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Am I required to bill with HCPCS modifer JW when reporting waste from a single use drug vial? 12/29/2016
Can HCPCS modifier JW be billed for the discarded amount of a drug from a multi-use vial? 12/29/2016
Can I bill Railroad Medicare for administering a Part D vaccine? 12/29/2016
Does Railroad Medicare cover shingles vaccines? 12/29/2016
Does Railroad Medicare cover TDAP shots? 12/29/2016
Does Railroad Medicare cover tetanus shots? 12/29/2016
What immunizations does Medicare Part B cover? 12/29/2016
What immunizations does Medicare Part D cover? 12/29/2016
When billing a drug with HCPCS modifier JW, should the modifier be applied to the amount of the drug that was administered, the amount discarded, or both? 12/29/2016
Appeals: What happens to an incomplete redetermination request? 12/14/2016
Are chiropractors required to submit therapy codes with both the GP and the GY HCPCS modifiers? 12/14/2016
Are observation codes submitted by the hour or by the calendar date? 12/14/2016
Are we required to complete the ICD Indicator field in Item 21 of the CMS-1500 (02/12) claim form? 12/14/2016
Are we required to submit a claim to Palmetto GBA for maintenance therapy? 12/14/2016
Are we required to submit our Medicare Secondary Payer (MSP) claims electronically? 12/14/2016
Are Your Medicare Secondary Claims Rejecting? 12/14/2016
As a rendering physician, how should I report my NPI on a claim? Do I submit differently if I am a member of a group? 12/14/2016
Benefits Coordination & Recovery Center (BCRC) Contractor Fact Sheet 12/14/2016
By the time you received my refund, you had already offset my claim. Why wasn't my refund returned to me? 12/14/2016
Can a chiropractor use a manual device to assist with manipulation? 12/14/2016
Can a nurse practitioner perform the initial hospital visit? 12/14/2016
Can a provider request immediate offset for voluntary refunds or for solicited overpayments prior to the 40-day interval? 12/14/2016
Can a provider submit a hospital inpatient or office/outpatient evaluation on the same calendar date as a critical service? 12/14/2016
Can a service with the GY HCPCS modifier be appealed? 12/14/2016
Can a single visit be counted as both the IPPE and an AWV? 12/14/2016
Can an ABN (Advance Beneficiary Notice of Noncoverage) be issued for HCPCS code A0427-ALS 1/Emergency Transports? 12/14/2016
Can an evaluation and management (E/M) service be performed as a split/shared service? 12/14/2016
Can ancillary staff that provides a service 'incident to' a physician or non-physician practitioner sign the documentation? 12/14/2016
Can I bill for drug wastage from a multi-dose/multiuse vial or package of drug or biological? 12/14/2016
Can I bill you for sending requested documentation for a prepayment or postpayment review? 12/14/2016
Can I call the Reopening line to change the total number of post-operative days I billed? 12/14/2016
Can I call the Telephone Reopening Line to correct a rejected claim? 12/14/2016
Can I submit a claim with both ICD-9-CM and ICD-10-CM codes? 12/14/2016
Can I submit a subsequent hospital visit if my documentation does not support one of the three levels of an initial hospital visit? 12/14/2016
Can I submit a subsequent nursing facility CPT code if my documentation does not support one of the three levels of initial nursing facility services? 12/14/2016
Can I submit a voluntary refund request and payment electronically via eServices? 12/14/2016
Can I use an ABN (Advance Beneficiary Notice of Noncoverage) for chiropractic services? 12/14/2016
Can I use the KX HCPCS modifier when filing claims to Railroad Medicare for charges that exceed the therapy cap? 12/14/2016
Can incident to occur in place of service (POS) 19 or 22 (outpatient hospital)? 12/14/2016
Can other medical services be performed at the same time as an AWV? If so, how are they coded? 12/14/2016
Can Railroad Medicare beneficiaries have coverage through a Medicare Advantage plan? 12/14/2016
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? 12/14/2016
Can time alone be used to select an E/M code? 12/14/2016
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? 12/14/2016
Can we combine two different problems/diagnoses to obtain the HPI or can we only use one problem? 12/14/2016
Can we utilize the 'status of three or more chronic/inactive conditions' as an extended History of Present Illness (HPI) for the 1995 guidelines? 12/14/2016
CMS ICD-10-CM/PCS Frequently Asked Questions Open in New Window12/14/2016
Do I need to obtain preapproval or precertification before I provide a Part B service to a Railroad Medicare patient? 12/14/2016
Do subsequent chiropractic visits need new treatment plans? 12/14/2016
Do you have a coding question? 12/14/2016
Do you have questions about portal verification films? 12/14/2016
Does a beneficiary need to sign an Advance Beneficiary of Noncoverage (ABN) for every visit? 12/14/2016
Does an order for a diagnostic test have to be delivered in writing? 12/14/2016
Does it matter what position modifiers are submitted on an anesthesia claim? 12/14/2016
Does it matter what position pricing modifiers are submitted on a claim? 12/14/2016
Does Medicare allow providers to bill a patient for a missed appointment? 12/14/2016
Does Medicare reimburse for ambulance transportation to and from a physician's office? 12/14/2016
Does Railroad Medicare have Local Coverage Determinations (LCDs)? 12/14/2016
Does time need to be documented in order to submit for a hospital or nursing facility discharge service? 12/14/2016
Generally speaking, when we say 'objective measures,' what does that mean? 12/14/2016
Generally speaking, when we say a 'treatment plan with specific goals', what does that mean? 12/14/2016
