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Use this decision flowchart to assist in correctly applying the 78 modifier.
Pass-through status is determined for newly FDA-approved drug and device products on an individual basis. Review this article for more details on pass-through devices in an ambulatory surgical center (ASC).
Payment for ambulatory surgical centers (ASCs) are made under a separate payment system. As such, certain modifiers are specific to ASCs. This article explores these modifiers.
Medicare approved the groundbreaking new cell-based gene therapy drug, Encelto, for use in the ambulatory surgical center setting, effective for claims with dates of service on or after October 1, 2025. This article details how to bill for…
Medicare covers behavioral, mental and psychiatric health services that may improve outcomes for Medicare patients. For more information, please view this article and share these valuable resources and references with your patients.
The PWK (paperwork) segment of the X12N version 5010 allows for submission of supporting documentation with a version 5010 837 electronic claim. This article the steps to complete this process.
Find the latest Medicare news identified specifically for opioid treatment programs as well as helpful information, education, and links to CMS resources pertaining to this specialty.
Some clinical laboratories in our jurisdiction are charging patients prior to performing services, a potential assignment violation. This article outlines Medicare regulations and potential penalties applicable to laboratories.
Claims that are returned as unprocessable cannot be appealed. So what do you do with them? An unprocessable claim is one that is filed with incomplete and/or invalid information. This article provides resources for you to diagnose unprocess…
Review this article if your claim is returning for reason code 326x4.