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Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims submitted on October 7 and after with dates of service June 3 or later.
CMS is implementing a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020. Review the fax coversheet needed for submission.
Ambulance modifiers identify the place of origin and destination of the ambulance trip and must be included on all ambulance claims.
CMS has removed CPT codes 64492 and 64495 from the listing of codes requiring prior authorization. View our article to learn more about these changes.
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. Repetitive ambulance services are often needed…
A procedure can have other policies or guidelines besides an LCD. Search our website for additional information.
Step 1: Perform a standard search in the First Coast website.
Care plan oversight (CPO) is supervision of patients under care of home health agencies or hospices that require complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of…
The MPPR on diagnostic imaging applies when multiple services are furnished by the same physician to the same patient in the same session on the same day. Find out the details here.
Learn how to take advantage of the features of our exclusive E/M interactive worksheet and find the code that best represents the level of evaluation and management services (E/M) furnished during a patient’s visit.
Change request (CR) 14070, effective June 23, 2025, reflects the addition of POS 19 allowed for preventive services, CR, and ICR services.