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Based on claims reviewed by the recovery audit contractor (RAC), First Coast has identified top denials for services within the category of vein ablation (codes 36475 and 36478) relating to endovenous radiofrequency ablation and laser treat…
Please review this article for details on how to properly bill Medicare secondary payer (MSP) and conditional payment request claims on 837 institutional claims, and the use of occurrence code (OC) 24 and date of denial.
To determine if a claim was medically reviewed, providers should submit the requests correctly.
To promote consistency in the claim submission process, follow these instructions when billing HCPCS code C9899.
To determine if a claim was medically reviewed, providers should submit the requests correctly.
Read this article to learn how to resolve claim rejects for reason code 34963.
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
CMS provided clarification regarding the Medicare guidance relating to complex administration CPT codes 96401-96549. Please read this article for more information.
This article explains how to respond to ADRs.
Are you providing outpatient therapy services on institutional claims and receiving reason code 34963 indicating the attending physician is invalid? Read this article for assistance to resolve your claim returns.