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View various sections of the Provider Reimbursement Manual applicable to audit and reimbursement.
First Coast wants you to prevent claim denials or unfavorable redetermination appeal decisions for inpatient SNF services.
Read this article to learn more about the 935 recoupment process.
This is a brief overview of the ESRD PPS.
The CAC is used to supplement the MAC’s internal expertise and to ensure an unbiased and contemporary consideration of “state of the art” technology and science. Please read this fact sheet for more details.
The purpose of the open meeting is to allow interested parties the opportunity to make presentations of information and offer comments related to proposed local coverage determinations (LCDs) and/or the revised portion of a proposed LCD tha…
This gives you a brief overview of the inpatient prospective payment system for acute care hospitals
This defines the criteria for an outlier case and how it is computed.
Previous instructions to bill Rebyota fecal microbiota, live-jslm with HCPCS G0455, expired effective June 30, 2023. Instead, providers shall bill HCPCS code J1440 on the same claim with HCPCS 0780T (fecal microbiota transplantation procedu…
To determine if a claim was medically reviewed, providers should submit the requests correctly.