Sep 8, 2015 | Medical billing basics
Provider Enrollment The provider enrollment process is a critical function that assures only qualified and eligible providers are enrolled in the Medicare program. Physicians and non-physician practitioners (NPPs) who provide services to Medicare beneficiaries must...
Sep 7, 2015 | Medical billing basics
What is the difference between LCDs and NCDs? A. Local coverage determinations (LCDs) for a specific jurisdiction are developed by the Medicare Administrative Contractor (MAC) assigned to that jurisdiction. First Coast Service Options Inc. is the MAC for Florida,...
Sep 2, 2015 | Medical billing basics
99233 Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least two of these three key components: a detailed interval history; a detailed examination; medical decision making of high complexity. Counseling and/or...
Aug 28, 2015 | Medical billing basics
Medicare Coverage of Ultrasound Screening for Abdominal Aortic Aneurysms (AAA) and Screening Fecal-Occult Blood Tests (FOBT) 82270-82274 Provider Types Affected This MLN Matters Article is intended for physicians, physician assistants, nurse practitioners and clinical...
Aug 21, 2015 | Medical billing basics
First Coast Service Options Inc. (First Coast) recently conducted data analysis due to the high comprehensive error rate testing (CERT) error rates for evaluation and management services pertaining to Current Procedural Terminology®(CPT®) codes 99223(initial hospital...
Aug 14, 2015 | Medical billing basics
The Centers for Medicare & Medicaid Services (CMS) finalized new rules which require physicians and, when applicable, other eligible professionals who write prescriptions for Part D drugs to be enrolled in an approved status or to have a valid opt-out affidavit on...
Aug 6, 2015 | Medical billing basics
Summary The Provider Enrollment, Chain, and Ownership System (PECOS) allow the contractor to verify all national provider identifiers (NPIs), regardless of the jurisdiction in which they are enrolled. Beginning April 1, 2015, physicians and suppliers billing...
Jul 31, 2015 | Medical billing basics
List of Valid ICD-10-CM Codes CMS has posted a complete list of the 2016 ICD-10-CM valid codes and code titles on the 2016 ICD-10-CM and GEMs web page http://www.cms.gov/Medicare/Coding/ICD10/Downloads/2016-Code-Descriptions-in-Tabular-Order.zip . The file is named...
Jul 30, 2015 | Medical billing basics
Provider Types Affected This MLN Matters Article is intended for physicians, providers, and suppliers submitting claims to Medicare Administrative Contractors (MACs), including Home Health & Hospice (HH&H) MACs and Durable Medical Equipment MACs (DME MACs) for...
Jul 22, 2015 | Medical billing basics
What services are included in the global surgery payment? When the physician who furnishes the surgery also furnishes the following services, Medicare includes them in the global surgery payment: •Pre-operative visits after the decision is made to operate. For major...
