Features of EPS with direct deposit or Virtual Card Payments:
Electronic Payments and Statements EPS• Receive payments and EOBs five to seven days faster than with paper• Multiple claim payments generated in one day for the same payer are combined into one...
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What is Document Control Number (DCN) - How to read
The DCN number is located on the remittance advice. This number must be used with adjustment/cancellation bills..
View ArticleRehabilitation Therapy Coverage Guidelines
The goal of rehabilitative medicine is recognizable, functional progress toward the restoration or maximization of impaired neuromuscular and musculoskeletal function.Medicare covers therapy services...
View ArticleMedicare CPT coe G0442, G0443, covered ICD 10 AND frequency
Alcohol Misuse Screening and CounselingAlso referred to as the Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol MisuseHCPCS/CPT CodesG0442 – Annual alcohol misuse...
View ArticleDo we need to report Medicare when new location opened?
Q: If a provider/supplier establishes a new practice, opens a new facility, or closes/changes the address of an existing practice/facility, how long does the provider/supplier have to inform Medicare...
View ArticleCPT code 76977, 77078, 77080, 77081 and G0130 - covred ICD 10 and benefit period
Bone Mass MeasurementsHCPCS/CPT Codes76977 – Ultrasound bone density measurement and interpretation, peripheral site(s), any method77078 – Computed tomography, bone mineral density study, 1 or more...
View ArticleHCPCS code G0108, G0109 - covered ICD 10 and frequency usage
Diabetes Self-Management Training (DSMT) HCPCS/CPT CodesG0108 – DSMT, individual, per 30 minutesG0109 – DSMT, group (2 or more), per 30 minutesICD-10-CM CodesSee...
View ArticleCPT code 90379, 90740, 90743, 90744 and G0010 - ICD 10 Z23
Hepatitis B Virus (HBV) Vaccine and AdministrationHCPCS/CPT Codes90739 – Hepatitis B vaccine, adult dosage (2 dose schedule), for intramuscular use90740 – Hepatitis B vaccine, dialysis or...
View ArticleHCPCS code G0432, G0433, G0435 and ICD 10 Z11.4, Z72.89
Human Immunodeficiency Virus (HIV) ScreeningHCPCS/CPT CodesG0432 – Infectious agent antibody detection by enzyme immunoassay (EIA) techniqueG0433 – Infectious agent antibody detection by enzyme-linked...
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How to change password in Medicare CMS SPOT
Q: How often do I need to change my password, and how do I change it?A: You must log in to the EIDM portal external link once every 60 days to change your password. You may change your Password as well...
View ArticleServices Offered by Medicare SPOT
Discover what you can do on the SPOTFirst Coast’s Secure Provider Online Tool (SPOT) is a free Web-based application hosted through the Centers for Medicare & Medicaid Services’ Enterprise Identity...
View ArticleCPT CODE G0447, G0473
Intensive Behavioral Therapy (IBT) for ObesityHCPCS/CPT CodesG0447 – Face-to-face behavioral counseling for obesity, 15 minutesG0473 – Face-to-face behavioral counseling for obesity, group (2–10), 30...
View ArticleCPT code G0402, G0403, G0404, G0405 and coverage frequency
Preventive Physical Examination (IPPE)Also known as the “Welcome to Medicare Preventive Visit” HCPCS/CPT CodesG0402 – IPPEG0403 – EKG for IPPEG0404 – EKG tracing for IPPEG0405 – EKG interpret &...
View ArticleMedical Nutrition Therapy (MNT) CPT code 97802, 97803, 97804, G0270, G0271
HCPCS/CPT Codes97802 – MNT; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes97803 – MNT; re-assessment and intervention, individual, face-to-face with the...
View ArticleInsurance payment for E & M service on Global day and multiple procedures
Significant, Separately Identifiable E&M with Global Day Service—Same DayPolicy will apply to all professional services performed in an office place of service, when significant, separately...
View ArticleCPT CODE G0102, G0103, G0101 - covered ICD 10 codes
Prostate Cancer ScreeningHCPCS/CPT CodesG0102 – Digital Rectal Exam (DRE)G0103 – Prostate Specific Antigen Test (PSA)ICD-10-CM CodesZ12.5Who Is CoveredAll male Medicare beneficiaries aged 50 and older...
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Claim reopening Guidelines
Q: What is the difference between a claim reopening and an adjustment?A: Reopening’s are different from adjustment bills based on the following rules:• Adjustment bills are subject to normal claims...
View ArticleHow much payment would get Assitant Surgeon, Co- Surgery and Team surgery
Assistant Surgeon ServicesHarvard Pilgrim reimburses assistant surgeon services when the assistant at surgery is a physician, a physician assistant, or a nurse practitioner consistent with CMS’...
View ArticleCommon reason for adjusting and reopening claims FAQ
Q: What are some common situations when I can or cannot adjust or reopen claims?A: Providers are responsible in determining when it is appropriate to make corrections to paid (status/location P/B9997)...
View ArticleMedicare Appeal time limit - Five level of appeal
When to file an appealOnce an initial claim determination is made, providers, participating physicians, and other suppliers have the right to appeal. Physicians and other suppliers who do not take...
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