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  • Posting Date: 07/29/2025
    55H2B

    Avoiding/Correcting This Error Ensure the submitted documentation supports the beneficiary is confined to the home. An individual shall be considered “confined to the home” (homebound) if the following two criteria are met:   [...]

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  • Posting Date: 07/29/2025
    55H1L

    Avoiding/Correcting This Error Clinical progress notes should show evidence of a steady decline or downward trajectory in the beneficiary’s clinical status over time. Documentation should be objective, measurable and must support a life [...]

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  • Posting Date: 07/29/2025
    38055

    Avoiding/Correcting This Error Verify the claim history using the FFS/DDE Provider Online system, your remittance advice and/or the CWF to determine the episode claim that is causing the overlap If there are services that should have been [...]

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  • Posting Date: 07/29/2025
    39934

    Avoiding/Correcting This Error You can find line level information by accessing MAP171D in the FISS/DDE Provider Online System: Hit <F2>/<PF2> once or <F11>/<PF11> twice from Claim Page 02 of the claim to access [...]

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  • Posting Date: 07/29/2025
    38050

    Avoiding/Correcting This Error Check your remittance advice or the claims processing system for a previously submitted/processed claim before submitting any new billing.

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  • Posting Date: 07/29/2025
    Collaborative Wheelchair Options and Accessories Webinar Coming September 30, 2025

    Collaborative Wheelchair Options and Accessories Webinar Coming September 30, 2025 This is your opportunity to hear directly from the Medicare contractors regarding Medicare’s criteria necessary for the coverage of wheelchair options and [...]

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  • Posting Date: 07/29/2025
    Learning Medicare Secondary Payer Interactively

    Join us for an interactive learning webinar where you can engage and have fun at the same time! It’s all about learning the Part B Medicare Secondary Payer (MSP) provisions with live case scenarios. Providers will understand their [...]

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  • Posting Date: 02/26/2024
    Ambulance Duplicate Claim Denials

    Ambulance Duplicate Claim Denials Duplicate trips may be reported on the same claim if the ZIP code for the point of pick-up for both trips is the same. If separate claims are submitted for the same beneficiary on the same day with the same [...]

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  • Posting Date: 03/27/2025
    Ambulance Services and the Advance Beneficiary Notice of Noncoverage

    Ambulance Services and the Advance Beneficiary Notice of Noncoverage To follow are Medicare’s guidelines regarding the use of an ABN for ambulance services. Per the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) [...]

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  • Posting Date: 01/31/2015
    Ambulance Transports Included in SNF Consolidated Billing

    Ambulance Transports Included in SNF Consolidated Billing Transport Description Medical Necessity Met Ambulance Billing Modifiers and Other Considerations Who is Responsible for Payment? Reference(s) SNF to [...]

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