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  • Posting Date: 07/18/2025
    59118

    Avoiding/Correcting This Error Review reason code 59118 in the Direct Data Entry system for applicable codes. Alternatively, review the latest Change Requests/MLN® Matters articles for relevant ICD-10 updates. The most current MLN Matters [...]

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  • Posting Date: 07/18/2025
    59118

    Avoiding/Correcting This Error Review reason code 59118 in the Direct Data Entry system for applicable codes. Alternatively, review the latest Change Requests/MLN® Matters articles for relevant ICD-10 updates. The most current MLN Matters [...]

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  • Posting Date: 07/18/2025
    59301

    Avoiding/Correcting This Error You have the right to submit an appeal when you believe the medical records support that the denied services were reasonable and medically necessary. To prevent similar denials, ensure that all coverage [...]

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  • Posting Date: 07/18/2025
    5ND07

    Avoiding/Correcting This Error To prevent this error, ensure all Medicare coverage and medical necessity requirements are met prior to billing. Providers can visit the CMS Coverage Database to review the NCDs and LCDs to determine the [...]

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  • Posting Date: 07/18/2025
    31836

    Avoiding/Correcting This Error Verify billing and, if appropriate, correct and resubmit the claim for payment. Related Content CMS PFS Look-up Tool Overview

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  • Posting Date: 06/14/2023
    Facet Joint Interventions for Pain Management Best Practices

    Facet Joint Interventions for Pain Management Best Practices Table of Contents Indications and/or Medical Necessity Coverage Documentation Requirements Diagnostic Facet Joint Injections (IA or MBB) Therapeutic Facet Joint Injection [...]

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  • Posting Date: 07/17/2025
    Prior Authorization Outpatient Department Claim Billing

    Prior Authorization Outpatient Department Claim Billing Providers may observe an increase in claim denials for PA services due to a mismatch of information provided on the PAR compared to the information supplied on the claim. Prior [...]

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  • Posting Date: 10/26/2022
    Prior Authorization OPD Alerts

    Prior Authorization OPD Alerts Month/Year Topic July 2025 Prior Authorization Outpatient Department Claim Billing July 2025 Prior Authorization Outpatient Department Exemption and ABN ADRs [...]

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  • Posting Date: 07/18/2025
    52MUE

    Avoiding/Correcting This Error You have the right to submit an appeal when you believe the medical records support that the denied services were reasonable and medically necessary. Providers should review the information on the CMS website [...]

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  • Posting Date: 07/18/2025
    32243

    Avoiding/Correcting This Error Review the claim and either update the charges or remove the line containing zero or blank charges. Return the claim for processing. 

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