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Some clinical laboratories in our jurisdiction are charging patients prior to performing services, a potential assignment violation. This article outlines Medicare regulations and potential penalties applicable to laboratories.
Claims that are returned as unprocessable cannot be appealed. So what do you do with them? An unprocessable claim is one that is filed with incomplete and/or invalid information. This article provides resources for you to diagnose unprocess…
Use this decision flowchart to assist in correctly applying the 79 modifier.
View this information regarding ANSI code OA-18.
CARC 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.
Read this article for tips on how to prevent claim adjustment reason code (CARC) PR 49.
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests pertaining to diagnostic radiology.
Service associates responding to calls via our toll-free service line are not permitted to provide claim status per Medicare regulations.
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for ESRD services.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for Application of skin substitutes. It is not intended to replace the published guidelines. Health ca…