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Can we use the therapy progress notes and/or the plan of care documentation without the Physician or Nurse Practitioner signature to code from for Medicare claims? 10/21/2019
Provider Contact Center (PCC) Frequently Asked Questions (FAQs): January 2018 - April 30, 2018 10/21/2019
What is the timeframe for submitting a claim adjustment? 10/21/2019
Provider Contact Center (PCC) Frequently Asked Questions (FAQs): July 2019 - September 2019 10/17/2019
A Group Health Plan (GHP) has recouped a primary payment on a claim processed over a year old indicating Medicare should have been primary. Will Medicare override timely filing rules and process an adjustment claim? 10/16/2019
A Local Coverage Determination (LCD) is denoted as superseded on the CMS website. Please provide me with the advisory, notice or policy that gives the verbiage which supersedes this LCD. It is rumored that the supporting diagnosis codes have been revised, but there is no record I have found to verify this. 10/16/2019
A PIP hospital provider received a demand letter requesting payment on a RAC DRG change that resulted in an overpayment. If the provider issues a check to Palmetto GBA and the claim is also adjusted in the FISS system, will we not be repaying the amount twice, both in the check issued and then upon cost report settlement? 10/16/2019
Are hospital labs that file institutional claims exempt from the MolDx Program requirements? 10/16/2019
Can a provider bill a skilled nursing facility (SNF) or swing bed (SB) claim if the patient does not have a qualifying hospital stay? 10/16/2019
Claims Overlap FAQs 10/16/2019
For the new A/B Rebilling process, what should be billed on the 13x type of bill (TOB) versus on the 12 TOB? 10/16/2019
How do I bill my claims when a patient revokes or elects hospice coverage during his/her inpatient stay? 10/16/2019
How do I enter three modifiers in Direct Data Entry (DDE)? There is no room to report the third modifier on Page 2 when keying a claim on DDE. 10/16/2019
How do you bill the JW Modifier for the drug amount discarded and/or not administered to the patient if the drug has a Medically Unlikely Edit (MUE)? 10/16/2019
How is the Medicare Advantage (MA) supplemental "wraparound" payment made to Federally Qualified Health Centers? 10/16/2019
How should I submit Medicare claims for Radium Ra-223? 10/16/2019
How should units be billed for outpatient Bevacizumab (Avastin) services? 10/16/2019
I am a provider and need to make a claim adjustment; can I submit a Voluntary Refund Form, include a hard copy check and send it to Finance and Accounting? 10/16/2019
I am receiving reason code W7062, which means 'code not recognized by OPPS; alternative code for same service may be available', on several of our outpatient hospital claims. Where can I find coding guidance? 10/16/2019
I have a claim where all lines are rejected due to reason code 10416. What does this code mean? 10/16/2019
I recently started receiving edits for medical necessity on my clinical trial claims. I am using the V707 diagnosis code. Was there a recent change to this diagnosis code for medical necessity? 10/16/2019
My claim contains HCPCS code C9399 (Unclassified drugs or biologicals), and received reason code 32512 indicating that the associated units must be equal to one. Please explain this reason code. 10/16/2019
Provider Contact Center (PCC) Frequently Asked Questions (FAQs): May 2018 - August 2018 10/16/2019
Provider Contact Center (PCC) Frequently Asked Questions (FAQs): September 2018 - December 2018 10/16/2019
We have a clinical pharmacist onsite that wants to talk to patients about their medications. Can the FQHC bill this service under Medicare Part A as a core visit? 10/16/2019
What conditions will contractors allow for exceptions to and extension of timely filing requirements? 10/16/2019
What is interim billing for prospective payment system hospitals? 10/16/2019
What is the correct billing for drug screens, specifically HCPCS code G0431? 10/16/2019
When is it appropriate to bill 14x Type of Bill (TOB) for lab charges? 10/16/2019
Where can providers find additional information regarding the Recovery Audit Contractor (RAC) process? 10/16/2019
Where is the SNF consolidated billing list? I have researched this on the CMS website and went to the SNF consolidated billing section, but I was never able to locate an actual list that shows any codes. 10/16/2019
Provider Contact Center (PCC) Frequently Asked Questions (FAQs): January 2019 - March 2019 10/09/2019
Provider Contact Center (PCC) Frequently Asked Questions (FAQs): April 2019 - June 2019 10/08/2019
Provider Enrollment Application: Frequently Asked Questions 10/08/2019
Can Medicare Secondary Payer and Tertiary Payer claims be submitted electronically? 10/02/2019
How do I find out why a claim has been returned to the provider (RTP) for correction? 10/02/2019
I have a lot of claims in 'S' status with reason code 30928. Can someone explain why my claims are being held? 10/02/2019
I submitted an electronic adjustment to correct a medically denied line, why was the claim returned to the provider (RTP)? 10/02/2019
What is a PTAN? 10/02/2019
After I receive a 277CA will I receive anything else? 09/19/2019
Can I share my DDE ID? 09/19/2019
How can I tell if I am set up for Electronic Billing? 09/19/2019
How do I reset my DDE password? 09/19/2019
How do I restore a remit file? 09/19/2019
If I have an existing DDE ID with another company, can I request a new ID? 09/19/2019
Is the 277CA returned for each test submission? 09/19/2019
Is the Submitter ID required on the DDE enrollment form? 09/19/2019
PC-ACE Pro32 software FAQs 09/19/2019
What information do I need to have available when calling for Electronic Data Interchange (EDI) assistance? 09/19/2019
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