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This article outlines billing, payment methodology, and documentation requirements for non-sheet skin substitute products. It clarifies that the appropriate application codes must be submitted on the same claim to avoid rejection.
This article contains the conversion factors for use in calculating payment for anesthesia services (procedure codes 00100 through 01999) for service dates January 1 through December 31, 2026.
Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).
Review the revised listing of CPT category III T codes that require documentation to avoid negative impacts to your claims.
Are you receiving additional documentation request (ADR) from SafeGuard Services LLC (SGS) or IntegriGuard? SafeGuard Services is responsible for combating and preventing fraud, waste, and abuse in the southeastern jurisdiction, which inclu…
We redesigned our provider specialty page to support independent clinical laboratory providers with accessing policy details, CLIA information, enrollment, claims submission and reimbursement tips, and other valuable resources.
Effective August 31, 2023, documentation is required for claims submitted with modifier 22. To avoid claim rejects and future appeals due to incorrect claim submissions, we’re providing guidance on how to properly submit a claim when applyi…
The principal physician of record appends modifier “-AI” to their initial hospital care or nursing facility visit code. All other physicians who perform an initial evaluation on this patient bill without modifier "-AI" to indicate specialty…
Providers are encouraged to use the KX modifier on 837D claims submitted with dental services inextricably linked to covered medical services. Read this article to learn more.
When a medical reviewer contacts the provider requesting to submit an attestation statement or signature log to authenticate a medical record, the provider must submit the attestation statement or signature log within 20-calendar days.