Claim submission guidelines
Process for pathology, laboratory, and other codes
Avoid negative impacts to your claims by providing the medical records for the laboratory, pathology and other codes claims submissions indicated in this article. First Coast requests specific…
Process for supplying invoice amount on certain HCPCS codes - avoid rejected claims
View the current listing of ASC HCPCS codes no longer requiring a paper invoice.
EDI: CMS-1450 paper claim to electronic claim crosswalk (5010)
The following article provides the requirements of the form locators within the CMS-1450 (UB-04) paper claim form and their electronic equivalents.
Submitting claims when the dollar amount exceeds $99,999.99
First Coast has seen an increase in claims for drugs, hemophilia clotting factors, and skin substitutes that exceed the dollar amounts above $99,999.99. Effective for claims received on or after…
Prevent errors on your OTP claims
Learn about the top errors First Coast has identified for Opioid Treatment Program (OTP) claims and how you can prevent the errors on your claims.
Prevent errors on your OTP claims
Learn about the top errors First Coast has identified for Opioid Treatment Program (OTP) claims and how you can prevent the errors on your claims.
Tips to prevent reason code 326x4
Review this article if your claim is returning for reason code 326x4.
Hospital off-campus outpatient department reporting requirements
Read this article to learn more about hospital off-campus outpatient department reporting requirements.
Medically Unlikely Edits: Avoid denials and appeals by properly coding the first time
First Coast wants you to prevent claim denials or appeals by coding the appropriate number of units correctly the first time.