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Posting Date: 04/21/2021
Related Content
Related Content CMS-1500 Claim Form Instructions CMS IOM Publication 100-02, Medicare Benefit Policy Manual CMS IOM Publication 100-04, Medicare Claims Processing Manual Chapter 1 - General Billing Requirements Chapter 12 - [...]
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Posting Date: 02/14/2019
Provider Revalidation Fact Sheet for Congressional Field Offices
Provider Revalidation Fact Sheet for Congressional Field Offices The Affordable Care Act, Section 6401 (a), requires enrolled providers to revalidate their Medicare enrollment every five years, and enrolled durable medical equipment suppliers [...]
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Posting Date: 03/19/2024
CMS Issues Change Request 13294 – Impacts Cost Reports with Disproportionate Share Hospital Reimbursement
CMS Issues Change Request 13294 – Impacts Cost Reports with Disproportionate Share Hospital Reimbursement CMS issued CR 13294,“Change Request (CR) to Implement the Medicare Program Final Action: Treatment of Medicare Part C Days in the [...]
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Posting Date: 03/26/2024
Chemotherapy General Infusion Information
Chemotherapy General Infusion Information There are CPT codes for several different types of infusions and injections for drugs and biologicals. These include codes for chemotherapy infusions and injections, therapeutic, prophylactic and [...]
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Posting Date: 03/19/2024
Credit Balance Reminder: Submissions For Quarter Ending 3/31/2024 Start Soon!
Credit Balance Reminder: Submissions For Quarter Ending 3/31/2024 Start Soon! CBR submissions can be submitted starting on 4/1/2024 and are due within 30 days to be considered timely. Remember, even if no monies are owed to Medicare for this [...]
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Posting Date: 03/26/2024
Unlisted Codes for Drugs and Biologicals (J3490, J3590 and J9999)
Unlisted Codes for Drugs and Biologicals (J3490, J3590 and J9999) An unlisted code should only be used when no other code adequately describes the service. They are commonly used when the drug/biological does not have a specific HCPCS code, [...]
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Posting Date: 03/26/2024
Compound Drugs
Compound Drugs If there is not a HCPCS code for the compound drug you are billing, then it is appropriate to bill J7999 ‒ Compounded Drug, Not Otherwise Classified. This applies to both pump and nonpump compound drugs. The name, dose and [...]
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Posting Date: 03/26/2024
Prolonged Drug and Biological Infusions Using an External Pump
Prolonged Drug and Biological Infusions Using an External Pump In some situations, a hospital outpatient department or physician office may purchase a drug for a medically reasonable and necessary prolonged drug infusion, begin the drug [...]
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Posting Date: 03/21/2024
[REVISED] Submitting Paper Claim Forms to National Government Services Due to the Change Healthcare Security Incident
[REVISED] Submitting Paper Claim Forms to National Government Services Due to the Change Healthcare Security Incident As a follow up to our 2/28/2024 article, Change Healthcare Security Incident, providers have asked if they can submit their [...]
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Posting Date: 01/26/2022
Coding for Sinuva™ Claims
Coding for Sinuva™ Claims This notice is a coding instruction, and not an indication of coverage. FDA labels should be consulted for indications and usage. Coding updated effective 4/1/2021: Claims submitted to National Government Services [...]
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