Part B
Ambulatory surgical center (ASC) prior authorization (PA) claim submission guidelines
Prior authorization (PA) for the ASC prior authorization demonstration is voluntary. However, if a provider elects to bypass PA, applicable ASC claims will be subject to prepayment medical review.
Proposed LCDs - submit comments
Please view these guidelines for submitting comments on proposed LCDs.
Proposed LCDs - submit comments
Please view these guidelines for submitting comments on proposed LCDs.
Part B fact sheet: Observation care services
Observation care is a well-defined set of specific, clinically appropriate services, which include ongoing short-term treatment, assessment, and reassessment, furnished while a decision is being made…
Part B fact sheet: Observation care services
Observation care is a well-defined set of specific, clinically appropriate services, which include ongoing short-term treatment, assessment, and reassessment, furnished while a decision is being made…
PWK option allows you to submit documentation with an initial claim
The PWK (paperwork) segment of the X12N version 5010 allows for submission of supporting documentation with a version 5010 837 electronic claim. This article details the process for using this option…
PWK option allows you to submit documentation with an initial claim
The PWK (paperwork) segment of the X12N version 5010 allows for submission of supporting documentation with a version 5010 837 electronic claim. This article details the process for using this option…
Potential assignment violations by clinical laboratories
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…
PC-ACE User Guide: Section 6 - Claim list management
The PC-ACE List Claim form provides a versatile interface from which the user can create, list, modify, print, and otherwise maintain claims.
PC-ACE User Guide: Section 6 - Claim list management
The PC-ACE List Claim form provides a versatile interface from which the user can create, list, modify, print, and otherwise maintain claims.