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  • Posting Date: 01/23/2020
    Hospice Cap

    Hospice Cap Table of Contents The Inpatient Day Limitation Aggregate Cap Calculation Beneficiary Count Proportional Method (applies to most hospices) Streamlined Method  [Return to Top] The Inpatient Day Limitation [...]

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  • Posting Date: 10/30/2023
    Proper Use of Modifiers JW and JZ

    Proper Use of Modifiers JW and JZ National Government Services Provider Contact Center has received several inquiries regarding claim denials related to the use of the JW and JZ modifier for drugs/biologicals. As a reminder, effective [...]

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  • Posting Date: 10/28/2014
    Claim Denials for Medically Unnecessary Ambulance Transports: Avoiding Reason Code 55B10

    Claim Denials for Medically Unnecessary Ambulance Transports Table of Contents Claim Denials for Medically Unnecessary Ambulance Transports Medical Necessity and Coverage Guidelines for Ambulance Transport Avoiding Reason Code 55B10 [...]

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  • Posting Date: 09/24/2021
    Inpatient Psychiatric Facilities Billing When Benefits Exhaust Job Aid

    Inpatient Psychiatric Facilities Billing When Benefits Exhaust Job Aid Table of Contents Inpatient Psychiatric Facilities Billing When Benefits Exhaust Job Aid Benefits Exhaust Date Submitting Claims Through the Benefits Exhaust Date [...]

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