Claim Submission Billing, Errors and Solutions

Blood and Blood Products Billing Guide - View requirements and descriptions

Claim Submission Error FAQs - View claim submission error related frequently asked questions (FAQs)

Diagnosis Driven MSP Claim Rejections - View steps necessary to adjust a claim that has rejected for a diagnosis driven insurance when claim is unrelated to an open file

Inpatient PPS Billing for Cost Outlier Decision Tree - Choose a scenario that applies to a beneficiary upon admission date and answer questions to determine how to bill

Miscellaneous Services and Charges - View various miscellaneous service topics and related charges

Off-Campus Hospital Outpatient Department Reporting Requirements - View additional detail on the requisite reporting of correct addresses of service locations, and the usage of PO, PN, and ER modifiers in different billing situations when outpatient services are rendered offsite from the main campus

Outpatient Coding Questions - Providers may address HCPCS related inquiries to "Central Office on HCPCS" Mail or fax

Overlapping Claim Resolution Tips - View tips to help resolve and avoid overlapping claim situations

Part A to B Rebilling Guidance - View guidelines on how to successfully submit claims for Part A to B rebilling

Provider Enrollment, Chain, and Ownership System (PECOS) - Whether a provider is enrolling in Medicare for the first time or needs to make changes to enrollment information, Internet-based PECOS is the most efficient process of submitting applications and keeping Medicare enrollment information up to date. View details

Quick Reference Billing Guide - View commonly used coding and billing processes for Medicare Part A claims

Reason Code Guidance - View common claim submission error codes, a description of issue and potential solutions

Returned to Provider (RTP) Help - View common reason codes for claims to be Returned to Provider (RTP) for correction

Services Provided Outside the United States - View exceptions to "foreign" exclusion

Services Provided to Relatives - Medicare regulations do not provide payment under Part A or Part B of Medicare for expenses that constitute charges by immediate relatives of the beneficiary or by members of his/her household

Total Invoice Price/Rebates - View instructions on submitting overpayments and voluntarily refunds associated with all discounts, rebates, refunds, or other adjustments on priced per invoice codes.


Last Updated Sep 14 , 2023