Claim submission guidelines
Important instructions for paper claim form CMS-1500 (version 02/12)
This article addresses important submission instructions for Optical Character Recognition (OCR) processing.
Outpatient Prospective Payment System (OPPS) addendums updates A, B, D1, and E
Review to find quarterly updates related to OPPS and I/OCE and review accessing the addendums* listed below.
Automated process for multiple PTAN matches to single NPI will reduce claim processing delays: Part B
For Part B providers with multiple billing PTANs linked to a single NPI, learn about our automated process to match the most appropriate PTAN to your NPI.
Hospital off-campus outpatient department reporting requirements
Effective July 6, 2026, outpatient claims with type of bills (TOB) 13X or 14X will be returned to provider (RTP) for reason code 34554 if modifier ER, PO, or PN is billed on all service lines, and…
Correct date of service for specific services
Physicians and non-physician practitioners need to identify the correct date of service for the services they provide to a Medicare patient. This article will discuss some of the situations where…
Appropriate use of not otherwise classified codes when billing drugs and biologicals
Correct coding requires the most specific code available describing a service to be reported. Not otherwise classified (NOC) codes must only be used when a more specific HCPCS or CPT code is not…
Drugs and biologicals Part B: Using the JW and JZ modifiers
The JW and JZ modifier policy applies to all drugs separately payable under Medicare Part B described as supplied in a “single-dose” containers. Read this article to understand how these modifiers…
Providers billing for drug Octagam HCPCS code J1568
Did you know the leading reason why the Recovery Audit Contractor denies the drug Octagam during a medical review is for lack of documentation? Learn more about preventing unnecessary denials.
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.