Reciprocal billing and fee-for-time compensation arrangements (formerly locum tenens arrangements)
The requirements for the submission of claims under reciprocal billing and fee-for-time compensation arrangements are the same...
Leqembi for monoclonal antibodies directed against amyloid for the treatment of Alzheimer's disease
Providers may be billing these services incorrectly. Please review this article and pay close attention to the billing loop and...
Requesting Medicare secondary payer conditional payments
Conditional payments are Medicare payments for Medicare covered services for which another insurer is primary payer, made under...
Split or shared E/M guidelines: Medicare Claims Processing Manual updates
This article summarizes the Medicare E/M guidelines for split or shared E/M services effective in 2024.
Multiple procedure payment reduction
Medicare applies a MPPR to the payment of select therapy services. The reduction applies to HCPCS codes contained on the list of...
New Fiscal Intermediary Shared System (FISS) consistency edit to validate attending physician NPI
Effective April 1, CMS implemented a new consistency edit to validate the attending physician NPI. Claims are returning with...
Resolve claim return reason code 34963 for outpatient therapy services
Are you providing outpatient therapy services on institutional claims and receiving reason code 34963 indicating the attending...
Medicare requirements on documenting E/M services by teaching physicians
CMS has new guidelines for teaching physicians effective January 1, 2022. These updates were implemented February 15, and...
Responding to additional documentation requests (ADRs)
This article explains how to respond to ADRs.
Process for pathology, laboratory, and other codes
Avoid negative impacts to your claims by providing the medical records for the other code claim submissions indicated in this...