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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.
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.
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.
Effective April 1, CMS implemented a new consistency edit to validate the attending physician NPI. Claims are returning with reason code 34963. Read on for more information.
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…