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Jurisdiction 11 Part B
Frequently Asked Questions



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How often are CARCs and RARCs updated?07/30/2014
Where can I find a list of CARCs and RARCs?07/30/2014
What are CARCs and RARCs?07/29/2014
Will supporting documentation be required for all adjustments such as paper and electronic claim?07/24/2014
Is AmnioFix covered by Medicare?07/21/2014
If a patient is being transported to a wound care center located within a hospital or on hospital grounds, which destination modifier would be used when filing the claim?07/15/2014
If a patient presents to the office for an injection, infusion or venipuncture, would it be acceptable to submit an office or other outpatient visit CPT code?07/15/2014
If a Physician Quality Reporting System (PQRS) code is separated from the qualifying procedure code and returned as unprocessable, is the PQRS code still reported to CMS?07/15/2014
If a physician talks with a patient about a do not resuscitate (DNR) order and documents his or her discussion, would this be a high-level risk management option under medical decision making even though their prognosis may not be poor?07/15/2014
If an attending physician requests a medical house physician see a patient for a specific problem, can this be submitted as a consultation?07/15/2014
If an established patient exhibits symptoms from which the physician diagnoses the condition and begins treatment by performing a minor procedure on the same day, can we bill an evaluation and management (E/M) service?07/15/2014
If anesthesia begins at 11 p.m. and ends at 12:15 a.m. the next day, what date of service should be used when submitting the claim?07/15/2014
If I am uncertain as to whether Medicare or the CERT contractor can read my doctor's signature may I voluntarily submit a signature log when asked to provide documentation?07/15/2014
If I order a diagnostic test in the office and I independently review the image, tracing or specimen do I receive three points (one for ordering the test and two for independently reviewing)?07/15/2014
If I provide a statutorily excluded service am I required to have the patient sign an ABN?07/15/2014
If Medicare determines that my records are not legible, will you treat this as if no documentation is available?07/15/2014
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?07/15/2014
If our office incorrectly reconstituted Herceptin (Trastuzumab) using sterile water instead of bacteriostatic water, and we are unable to store and use the rest of the vial, can our facility bill for the wasted drug and the administered amount?07/15/2014
If the physician documents that 'the patient was a difficult historian' without further elaboration, is this documentation sufficient?07/15/2014
If the Recovery Audit Contractor (RAC) seeks an overpayment, does the provider have to pay the money back right then or can they file an appeal on the request?07/15/2014
In the following Medicare Secondary Payer calculations, can a patient be billed: primary insurer allowed $200, amount applied to primary insurance deductible was $0, primary insurance paid $160, Medicare allowed amount $100, amount applied to Medicare deductible was $100, and Medicare payment was $0?07/15/2014
Is a chiropractor required to submit claims for non-covered services, such as an office visit? How do I know if the patient's secondary insurance will consider the service if Medicare does not cover it?07/15/2014
Is it appropriate to submit a health and behavior code for a patient that has dementia?07/15/2014
Is the immunosuppressive therapy included in the 90-day global period for kidney transplants?07/15/2014
Is the Part B deductible applied to claims based on the date of service?07/15/2014
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last updated on 8/01/2014
ver 1.0.51