How can I check the status of my Appeal request submitted through eServices? 12/14/2016
How can I get a duplicate remittance notice? 12/14/2016
How do I access Immediate Offset and electronic payments for Medicare overpayments and voluntary refunds in eServices? 12/14/2016
How do I address Chiropractic treatment goals if I see the patient once and no further treatment is necessary? 12/14/2016
How do I bill chiropractic manipulative treatment correctly? 12/14/2016
How Do I Find a Form? 12/14/2016
How do I indicate the ICD-CM diagnosis type billed on my claim? 12/14/2016
How do I make the text larger to make it easier to read? 12/14/2016
How do I obtain my Continuing Education Unit (CEU) credit from a Palmetto GBA training session I attended? 12/14/2016
How do I register for listservs? 12/14/2016
How do I request immediate offset on an established overpayment due to Railroad Medicare? 12/14/2016
How do I submit an Appeal online? 12/14/2016
How do I upload attachments to an Appeal request? 12/14/2016
How do I verify the effective date of my electronic fund transfer (EFT)? 12/14/2016
How do you determine if an ambulance transport is considered emergent? 12/14/2016
How does a chiropractor submit a claim for an office visit and X-rays to Medicare for the denial of statutorily excluded services for the patient's secondary insurance company? 12/14/2016
How does Palmetto GBA decide when to request documentation, for what and from whom? 12/14/2016
How many units of services should I submit when I am billing a bilateral surgical procedure with CPT modifier 50? 12/14/2016
How should I list the name of the ordering/referring provider when submitting my paper and electronic claims? 12/14/2016
How would I know a Railroad patient is enrolled in a Medicare Advantage plan when they presented their Railroad Medicare Card? 12/14/2016
I've received a demand letter regarding an overpayment for a post pay review, or some other adjustment, in which it was determined that I have been overpaid and a refund is due to Medicare, if I appeal, do I also need to refund the money? 12/14/2016
I am a hospitalist and all records for my services are part of the patient's hospital record. Why do Medicare contractors send me the request for medical records and not the hospital? 12/14/2016
I am submitting an appeal request through eServices. Can I attach an appointment of representative form with my supporting documentation? 12/14/2016
I billed for a chemotherapy drug with HCPCS code J9999 and it denied. Why? 12/14/2016
I billed multiple patients on one ambulance trip with HCPCS modifier GM, why are my claims still being denied? 12/14/2016
I have primary payment for a consultation service. My software does not allow me to change the procedure code to an E/M code that Medicare will accept. Since Medicare no longer accepts consultation codes, can I bill the patient the co-pay from the primary insurance and not submit a claim to Medicare? 12/14/2016
I have received a payment marked PQRS (Physicians Quality Reporting System) from Railroad Medicare, but my remittance shows a negative dollar amount. Is this a recoupment or withholding? 12/14/2016
I need to refund an overpayment to Railroad Medicare. What documentation should I include with my check? 12/14/2016
I noticed a 'multiple procedure' modifier on my remittance advice but I did not submit it. The service was allowed, but should I have included this modifier on my claim? 12/14/2016
I rarely file paper claims and do not want to buy new forms. What are my options? 12/14/2016
I received a letter from Medical Review requesting supporting documentation for a claim. What form should I use when returning the requested information? 12/14/2016
I received a letter saying I have to file claims electronically with Railroad Medicare and references 'ASCA'. What does 'ASCA' mean? 12/14/2016
I sent a written request to Railroad Medicare, and it was returned stating I didn't include enough information. What information does Railroad Medicare need to answer my written inquiries? 12/14/2016
I sent my claim to Railroad Medicare but the IVR and eServices indicate that it is not on file. Should I call and ask a representative to search for the claim? 12/14/2016
I submitted an assigned claim. Why was the payment sent to the patient? 12/14/2016
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? 12/14/2016
If a paramedic (not an EMT) is requested for a transport (emergent or non-emergent), but no advanced life support (ALS) procedures are performed is it considered an ALS transport? 12/14/2016
If a patient had one system complaint that was documented for the review of systems (ROS) and then the provider documented: 'patient has no other complaints', is that enough to receive a complete ROS? 12/14/2016
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? 12/14/2016
If a patient presents to the office for an injection or venipuncture, would it be acceptable to submit an office or other outpatient visit CPT code? 12/14/2016
If a physician has recorded a review of systems (ROS) and past, family and social history (PFSH) on a previous encounter, does the physician need to re-record this information? 12/14/2016
If a provider administers Tylenol in the emergency room, is the level of risk considered 'low' under management option(s)? 12/14/2016
If a provider sees a new patient and performs a comprehensive history, does the comprehensive history warrant submitting a higher level service? 12/14/2016
If an ambulance is dispatched as a result of a 911 call, arrives at the scene, does an assessment of the patient and it is found there is no need for the transport, would the Advanced Beneficiary Notice (ABN) be used in this case if we intend to bill the patient? 12/14/2016
