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  • Posting Date: 11/12/2021
    Limitation of Liability (Advance Beneficiary Notice of Noncoverage)

    Limitation of Liability (Advance Beneficiary Notice of Noncoverage) Services denied as not reasonable and medically necessary, under section 1862(a) (1) of the Social Security Act, are subject to the Limitation of Liability (ABN) provision. [...]

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  • Posting Date: 11/12/2021
    Medically Unlikely Edits

    Medically Unlikely Edits In January 2007, CMS developed MUEs to reduce the paid claims error rate for Part B claims. An MUE for a HCPCS /CPT code is the maximum units of service that a provider would report under most circumstances for a [...]

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  • Posting Date: 11/12/2021
    Medicare Coverage Database

    Medicare Coverage Database The Medicare Coverage Database is an administrative and educational tool to assist providers, physicians and suppliers in submitting correct claims for payment. The Medicare Coverage Database features LCDs developed [...]

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  • Posting Date: 11/12/2021
    Medicare Electronic Data Interchange

    Medicare Electronic Data Interchange Information about how providers can communicate electronically with the Medicare Program can be found on the CMS website at Medicare Electronic Billing & EDI Transactions. This web page contains EDI [...]

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