-
Posting Date: 11/08/2023
Determine Beneficiary Responsibility on an MSP Claim
Table of Contents Determine Beneficiary Responsibility on an MSP Claim Step 1: Review the Remittance Advice Step 2: Assess the Beneficiary’s Responsibility The MSP Patient Responsibility Formula: The Beneficiary’s Responsibility on [...]
Read More -
Posting Date: 11/09/2023
MLN Connects® Newsletter: November 9, 2023
MLN Connects® Newsletter: November 9, 2023 News CMS Roundup (Nov 3, 2023) Marriage and Family Therapists & Mental Health Counselors: Enroll in Medicare Now American Indians or Alaska Natives: Help Your Patients Achieve Optimal [...]
Read More -
Posting Date: 05/03/2022
Vein Ablation and Related Services
General Documentation Requirements for Vein Ablation and Related Services Checklist of prior authorization request (PAR) information to include: Doppler ultrasound results Documentation stating presence or absence of DVT (deep vein [...]
Read More -
Posting Date: 03/17/2016
Electrical Stimulation Therapy: Important Coverage and Documentation Reminders
Electrical Stimulation Therapy: Important Coverage and Documentation Reminders Table of Contents CPT/HCPCS: 97032 Coverage and Documentation Provider Actions Related Content [Return to Top] CPT/HCPCS: 97032 National Government [...]
Read More -
Posting Date: 02/26/2016
Documentation Reminder: Psychiatry and Psychology Services
Documentation Reminder: Psychiatry and Psychology Services Table of Contents Documentation Reminder: Psychiatry and Psychology Services Submitting Documentation Provider Actions Related Content [Return to Top] Documentation [...]
Read More -
Posting Date: 05/03/2022
Botulinum Toxin Injections
General Documentation Requirements for Botulinum Toxin Injections Prior authorization is only required when one of the required Botulinum Toxin codes (J0585, J0586, J0587, or J0588) is used in conjunction with one of the required CPT injection [...]
Read More -
Posting Date: 11/09/2023
Processing Issue Botulinum Toxin Claims Returned to Provider with 5PRIA
Part A claims that have been submitted with Botulinum J codes (J0585, J0586, J0587, J0588) have incorrectly RTP with reason code 5PRIA.
Read More -
Posting Date: 08/04/2022
Medicare Part B Coverage and Billing Guidance for Breast Ultrasound
Medicare Part B Coverage and Billing Guidance for Breast Ultrasound Breast ultrasound uses sound waves to produce pictures of the inside of the breast and can show changes that are more difficult to see on a mammogram. Breast ultrasound is not [...]
Read More