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Read this article for tips on how to prevent claim adjustment reason code (CARC) PR 96.
Review the top denial/partial denial reasons and high-level results from each round of DRG 226 and 267 TPE.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for transitional care management (TCM) services.
Definitions of par fee, nonpar fee, and limiting charge in the Medicare Physician Fee Schedule.
How to find policy indicators such as global days for a service, relative value units (RVUs) for a particular code, and more.
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.
When a patient enrolls in or disenrolls from a Medicare Advantage plan during his/her inpatient stay, the following factors will determine whether to bill the Medicare Advantage plan and/or original Medicare.
There are special billing guidelines to follow when the beneficiary becomes entitled to Part A benefits in the middle of an inpatient stay.
View the qualification and documentation requirements for becoming a Medicare-enrolled clinical nurse specialist.
Access all of our self-service tools here.