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The MPPR on diagnostic imaging applies when multiple services are furnished by the same physician to the same patient in the same session on the same day. Find out the details here.
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.
Avoid negative impacts to your claims by providing the medical records for the laboratory, pathology and other codes claims submissions indicated in this article. First Coast requests specific documentation with submission of these codes. P…
This article explains how to respond to ADRs.
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…
Conditional payments are Medicare payments for Medicare covered services for which another insurer is primary payer, made under the condition they are subject to repayment if and when the primary payer makes payment.
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.
Read this article for more information on how to bill claims when Medicare is the secondary payer.