Part B service-specific review – drugs and biologicals (J0178 Eylea, J0897 Prolia, J2778 Lucentis, J9217 Lupron (Leuprolide))
Summary for drugs and biologicals (April-May 2021).
Articles
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Category
Checklist: Transitional Care Management services documentation
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...
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 for repetitive, scheduled non-emergent ambulance transports (RSNAT)
CMS has implemented the prior authorization program for certain repetitive, scheduled non-emergent ambulance transports in...
Targeted probe and educate (TPE)
TPE is one process that a MAC can utilize when providers are selected by medical review.
Medical necessity requirements for skilled nursing facility (SNF) admissions
This questionnaire is intended to provide health care providers with a reference for use when screening a new patient for a SNF...
Checklist: Drugs and Biologicals
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...
Checklist: Skin lesion removal
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation...