2025 jurisdiction list for DMEPOS HCPCS codes
CMS annually updates the durable medical equipment prosthetics, orthotic, and supplies (DMEPOS) for DME MAC and Part B MAC...
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Pathology and laboratory codes requiring documentation
Avoid negative impacts to your claims by providing medical records with your initial claim submission for the pathology and lab...
Payment issue affecting end stage renal dialysis services on type of bill 72X
Payment issue affecting end stage renal dialysis services on type of bill 72X.
Claims with CPT code 90658, influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use, pricing incorrectly
Payment issue affecting CPT code 90658, influenza virus vaccine.
CPT Category III T Codes requiring documentation
Avoid negative impacts to your claims by providing medical records with your initial claim submission for the T codes listed...
Prior authorization program
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process...
Prior authorization program for repetitive, scheduled non-emergent ambulance transports (RSNAT)
CMS has implemented the prior authorization program for certain repetitive, scheduled non-emergent ambulance transports in...
Drug HCPCS codes no longer requiring a paper invoice (JN)
To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.
When the invoice information...
Targeted probe and educate (TPE) round results: Wound debridement (CPT 11042-11045)
Top denial / partial denial reasons and high-level results are listed below from each round of Wound debridement TPE reviews...