providers billing Medicare should determine if a patient is enrolled in hospice before billing Medicare Part A. This article has tips on checking patient eligibility and avoiding hospice claim…
Tips to prevent reject reason code C7010
Read this article for tips on how to prevent reject reason code C7010.
Tips to prevent reject reason code U5233
Read this article for tips on how to prevent reject reason code U5233.
Tips to prevent claim adjustment reason code (CARC) CO 97
There are a few scenarios that exist for denial reason code CO 97, as outlined below. Please review the associated remittance advice remark code (RARC) noted on the remittance advice for your claim…
Tips to prevent claim adjustment reason code (CARC) CO 22
This care may be covered by another payer per coordination of benefits. This denial was received because Medicare records indicate that Medicare is the secondary payer.
Tips to prevent reason code 326x4
Review this article if your claim is returning for reason code 326x4.
Avoid negative impacts to your claims -- review LCD L39073 and billing and coding article A58812 pharmacogenomics testing
Important information you must know if you bill for pharmacogenomics testing.