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First Coast has compiled a list of questions on specific topics that are listed in the CMS IRF RCD Medical Records Review Checklist as well as the Code of Federal Regulations that providers can use as a resource to determine if their docume…
Payment issue affecting end stage renal dialysis services on type of bill 72X.
Due to a claim issue identified, exempt hospital OPDs will be receiving a revised exemption ADR letter with a revised letter fax cover sheet.
CMS covers the implantation of central nervous system stimulators as a therapy for the relief of chronic intractable pain.
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for Drugs and Biologicals.
Claims submitted for a prior authorization request (PAR) that received a provisional affirmation PA decision, including any service that was part of a partially affirmed decision, must include the 14-byte unique tracking number (UTN) number…
CMS is implementing a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020. Review the fax coversheet needed for submission.
CMS has removed CPT codes 64492 and 64495 from the listing of codes requiring prior authorization. View our article to learn more about these changes.
View targeted probe and educate (TPE) round results for clinical laboratory services: culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed CPT 87150.
Review the top denial / partial denial reasons and high-level results listed for DRG 885.