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Posting Date: 10/14/2024
Reminder – Beginning 11/18/2024, Beneficiary Eligibility Information Not Offered on the IVR
Reminder – Beginning 11/18/2024, Beneficiary Eligibility Information Not Offered on the IVR To help protect Medicare beneficiaries against fraud, CMS is instructing all MACs to remove beneficiary eligibility information from our IVR [...]
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Inpatient Hospital Issued Notices
Inpatient Hospital Issued Notices Applies to: All hospitals Medicare beneficiaries and hospitals have certain rights and protections related to financial liability and appeals under the Medicare Program. These financial liability and appeal [...]
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Posting Date: 10/31/2022
Modifier Usage
Modifier Usage Table of Contents E/M Services Within a Global Surgical Period – Modifiers 24, 25 and 57 24 – Unrelated E/M Service by the Same Physician During a Postoperative Period 25 – Significant, Separately Identifiable E/M [...]
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Posting Date: 08/05/2022
Proper Use of Modifiers 59 and 91
Proper Use of Modifiers 59 and 91 Table of Contents Modifier 59 Appropriate Usage Inappropriate Usage Modifier 91 Appropriate Usage Inappropriate Usage Additional Information Related Content [Return to Top] [...]
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Posting Date: 08/04/2022
Repeat Procedures - Modifiers 76 and 77
Repeat Procedures - Modifiers 76 and 77 Exact duplicate data fields submitted for claims include: Same beneficiary Same provider Same dates of service Same types of services Same place of service Same procedure codes Same billed [...]
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Posting Date: 10/26/2022
Deceased Beneficiary Claims
Medicare Part B 101 Deceased Beneficiary Claims Table of Contents Deceased Beneficiary Claims Unpaid Bills Paid Bills Assigned Claims [Return to Top] Deceased Beneficiary Claims Medicare law outlining the payment of the medical [...]
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Posting Date: 10/07/2022
Payment Floor Standards
Medicare Part B 101 Manual Payment Floor Standards The “payment floor” establishes a waiting period during which time the contractor may not pay, issue, mail or otherwise finalize the initial determination on a clean claim. The “payment [...]
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Posting Date: 10/06/2021
Limiting Charge
Medicare Part B 101 Manual Limiting Charge Table of Contents Federal Limiting Charge Federal Limiting Charge for Medicare Secondary Payer [Return to Top] Federal Limiting Charge As part of the Omnibus Budget Reconciliation Act of [...]
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