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Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy),…
Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.
This edition includes information on a new model to target wasteful, inappropriate services in Original Medicare, CY 2026 proposed rules for ESRD and home health, revalidation deadline for skilled nursing facilities, and more.
This edition includes information on dementia care, the skilled nursing facility value-based purchasing program, FY 2025 ICD-10-CM diagnosis codes, and more.
This edition includes information for critical access hospitals, skilled nursing facilities, inpatient psychiatric facilities, and more.
View targeted probe and educate (TPE) round results drugs and biologicals (HCPCS J1569).
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for chemotherapy, drugs, biologicals, and injection services.
To ensure that our site meets the needs of providers, we carefully analyze feedback and implement changes to improve customer satisfaction.
This how-to guide offers tips for searching for medical policy information via First Coast’s search tools and the CMS Medicare coverage database (MCD).
We'd like to remind providers of medical documentation you'll need to submit when filing a redetermination or clerical error reopening for a claim (or line item) denied due to an MUE.