Claim submission guidelines
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.
Returned or rejected as unprocessable claims affect timely filing
A claim must be submitted to Medicare no later than one year after the date of service to be considered filed timely. Claims returned or rejected as unprocessable have not been filed successfully.
Guidelines for billing acute inpatient noncovered days
This article provides guidance for billing provider-liable acute inpatient non-covered and acute partial inpatient non-covered days, and acute inpatient non-covered beneficiary-liable days.
Guidelines for billing acute inpatient noncovered days
This article provides guidance for billing provider-liable acute inpatient non-covered and acute partial inpatient non-covered days, and acute inpatient non-covered beneficiary-liable days.
Incarcerated beneficiary
View these guidelines for a beneficiary who is incarcerated or in custody at the time items and services are furnished.
Incarcerated beneficiary
View these guidelines for a beneficiary who is incarcerated or in custody at the time items and services are furnished.
Method II critical access hospital: Professional billing requirements for emergency department services
New section, Emergency department procedure codes for Method II CAH, added to the Medicare Claims Processing Manual Pub.100-04, chapter 4, section 250.18.
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.
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.