Medical review
Prior authorization fax coversheet
CMS is implementing a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020. Review the fax coversheet needed for submission.
How to bill correctly for transcranial magnetic stimulation (TMS) in the treatment of adults with major depressive disorder
First Coast is receiving first-level appeals (redeterminations) based on claim denials for providers not including the ordering psychiatrist on the claim when billing for transcranial magnetic…
How to bill correctly for transcranial magnetic stimulation (TMS) in the treatment of adults with major depressive disorder
First Coast is receiving first-level appeals (redeterminations) based on claim denials for providers not including the ordering psychiatrist on the claim when billing for transcranial magnetic…
Cervical fusion with disc removal
Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for cervical fusion with disc removal if performed…
Cervical fusion with disc removal
Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for cervical fusion with disc removal if performed…
Signature requirements: Guidelines for authentication of Medicare services
CMS requires that any Medicare service provided or ordered must be authenticated by the author - the one who provided or ordered that service. This article outlines acceptable forms of authentication…
Signature requirements: Guidelines for authentication of Medicare services
CMS requires that any Medicare service provided or ordered must be authenticated by the author - the one who provided or ordered that service. This article outlines acceptable forms of authentication…
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 requests for Transitional Care Management.
Targeted probe and educate (TPE) round results: Endovascular cardiac valve replacement and supplement procedure (DRG 266 & 267)
Review the top denial/partial denial reasons and high-level results from each round of DRG 226 and 267 TPE.
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 requests for Transitional Care Management.