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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

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

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
 

Last Updated Feb 13, 2018