Browse by Topic - JE Part A
Browse by Topic
Advance Beneficiary Notice of Noncoverage (ABN) - View an ABN overview, use, requirements, and resources
Appeals - If dissatisfied with an initial claim determination, you have the right to request an appeal. There are many appeal levels and each level must be processed before proceeding to the next. View details
Cardiac and Pulmonary Rehabilitation Programs - View details regarding coverage provisions for CR and PR items and services, physician standards and limitations to the sessions that may be covered
Claims - View claim submission assistance and general claims related information
Compliance Program - View overview of Medicare compliance program requirements
Dental - View information regarding dental services, coverage and exclusions
Direct Data Entry (DDE) - DDE allows providers to check eligibility and claim status. View details
Documentation Requirements - View checklists to help providers submit appropriate documentation to Medicare
Drugs, Biologicals and Injections - View guidance on drugs, biologicals and injections
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) - Access the Noridian DME Homepages, Latest Updates, contact information, Local Coverage Determinations (LCDs) and articles, and Jurisdiction Lists
Electronic Data Interchange (EDI) - Connect with EDI regarding electronic claim submissions
Emergencies and Disasters - In the event of a national or regional catastrophe or disaster, view resources
Fraud & Abuse - View information regarding fraud, abuse, and the related process to report potential concerns
Incentive Programs - View variety of CMS programs with financial incentives for providers
Medicare Secondary Payer (MSP) - Term used to describe when another payer is responsible for paying a beneficiary's claims before Medicare pays. Access related MSP content from this page
Modifiers - Modifiers can be two digit numbers, two character modifiers, or alpha-numeric indicators. View details
Noridian Medicare Portal (NMP) - Access General, Registration, End User, and Administrator function related guides and details
Observation - What is/is not observation?, Observation time, Observation in CAH vs. PPS Facility, Outpatient to Inpatient/Inpatient to Outpatient, Observation over 48 hours. View details
Overpayment and Recoupment - This webpage defines the two situations in which overpayment occurs MSP (Medicare Secondary Payer) Overpayments and Non MSP Overpayments.
Preventive Services - Medicare pays for many preventive services to keep beneficiaries healthy. Preventive services can find health problems early, when treatment works best, and can keep them from getting certain diseases. View details
Radiology and Radiation Oncology - Access information regarding radiology and radiation oncology services
Remittance Advice (RA) - View information regarding how to read an RA (paper and electronic) as well as information on the reason and remark contains that appear on RAs
Telehealth - Who can serve as an Originating Site and how to bill for the Originating Site Facility Fee, the payment methodology for those services, what geographical location that Originating Site must be located, an overview of what Part B services are eligible for Telehealth, which Part A facilities may bill for Distant Site services and additional resources. View details
Wound Care - View information regarding wound care related services
Last Updated Mon, 08 May 2023 16:46:22 +0000
CPT, ADA, and AHA End User License Agreement for Providers
Note: Should you have landed here as a result of a search engine (or other) link, be advised that these files contain material that is copyrighted by the American Medical Association. You are forbidden to download the files unless you read, agree to, and abide by the provisions of the copyright statement. Read the copyright statement now and you will be linked back to here.
CPT codes, descriptors and other data only are copyright 2018 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.
Copyright © 2018, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816
Making copies or utilizing the content of the UB-04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of UB-04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association.