Medical review

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Targeted probe and educate (TPE) round results: Major hip and knee replacement (DRG 470)

Review the top denial / partial denial reasons and high-level results from each round of DRG 470 TPE.

Targeted probe and educate (TPE) round results: Inpatient rehabilitation facilities (IRF)

Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).

Targeted probe and educate (TPE) round results: Inpatient rehabilitation facilities (IRF)

Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).

Targeted probe and educate (TPE) round results: Clinical laboratory services

View targeted probe and educate (TPE) round results for clinical laboratory services.

Targeted probe and educate (TPE) round results: Clinical laboratory services

View targeted probe and educate (TPE) round results for clinical laboratory services.

How to bill correctly for transcranial magnetic stimulation (TMS) in the treatment of adults with major depressive disorder

First Coast is receiving first-level appeals (redeterminations) based on claim denials for providers not including the ordering psychiatrist on the claim when billing for transcranial magnetic…

How to bill correctly for transcranial magnetic stimulation (TMS) in the treatment of adults with major depressive disorder

First Coast is receiving first-level appeals (redeterminations) based on claim denials for providers not including the ordering psychiatrist on the claim when billing for transcranial magnetic…

Cervical fusion with disc removal

Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for cervical fusion with disc removal if performed…

Cervical fusion with disc removal

Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for cervical fusion with disc removal if performed…

Signature requirements: Guidelines for authentication of Medicare services

CMS requires that any Medicare service provided or ordered must be authenticated by the author - the one who provided or ordered that service. This article outlines acceptable forms of authentication…