Medical policy
Prior authorization for ambulance transports is for repetitive transports
A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a 10-day period OR at least once per week for at least three weeks.…
Prior authorization for ambulance transports is for repetitive transports
A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a 10-day period OR at least once per week for at least three weeks.…
New FastTrack to Medicare coverage policies tool
Do you find it challenging to identify a Medicare coverage policy concerning a particular item or service? Not sure what to do if a Medicare coverage policy doesn’t exist? A new FastTrack to Medicare…
New FastTrack to Medicare coverage policies tool
Do you find it challenging to identify a Medicare coverage policy concerning a particular item or service? Not sure what to do if a Medicare coverage policy doesn’t exist? A new FastTrack to Medicare…
No Medicare policies identified
In the absence of a LCD, NCD, billing and coding article or CMS manual instruction, NCCI or MUE, reasonable and necessary guidelines still apply. Read this article to learn more.
No Medicare policies identified
In the absence of a LCD, NCD, billing and coding article or CMS manual instruction, NCCI or MUE, reasonable and necessary guidelines still apply. Read this article to learn more.
Billing for Rebyota fecal microbiota, live-jslm, HCPCS code J1440 -- Avoid rejections
Previous instructions to bill Rebyota fecal microbiota, live-jslm with HCPCS G0455, expired effective June 30, 2023. Instead, providers shall bill HCPCS code J1440 on the same claim with HCPCS 0780T…
Billing for Rebyota fecal microbiota, live-jslm, HCPCS code J1440 -- Avoid rejections
Previous instructions to bill Rebyota fecal microbiota, live-jslm with HCPCS G0455, expired effective June 30, 2023. Instead, providers shall bill HCPCS code J1440 on the same claim with HCPCS 0780T…
Reporting the national drug code
Read this article for helpful information to report the national drug code on claims.
Locate guidelines on the CMS website
A procedure can have other policies or guidelines besides an LCD or NCD. The CMS website has a wealth of information. Read this article for more information.