If an established patient presents to the office for a visit with a non-physician practitioner (NPP), and during the encounter the patient has a new problem/condition, can this service be submitted 'incident to'? What if the NPP only orders tests, but does not establish a plan of care? 12/14/2016
If another provider admits a patient into Observation Care and I provide a consult, can I bill the observation care code? 12/14/2016
If I document 'no edema present' or 'Extremities: No edema noted,' would 'credit' be given for both upper and lower extremities? 12/14/2016
If I provide a statutorily excluded service am I required to have the patient sign an ABN? 12/14/2016
If Medicare determines that my records are not legible, will you treat this as if no documentation is available? 12/14/2016
If my claim is denied for failure to submit requested documentation within 45 days of an Additional Documentation Request (ADR), should I submit a new claim and attach the requested documentation with the new claim? 12/14/2016
If my patient is registered in the emergency department and I am asked to see him/her, may I submit the emergency service? 12/14/2016
If the patient's secondary insurance is requiring a denial from Medicare for services that are statutorily non-covered, how does a chiropractor submit a claim for an office visit and X-rays to Medicare for denial? 12/14/2016
If the physician elects to report the level of service based on counseling and/or coordination of care, does the total length of time of the encounter (face-to-face or floor time, as appropriate) need to be documented? 12/14/2016
In my notes, I documented pain and muscle spasm in the lumbar region at L2-L3, but my claim denied due to an incomplete P.A.R.T. exam. Can you explain why? 12/14/2016
In the E/M documentation guidelines, what does 'more detail' regarding the exam mean, and what is the difference between an expanded problem-focused exam and detailed exam? 12/14/2016
In the Table of Risk, under the diagnostic procedures ordered, where would you give credit for collecting a Pap smear? 12/14/2016
Incarcerated Beneficiary Claim Denial: Frequently Asked Questions 12/14/2016
Is a chiropractor required to submit claims for non-covered services, such as an office visit, and how do I know if the patient's secondary insurance will consider the service if Medicare does not cover it? 12/14/2016
Is a supervising physician's signature required for services performed by a physician assistant in the emergency department? 12/14/2016
Is an intravenous insulin drip considered a 'drug requiring intensive monitoring for toxicity' under the Table of Risk? 12/14/2016
Is Coumadin or Heparin considered a 'drug requiring intensive monitoring for toxicity' under the Table of Risk? 12/14/2016
Is it acceptable to document 'VSS' (vital signs stable)? How many vital signs must be listed in order to receive 'credit' for the 1995 guidelines under 'constitutional'? 12/14/2016
Is it acceptable to highlight information in the medical records when responding to a Medical Review Additional Documentation Request (ADR)? 12/14/2016
Is it acceptable to use 'noncontributory, unremarkable or negative' when reporting past, family or social history? 12/14/2016
Is the Annual Wellness Visit (AWV) the same as a beneficiary's yearly physical? 12/14/2016
Is the Beneficiary Signature required for emergency ambulance transports? 12/14/2016
Is the webcast audio available to attendees by telephone? 12/14/2016
Is there a deductible or coinsurance/copayment for the Annual Wellness Visit (AWV)? 12/14/2016
May we fax documentation in response to Additional Documentation Request (ADR) letters? 12/14/2016
Medicare Secondary Payer (MSP) Frequently Asked Questions 12/14/2016
Must a problem be new to the patient or new to the provider in order for it to be considered a 'new problem' when scoring diagnosis/management options for an evaluation and management (E/M) service? 12/14/2016
My claim denied due to an MUE, how do I request a review of MUE limits? 12/14/2016
My claim denied for timely filing. When can timely filing be waived? 12/14/2016
My claim for post-operative services billed with modifier 55 was rejected, what information was missing? 12/14/2016
My claim rejected with a remittance message code MA83, saying: 'Did not indicate whether we are the primary or the secondary payer?' What does this mean? 12/14/2016
My claim rejected with remittance message MA116 - Did not complete the statement 'Homebound' on the claim to validate whether laboratory services were performed at home or in an institution. Where do I put 'Homebound' on a claim? 12/14/2016
My claim was denied with remittance messages 183 and N574? I submitted the name and NPI of the ordering/referring provider. What is wrong? 12/14/2016
My claim was denied with remittance messages N264 and N575. I submitted the name and NPI of the ordering/referring provider. What is wrong? 12/14/2016
My claims are denying because Medicare records show another insurance should be paying as primary to Medicare. The patient has recently retired and says the insurance has ended. Who can I call to get the patient's Medicare record updated? 12/14/2016
My electronic claim was rejected with remittance message N265? What information was missing? 12/14/2016
My electronic claims are rejecting with remittance message N198 - Rendering provider must be affiliated with the pay-to provider. What does that mean? 12/14/2016
My paper claim was rejected with message N34, incorrect claim form/format for this service. What is wrong with my claim form? 12/14/2016
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