The PWK (paperwork) segment of the X12N version 5010 allows for submission of supporting documentation with a version 5010 837 electronic claim. This article details the process for using this option.
Prior authorization (PA) for the ASC prior authorization demonstration is voluntary. However, if a provider elects to bypass PA, applicable ASC claims will be subject to prepayment medical review.
The PAR fax/mail coversheet for ASCs is now available for Florida ASCs participating in the ASC PA demonstration. ASCs in Florida can submit PARs beginning on January 5, 2026, for dates of service (DOS) on or after January 19, 2026.
When billing for rehabilitation therapy services, there are some documentation requirements that must be met to comply with the reasonable and necessary definition.