OA-18

Avoiding/Correcting This Error A duplicate claim submission occurs when a provider resubmits a claim either on paper or electronically for a single encounter and the service is provided by the same provider to the: same beneficiary; for the [...]

Ambulance Services and the Advance Beneficiary Notice of Noncoverage

Ambulance Services and the Advance Beneficiary Notice of Noncoverage To follow are Medicare’s guidelines regarding the use of an ABN for ambulance services. Per the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) [...]

MLN Connects® Newsletter: March 27, 2025

MLN Connects® Newsletter: March 27, 2025 News Extension of Medicare Provisions Final National Coverage Determination: Transcatheter Tricuspid Valve Replacement Nutrition-Related Health Conditions: Recommend Medicare Preventive Services [...]

Fundamentals of Medicare

CO-109

Avoiding/Correcting This Error This denial is received when your Medicare patient is enrolled in an MA plan, instead of “traditional fee-for-service” Medicare. MA plans are health plans offered by private companies approved by Medicare [...]

LCD Open Meeting Records

Open Meeting Records Jurisdiction 6 and Jurisdiction K Open Meeting Records Meeting Date Audio Transcript 3/13/2025 – J6/JK Open Meeting Recording Transcript  10/24/2024 – J6/JK Open Meeting [...]

OA-18

Avoiding/Correcting This Error A duplicate claim submission occurs when a provider resubmits a claim either on paper or electronically for a single encounter and the service is provided by the same provider to the: same beneficiary; for the [...]

Hospital Acquired Conditions and Present on Admission Resource for Acute Care Hospital Facilities

Hospital Acquired Conditions and Present on Admission Resource for Acute Care Hospital Facilities The hospital is the entity required to bill POA indicators on all inpatient claims billed to Medicare. However, accurate coding of all diagnosis [...]

The National Correct Coding Initiative Lookup Tool

The National Correct Coding Initiative Lookup Tool The National Correct Coding Initiative Lookup Tool is designed to help providers identify when certain codes are subject to the automated code pair edits. Search for coding pairs by entering a [...]

NCCI Lookup Tool Top

National Correct Coding Initiative Lookup Tool The NCCI PTP lookup tool is designed to help providers identify when certain codes are subject to the automated code pair edits. When two codes of an edit pair are identified, the major code [...]