Alternative Services Available - JE Part B

Common Reasons for Message

• Medical documentation is lacking medical necessity

Next Step

• Verify medical documentation for the following:
  • Service is appropriate to bill
  • Date of Service
  • Contains Signature
  • Include vital signs
  • Reason for ambulance transport (explain medical necessity)
• Verify if a modifier is required
• Submit an Appeal request - Items or services with this message have appeal rights
  • Submit documentation with Redetermination request. View Medical Documentation Requirements

Claim Submission Tips

• Bill with appropriate modifiers
• Allow 30 days from first claim submission before resubmitting
• Check claim status via Interactive Voice Response (IVR) or the Noridian Medicare Portal