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Auxilary Aids & Services

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Jurisdiction 11 Part B
Frequently Asked Questions

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How can I search local coverage determinations (LCD) for a specific CPT/HCPCS code?08/21/2015
My claim for post-operative services billed with modifier 55 was rejected, what information was missing?08/19/2015
Why was the post-operative care service I billed with modifier 55 underpaid?08/19/2015
Are we required to complete the ICD Indicator field in Item 21 of the CMS-1500 (02/12) claim form?08/18/2015
My paper claim was returned with a letter because I submitted a PTAN on the claim. Why wasn't my claim processed?07/22/2015
Who are the medical directors for Palmetto GBA?07/01/2015
Are Critical Access Hospitals (CAHs) subject to the outpatient therapy caps and thresholds in 2013?06/19/2015
As a non-participating provider, why can I not charge up to the limiting charge if I accept assignment?06/19/2015
Can a travel allowance fee be charged for medically necessary specimen collection from a nursing home or homebound patient?06/19/2015
Can an Anesthesiologist Assistant (AA) append HCPCS modifier QZ to an aesthesia service?06/19/2015
Can an attending physician and an office physician both submit a claim for their services?06/19/2015
Can an audiology service performed by an audiologist (technician) be submitted under the ENT physician's provider number when the ENT physician is out of the office on vacation? Could this be an example of 'incident to' services?06/19/2015
Can I appeal an outpatient therapy threshold prior authorization decision?06/19/2015
Can I submit an established patient code if the minimal documentation requirements are not met for a new patient code?06/19/2015
Can I submit ICD10 test files with my existing Submitter ID or do I have to obtain a new one?06/19/2015
Can physical and occupational therapists both provide services to one patient at the same time?06/19/2015
Can providers of the same specialty/same group bill for critical care add on codes on the same date of service?06/19/2015
Can the modifier that indicates 'increased procedural services' be submitted with an E/M service when a physician spends an extended amount of time with a patient?06/19/2015
Can we fax a primary payer's Explanation of Benefits (EOB) for Medicare Secondary Payer (MSP) claims using the fax attachments for electronic claims process described in the Medicare Advisory?06/19/2015
Can you clarify the minimum amount of time to establish the apnea-hypopnea index (AHI)? Is it two hours of recorded time or two hours of sleep time?06/19/2015
Could a situation exist where Medicare would not be secondary even if the person has an Employer Group Health Plan (EGHP)?06/19/2015
Do I need to send documentation for prolonged care code with each claim?06/19/2015
Does Palmetto GBA consider Coumadin or Heparin a 'drug requiring intensive monitoring for toxicity'?06/19/2015
Does Palmetto GBA cover electromagnetic wound therapy when delivered using MicroVas?06/19/2015
Does Palmetto GBA monitor the use of locum tenens HCPCS modifier Q6?06/19/2015
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last updated on 8/01/2015
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