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Posting Date: 01/27/2021
RM 1-HHH_Who May File an Appeal
When Is an Appointment Not Necessary? If the requestor is the beneficiary’s legal guardian, surrogate decision maker for an incapacitated beneficiary, an SSA-appointed representative payee, or is otherwise authorized under state law, no [...]
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Posting Date: 03/22/2021
Dental Codes Billed As Principal Diagnosis Code Cause Claim Rejections
Claims Submitted With Dental Codes As Principal Diagnosis Will RejectOn 1/3/2021, EDI added a new edit to the EDI Front-End. If an 837I claim contains principal diagnosis code 2300 HI with qualifier ABK (principal diagnosis) that is a dental [...]
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Adjustment of Claims with Automated Medical Review Denials
Adjustment of Claims with Automated Medical Review Denials National Government Services would like to provide clarification to providers receiving automatic denials on claims. In certain circumstances it may be necessary to correct a billing [...]
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Posting Date: 11/12/2020
Skilled Nursing Facility Medicare Part A Benefit Quick Reference Fact Sheet
Skilled Nursing Facility Medicare Part A Benefit Quick Reference Fact Sheet Beneficiary must have Medicare Part A with days left in their 100 day benefit period. A medically necessary inpatient hospital stay of at least three consecutive days [...]
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Posting Date: 03/10/2015
Incident to Job Aid for Place of Service Office
“Incident to” Job Aid for Place of Service Office Employed by the same entity - The person supervising and person performing the service must be employed by the same entity. They may be an employee, leased employee, or independent [...]
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