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This article is a reminder for all outpatient claim submitters about how to correctly submit the date of service on the claim.
Medical documentation from ordering physicians plays a vital role in validating medical necessity of ordered laboratory tests.
This article informs you and your vendors about changes that will allow you to request reopening of claims electronically.
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…
CMS provided clarification regarding the Medicare guidance relating to complex administration CPT codes 96401-96549. Please read this article for more information.
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
The January Integrated Outpatient Code Editor (IOCE) expands editing related to manifestation diagnosis codes. Read this article to find out more about the editing.
Review our tutorial and learn how to correctly complete this form to ensure more accurate processing.
You must determine if the services were provided during the covered period of the SNF Part A stay or after the benefits exhausted, since consolidated billing rules may or may not apply.