Billing
Multiple procedure payment reduction on the professional component and technical component of certain diagnostic imaging procedures
The MPPR on diagnostic imaging applies when multiple services are furnished by the same physician to the same patient in the same session on the same day. Find out the details here.
Payment of codes for chemotherapy administration and nonchemotherapy injections and infusion
CMS provided clarification regarding the Medicare guidance relating to complex administration CPT codes 96401-96549. Please read this article for more information.
Payment of codes for chemotherapy administration and nonchemotherapy injections and infusion
CMS provided clarification regarding the Medicare guidance relating to complex administration CPT codes 96401-96549. Please read this article for more information.
Responding to additional documentation requests (ADRs)
This article explains how to respond to ADRs.
Responding to additional documentation requests (ADRs)
This article explains how to respond to ADRs.
Resolve claim return reason code 34963 for outpatient therapy services
Are you providing outpatient therapy services on institutional claims and receiving reason code 34963 indicating the attending physician is invalid? Read this article for assistance to resolve your…
New Fiscal Intermediary Shared System (FISS) consistency edit to validate attending physician NPI
Effective April 1, CMS implemented a new consistency edit to validate the attending physician NPI. Claims are returning with reason code 34963. Read on for more information.
Multiple procedure payment reduction
Medicare applies a MPPR to the payment of select therapy services. The reduction applies to HCPCS codes contained on the list of “always therapy” services, regardless of the type of provider or…
Limitation on recoupment (935) process
This information outlines the process for the 935 recoupment.
Limitation on recoupment (935) process
This information outlines the process for the 935 recoupment.