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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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Posting Date: 10/07/2021
Nonphysician Practitioners
Medicare Part B 101 Manual Nonphysician Practitioners Table of Contents Nonphysician Practitioners Direct Billing/Payment for NPP Services Furnished to Inpatients and Outpatients Related Content [Return to Top] Nonphysician [...]
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Posting Date: 10/28/2022
Standard Remittance ANSI Codes and Remittance Advice
Medicare Part B 101 Manual Standard Remittance ANSI Codes and Remittance Advice Table of Contents What Is a Remittance Advice? What are the Uses for a Remittance Advice? What are the Different Types of Remittance Advice? What You [...]
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Posting Date: 10/06/2021
Appendix 1: Forms
Medicare Part B 101 Manual Appendix 1: Forms Appeals Coverage Customer Care Documentation EDI Enrollment Other Advance Payments CMS Forms Investigational Device Exemption Requests Medicare Privacy Statement Form Vaccine [...]
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Posting Date: 10/14/2022
Appendix 2: Glossary
Medicare Part B 101 Manual Appendix 2: Glossary of Terms The Glossary of Terms listed below are in alphabetical order. Term Definition ABN Advance Beneficiary Notice: A formal notice of noncoverage that a [...]
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