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Introduction to Medicare

March 3, 2026
The Provider Outreach and Education team at First Coast welcomes you to Medicare. Providers are responsible for knowing and following the rules and regulations that apply to all services billed to Medicare under their provider number.

Billing for vein ablation services? Access our LCD guidelines

March 18, 2026
Based on claims reviewed by the recovery audit contractor (RAC), First Coast has identified top denials for services within the category of vein ablation (codes 36475 and 36478) relating to endovenous radiofrequency ablation and laser treat…

Billing instructions for implanted prosthetic devices with HCPCS code C9899: Reason code 32354

March 18, 2026
To promote consistency in the claim submission process, follow these instructions when billing HCPCS code C9899.

Medically Unlikely Edits: Avoid denials and appeals by properly coding the first time

March 25, 2026
First Coast wants you to prevent claim denials or appeals by coding the appropriate number of units correctly the first time.

Prohibition on billing dually eligible individuals enrolled in the Qualified Medicare Beneficiary (QMB) program

May 4, 2026
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.

Critical care services

April 9, 2026
CMS updated guidelines for critical care services effective January 1, 2022. These updates were implemented, and address billing and coding processes.

Process for pathology, laboratory, and other codes

March 11, 2026
Avoid negative impacts to your claims by providing the medical records for the laboratory, pathology and other codes claims submissions indicated in this article. First Coast requests specific documentation with submission of these codes. P…

Multiple procedure payment reduction

May 5, 2026
Medicare applies a MPPR to the payment of select therapy services. The reduction applies to HCPCS codes contained on the list of “always therapy” services, regardless of the type of provider or supplier furnishing the services. Find out the…

Split or shared E/M guidelines: Medicare Claims Processing Manual updates

March 30, 2026
This article summarizes the Medicare E/M guidelines for split or shared E/M services effective in 2024.

Leqembi for monoclonal antibodies directed against amyloid for the treatment of Alzheimer's disease

March 25, 2026
Providers may be billing these services incorrectly. Please review this article and pay close attention to the billing loop and segment information detailed within. The NCT number has been added to the instructions.
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