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Read this third quarter edition of the Insider's Guide to learn more about CERT errors for ambulance, chiropractic, and drugs and biological claim reviews.
Read this article for information on billing PrEP for HIV drugs.
CMS is implementing a five-year demonstration project for the prior authorization of certain services provided in Ambulatory Surgical Centers (ASCs) and will be implementing the demonstration in two phases.
Read this article for information about how CERT may grant temporary administrative relief to certain affected providers and suppliers during a disaster.
This edition includes information on adjusting claims for care coordination services, ICD-10 revisions to NCDs, HCPCS application summaries and coding determinations, and more.
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…
The NCCI was implemented to promote national correct coding methodologies and to control improper coding leading to inappropriate payment.
Use this decision flowchart to assist in correctly applying the 25 modifier.
Use this decision flowchart to assist in correctly applying the 57 modifier.