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CMS updated guidelines for critical care services effective January 1, 2022. These updates were implemented, and address billing and coding processes.
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…
This article summarizes the Medicare E/M guidelines for split or shared E/M services effective in 2024.
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.
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.
Pricing has been updated for codes 93241, 93243, 93245, and 93247.
First Coast is able to accept Part B dental claims in the 837D electronic claims format. These files may be submitted by dental providers or billing services and clearinghouses after being enrolled for 837D and passing the 837D test file re…
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…
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to prior authorization (PA) may be eligible for exemption. This exemption would remain in effect for a 12-month peri…
Review this checklist to learn about the documentation requirements for medical professionals related to the repetitive, scheduled, non-emergency prior authorization program.