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Posting Date: 07/25/2023
Attention all OPPS Providers: Provider-Based Department Edits Being Implemented on/after 8/1/2023
Attention All OPPS Providers: Provider-Based Department Table of Contents Edits Being Implemented on/after 8/1/2023 Reason Code 34977: Practice address issue Reason Code 34978: PO and/or PN modifier missing Reason Code 34984: ER [...]
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Posting Date: 07/07/2023
URGENT: Billing Reminders for OPPS Providers with Multiple Service Locations
URGENT: Billing Reminders for OPPS Providers with Multiple Service Locations Table of Contents Urgent: Provider Compliance Required Effective 8/1/2023 Requirements Claim Filing Requirements Final Reminders Related Content [Return to [...]
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Posting Date: 12/17/2019
ESRD Facilities: Clarification for Providing Dialysis Services to Patients Acute Kidney Injury
ESRD Facilities: Clarifications for Providing Dialysis Services to Patients Acute Kidney Injury Effective 1/1/2017. ESRD facilities (hospital-based and freestanding) may furnish renal dialysis services to beneficiaries with AKI (both adult and [...]
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Posting Date: 09/12/2017
JK: Medicare Paid Hospital Providers Twice for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient IPPS Hospital Stays
Medicare Paid Hospital Providers Twice for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient IPPS Hospital Stays Table of Contents Provider Action Payment Window Policy and Under Arrangement Policy [...]
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Posting Date: 12/22/2020
Professional Services During a Patient Hospice Election
Professional Services during a Patient Hospice Election Table of Contents Article Overview Hospice Election Medicare Payment During Hospice Election Determining the Correct Entity to Bill Separately Payable Part B Services Hospice and [...]
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Posting Date: 09/18/2023
Direct Data Entry Users May Need to Adjust Screen Size
Direct Data Entry Users May Need to Adjust Screen Size CMS recently issued Change Request 13138 “Implementation to Expand Monetary Amount Fields Related to Billing and Payment to Accommodate 10-Digits in Length ($99,999,999.99) - Phase 1”. [...]
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Posting Date: 10/14/2021
Drugs and Biologicals - Coverage and Billing
Drugs and Biologicals – Coverage and Billing Medicare Part B will provide coverage for drugs that are furnished “incident to” a physician’s service. Coverage applies to drugs are not usually self-administered by the patients who take them. In [...]
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Posting Date: 02/10/2015
Outpatient Therapy Functional Reporting
Outpatient Therapy Functional Reporting Table of Contents Outpatient Therapy Functional Reporting Reporting Episode - similar to the therapy episode of care Required Functional Reporting Discharge Reporting Unique Functional Reporting [...]
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