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Jurisdiction 11 Part A

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Is there a 'Returned To Provider' report that is available for providers to print and review?12/16/2014
Palmetto GBA has stated that granular details will be provided when a claim is reviewed and denied by Medical Review. The nurse will notate specific details as to why the claims was denied. What page in the Fiscal Intermediary Shared System (FISS) Direct Data Entry (DDE) can providers review these details?12/16/2014
We sent a claim as Medicare primary and later discovered that another payer is primary to Medicare. When we adjusted the claim to make Medicare secondary with a D7 condition code, the claim was rejected because no payment is reported from the primary. What should we do?12/16/2014
What is a PTAN?12/16/2014
What is the appropriate use of Occurrence code 42?12/16/2014
What is the effective date for the new occurrence code 55 used to report the date of death?12/16/2014
Why are my adjusted claims receiving reason code 30902?12/16/2014
Will ICD-10 testing be available for providers that use Palmetto GBA's online service rather than going through a clearinghouse?12/16/2014
Can we find out if the outpatient therapy cap has been met through the Direct Data Entry system?12/15/2014
FAQs on How to Use Event Registration Portal12/15/2014
How can I determine if the outpatient therapy cap has been met?12/15/2014
I have a lot of claims in 'S' status with reason code 30928. Can someone explain why my claims are being held?12/15/2014
If our claim denies for a Medically Unlikely Edit (MUE), do we have to submit a first level appeal (Redetermination) or can we submit a Clerical Error Reopening Request form instead?12/15/2014
After I receive a 277CA will I receive anything else?12/11/2014
Are Critical Access Hospitals (CAHs) subject to the outpatient therapy caps and thresholds in 2013?12/11/2014
Are there MSP examples available to view?12/11/2014
Can a provider aggregate records and reply to more than one Additional Documentation Request (ADR) for a patient at the same time?12/11/2014
Can an inpatient hospital stay in a Veteran’s Administration (VA) hospital be used to meet the Medicare Skilled Nursing Facility (SNF) 3-day qualifying stay in an inpatient hospital requirement?12/11/2014
Can I appeal an outpatient therapy threshold prior authorization decision?12/11/2014
Can I submit ICD10 test files with my existing Submitter ID or do I have to obtain a new one?12/11/2014
Do you have any recommendations on software specifically for outpatient physical therapy?12/11/2014
Do you know if the physical address requirement is just for Medicare or all insurance?12/11/2014
For physical therapy claims where the service is performed in the patient's home (PS=12), does there need to be a 2310C loop with the patient's home address? If so, does is it need a 9-digit zip code?12/11/2014
How can I search local coverage determinations (LCD) for a specific CPT/HCPCS code?12/11/2014
How Do I Find a Form?12/11/2014
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last updated on 12/01/2014
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