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The requirements for the submission of claims under reciprocal billing and fee-for-time compensation arrangements are the same for assigned and non-assigned claims. This article shows when these requirements apply.
Learn the correct pairing of value codes (VC) and payer codes (PC) to use when billing different types of Medicare secondary payer (MSP) claims.
Payment for ambulatory surgical centers (ASCs) are made under a separate payment system. As such, certain modifiers are specific to ASCs. This article explores these modifiers.
Here are additional educational resources identified specifically for hospice and home health care.
Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims submitted on October 7, 2024 and after with dates of service June 3, 2024 or later.
The Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of voluntarily developed and implemented compliance plans. The OIG has supplied guidance as to the elements of a model compliance plan.
Information pertaining to Part A hospitals - Centers for Medicare & Medicaid Services (CMS) internet-only manuals (IOMs).
A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a 10-day period OR at least once per week for at least three weeks. Repetitive ambulance services are often needed…
Facet joint interventions may be used in pain management for chronic cervical/thoracic and lumbar/sacral pain arising from the paravertebral facet joints. Imaging guidance (fluoroscopy or CT per code descriptor) is used to assure accurate p…
The PWK (paperwork) segment of the X12N version 5010 allows for submission of supporting documentation with a version 5010 837 electronic claim. This article details the process for using this option.