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Jurisdiction 11 Part B
Frequently Asked Questions

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Can we bill a patient for a service that denied due to MUE? Should we issue an Advance Beneficiary Notice (ABN) to the patient in this case?12/17/2014
Can we submit an appeal if we disagree with an Medically Unlikely Edit (MUE) denial?12/17/2014
My claim was denied with remittance messages N362 (The number of Days or Units of Service exceeds our acceptable maximum) and 151 (Payment adjusted because the payer deems the information submitted does not support this many/frequency of services). What does that mean?12/17/2014
Our claim was denied for MUE. Can we request a reopening to change the units of service billed?12/17/2014
Where can I see the Medically Unlikely Edit (MUE) value assigned to a CPT or HCPCS code?12/17/2014
Will ICD-10 testing be available for providers that use Palmetto GBA's online service rather than going through a clearinghouse?12/16/2014
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 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
How do I obtain my Continuing Education Unit (CEU) credit from a Palmetto GBA training session I attended?12/11/2014
How do we distinguish test from production submissions?12/11/2014
I heard that 5010 requires a physical address in box 33 and P.O. Boxes are no longer accepted. Is this true?12/11/2014
I received an adjusted claim stating 'Social Security records indicate that this patient was a prisoner when the service was rendered.' The patient is now deceased; how do I find which government entity is responsible for this claim?12/11/2014
I was late to the webcast and missed information presented at the beginning. Is there a way for me to watch the session in its entirety later?12/11/2014
If we pass testing as a submitter, will we be able to submit claims for all our providers without them testing as well?12/11/2014
Is it acceptable to highlight information in the medical records when responding to a Medical Review Additional Documentation Request (ADR)?12/11/2014
Is the 277CA returned for each test submission?12/11/2014
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last updated on 12/01/2014
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