Clinicians: Are You Ordering Ankle-Foot/Knee-Ankle-Foot Orthoses for Your Patients?

Clinicians: Are You Ordering Ankle-Foot/Knee-Ankle-Foot Orthoses for Your Patients? The DME MACs are providing helpful guidance to assist suppliers in providing a lower limb orthosis to your patient. Medicare must be able to verify that there [...]

PA RSNAT Coversheet

Medicare Part A

Section 2: Medicare Basics Medicare Part A Table of Contents Medicare Part A Benefit Periods—Medicare Part A Ending a Benefit Period Benefit Period Examples [Return to Top] Medicare Part A Medicare Part A is referred to as Hospital [...]

Clinicians: Are You Ordering Knee Orthoses for Your Patients?

Clinicians: Are You Ordering Knee Orthoses for Your Patients? The DME MACs are providing helpful guidance to assist suppliers in providing a knee orthosis to your patient. Medicare must be able to verify that there is medical record [...]

MLN Connects® Newsletter: January 8, 2025

MLN Connects® Newsletter: January 8, 2025 News Medicare Part B Vaccine Administration: CY 2025 Payment Amounts Historically Excepted Tribal Federally Qualified Health Centers: CY 2025 Payment Rate DMEPOS: Adding New Product Category to [...]

Fourth Quarter Top Ten EDI Part B Edits

Fourth Quarter Top Ten EDI Part B Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the 2024 fourth quarter. Visit Quarterly Top Ten EDI Part B Edits to view the edits, their description and learn what you can do to correct [...]

Helping Your Patients Stop Smoking

Helping Your Patients Stop Smoking Quitting tobacco use presents various challenges for patients, and staying motivated can be difficult. All health care providers, especially those with direct patient contact, have a unique opportunity to [...]

31605

Avoiding/Correcting This Error The occurrence span code 77 should only be used to indicate the span of days that were not covered on claims. Related Content Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77  

7C625

Avoiding/Correcting This Error Hospice – Clarify reason for discharge. Claim is being returned for one of the following reasons: Remarks are not present or do not indicate valid reason for discharge/transfer. Remarks indicate beneficiary [...]

37402

Avoiding/Correcting This Error Hospice – This error occurs when a claim is submitted and the previous month's claim has not been found in the system or there is a gap between Through date of the previous claim and From date on this claim. [...]

U5106

Avoiding/Correcting This Error When the hospice NOE was received it fell within a previously established election period. Verify that the NOE is billed with correct dates. If benefit period from the previous hospice is still open, allow [...]

U5194

Avoiding/Correcting This Error In instances where a NOE is not timely-filed, the days of hospice care from the hospice admission date to the date the NOE is submitted to and subsequently processed by the Medicare contractor will not be [...]

Jurisdiction 6 Part B Top Claim Errors Are Updated

Jurisdiction 6 Part B Top Claim Errors Are Updated Did you know we publish the top claim errors on our website? This resources provides detailed information including: the error reason code; a description of the error; the error type; [...]

U537F

Avoiding/Correcting This Error Always verify billing before submitting a new NOA for a beneficiary admission. There should not already be an NOA in the system pending processing or finalized prior to submitting a new NOA for a beneficiary. [...]

U5166

Avoiding/Correcting This Error If a transfer occurred, verify that all claims and notices are submitted in order. The transferring-from hospice agency needs to submit their final claim prior to the transferring-to hospice agency submitting [...]

37402

Avoiding/Correcting This Error Hospice – This error occurs when a claim is submitted and the previous month's claim has not been found in the system or there is a gap between Through date of the previous claim and From date on this claim. [...]

U5233

Avoiding/Correcting This Error Collect all insurance information from the beneficiary when admitted to your HHA. Talk to the beneficiary about insurance changes and check CWF before billing Medicare. Many times a claim will overlap an MAO [...]

U537F

Avoiding/Correcting This Error Always verify billing before submitting a new NOA for a beneficiary admission. There should not already be an NOA in the system pending processing or finalized prior to submitting a new NOA for a beneficiary. [...]

U5109

Avoiding/Correcting This Error When submitting a transaction to indicate the beneficiary’s election to revoke the hospice benefit, transfer the patient, cancel the election, or a change of ownership, the information on the transactional bill [...]

U5111

Avoiding/Correcting This Error Hospice – When submitting a hospice Notice of Termination/Revocation (TOB 8XB) or a Cancel Notice of Election (TOB 8XD) ensure that the From date on the transaction matches the Start date posted on CWF for that [...]