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This table of MLN Matters articles includes articles released by CMS from July to September.
First Coast has seen an increase in claims for drugs, hemophilia clotting factors, and skin substitutes that exceed the dollar amounts above $99,999.99. Effective for claims received on or after November 6, claims missing the required infor…
These tips are based on questions posed regarding whether to bill an evaluation and management visit on the same day as a procedure or other services with modifier 25.
Trump administration issues request for information, guidance to expand access to real prices.
This edition includes information on the anniversary of the lower cost prescription drug law, seasonal flu vaccine pricing for the 2024-2025 season, increased oropouche virus activity, and more.
Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy),…
Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.
This edition includes information on a new model to target wasteful, inappropriate services in Original Medicare, CY 2026 proposed rules for ESRD and home health, revalidation deadline for skilled nursing facilities, and more.
This edition includes information on dementia care, the skilled nursing facility value-based purchasing program, FY 2025 ICD-10-CM diagnosis codes, and more.
Information pertaining to Part A rehabilitation services, including links to LCDs/NCDs, education, FAQs, provider enrollment, CMS IOMs, and other resources.