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This article provides beneficiary guidelines for submitting claims rendered in Florida, U.S. Virgin Islands, or Puerto Rico.
Breaking news for critical access hospitals (CAHs): CMS has directed MACs to immediately turn off reason codes 31006 and 31007 to give providers time to submit all method II reassignments to their Part A CAHs promptly. Read further to learn…
CAH Part A Method II claims for professional services will return to provider (RTP) if a reassignment isn’t in PECOS. Watch the on-demand learning video, "CAHs Method II Professional Reassignments," for instructions to add reassignments.
To bill correctly under the Outpatient Prospective Payment System (OPPS), please review the addendums* listed below.
Is your facility receiving denials for a claim overlapping a skilled nursing facility (SNF) stay? Claims overlapping with a skilled nursing facility (SNF) stay can occur for several reasons. This article is intended to assist providers with…
Ambulance modifiers identify the place of origin and destination of the ambulance trip and must be included on all ambulance claims.
The JW and JZ modifier policy applies to all drugs separately payable under Medicare Part B described as supplied in a “single-dose” containers. Read this article to understand how these modifiers should be billed.
Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims submitted on October 7, 2024 and after with dates of service June 3, 2024 or later.
These tables display processing issues that are being worked currently or have been resolved recently.
Did you know the leading reason why the Recovery Audit Contractor denies the drug Octagam during a medical review is for lack of documentation? Learn more about preventing unnecessary denials.