Frequently Asked Questions

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When is a beneficiary eligible for the Annual Wellness Visit? 09/03/2019
When the history of present illness (HPI), review of systems (ROS) and past/family/social history (PFSH) are unobtainable, does a physician have to document the reason why, or can it be inferred by other documentation within the HPI (e.g., patient had severe dementia)? 09/03/2019
When using bilateral procedure modifier, do I always submit "1" in the units field? 09/03/2019
When using the 1995 E/M guidelines, can you add body areas and organ systems together to determine the appropriate level for the examination component? 09/03/2019
When using the Clock Draw test (CDT) to assess the patient's cognitive function as part of the Annual Wellness Visit, do we need to scan the actual paper CDT into the patient's medical record? 09/03/2019
Where can I find information about the New Medicare Cards project? Open in New Window09/03/2019
Where can I see the Medically Unlikely Edit (MUE) value assigned to a CPT or HCPCS code? 09/03/2019
Who are the Comprehensive Error Rate Testing (CERT) contractors? 09/03/2019
Who are the medical directors for Palmetto GBA? 09/03/2019
Why are my claims rejecting Medicare Secondary Payer (MSP) with Reason Code CO-16 and remarks codes MA04 and MA130 and what do I need to do? 09/03/2019
Why are some of our claims denying with message B9 (patient enrolled in hospice)? The services are unrelated to the patient's hospice diagnosis. 09/03/2019
Why can't we get claim status, entitlement or deductible information from a customer service representative? 09/03/2019
Why did Medicare deny my claim indicating that a Skilled Nursing Facility (SNF) is responsible for payment of my service? 09/03/2019
Why isn't a procedure code listed on the Medicare Physician Fee Schedule (MPFS)? 09/03/2019
Why was my office visit denied when billed on the same surgery date of service? 09/03/2019
"Incident To" and Split/Shared Services Frequently Asked Questions 09/03/2019
Quarterly Frequently Asked Questions (FAQs): June 2019 05/27/2019
Quarterly Frequently Asked Questions (FAQs): March 2019 03/28/2019
Quarterly Frequently Asked Questions (FAQs): November 2018 11/20/2018
Quarterly Frequently Asked Questions (FAQs): August 2018 08/13/2018
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