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This edition includes information on April updates to the Medicare Physician Fee Schedule, vaccine administration national fee schedule, and other updates.
Top denial/ partial denial reasons and high-level results are listed below from each round of Transitional Care Management (TCM) services TPE reviews that have been conducted thus far by Medical Review.
Steps to import a print image file into PC-ACE.
Claims are introduced into PC-ACE by either entering them manually or by importing them from an external source. The claim import method is ideal for facilities that maintain their claims in an upstream claims management system.
View TPE round results for rehabilitation services outpatient (KX modifier).
Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.
Learn how to submit a provider enrollment appeal in the form of a corrective action plan or reconsideration request.
Use these self-service tools and forms related to claims.
Effective July 1, 2026, new billing instructions apply related to no longer submitting the AX modifier and hemodiafiltration and AKI claims.
Read this article for guidance for the treatment of Medicare Part C days in the calculation of a provider's Medicare disproportionate share hospital adjustment.