Medical policy
Prior authorization for ambulance transports is for repetitive transports
A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a 10-day period OR at least once per week for at least three weeks.…
RSNAT (repetitive scheduled non-emergent ambulance transportation) glossary tool
The following article provides a list of common terms used by the medical review department for prior authorization requests.
No Medicare policies identified
In the absence of a LCD, NCD, billing and coding article or CMS manual instruction, NCCI or MUE, reasonable and necessary guidelines still apply. Read this article to learn more.
Billing for Rebyota fecal microbiota, live-jslm, HCPCS code J1440 -- Avoid rejections
Previous instructions to bill Rebyota fecal microbiota, live-jslm with HCPCS G0455, expired effective June 30, 2023. Instead, providers shall bill HCPCS code J1440 on the same claim with HCPCS 0780T…
Billing for Rebyota fecal microbiota, live-jslm, HCPCS code J1440 -- Avoid rejections
Previous instructions to bill Rebyota fecal microbiota, live-jslm with HCPCS G0455, expired effective June 30, 2023. Instead, providers shall bill HCPCS code J1440 on the same claim with HCPCS 0780T…
Reporting the national drug code
Read this article for helpful information to report the national drug code on claims.
New FastTrack to Medicare coverage policies tool
Do you find it challenging to identify a Medicare coverage policy concerning a particular item or service? Not sure what to do if a Medicare coverage policy doesn’t exist? A new FastTrack to Medicare…
New FastTrack to Medicare coverage policies tool
Do you find it challenging to identify a Medicare coverage policy concerning a particular item or service? Not sure what to do if a Medicare coverage policy doesn’t exist? A new FastTrack to Medicare…
No Medicare policies identified
In the absence of a LCD, NCD, billing and coding article or CMS manual instruction, NCCI or MUE, reasonable and necessary guidelines still apply. Read this article to learn more.
Document and bill genetic tests correctly
First Coast identified several errors when providers bill for genetic testing. Read this article to learn more about billing these services correctly.