Part B
Before you appeal a claim or request a redetermination
Before you request a redetermination on a denied claim, review these tips to avert delays in payment and save some valuable time.
Before you appeal a claim or request a redetermination
Before you request a redetermination on a denied claim, review these tips to avert delays in payment and save some valuable time.
Appeal reminder for medically unlikely edits (MUEs)
We'd like to remind providers of medical documentation you'll need to submit when filing a redetermination or clerical error reopening for a claim (or line item) denied due to an MUE.
Modifier 52 fact sheet
Effective August 31, 2023, documentation is required for claims submitted with modifier 52. To avoid claim rejects and future appeals due to incorrect claim submissions, we’re providing guidance on…
Modifier 22 fact sheet
Effective August 31, 2023, documentation is required for claims submitted with modifier 22. To avoid claim rejects and future appeals due to incorrect claim submissions, we’re providing guidance on…
Medical decision making and the impact of prescription drug management
Medical decision-making (MDM) is one of the key components used to determine the level of service for Evaluation and Management (E/M) coding. Since 2021, the American Medical Association (AMA) and…