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Frequently Asked Questions

Displaying FAQs 1 to 25 of 302 in All Categories Select A Category Filter: All Categories All Part A Categories All Part B Categories Comparative Billing E&M LPET Enrollment Inpatient Rehabilitation Facilities (IRFs) Outpatient Hospital Podiatry Rehabilitation/Therapy Skilled Nursing Facilities Enter A Search Term or Phrase (optional):

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Question	Date Updated
Can a PA perform and bill Medicare directly for Consultation E/M services in a hospital setting?	8/18/2008 10:54 AM
Where can I find the Medically Unlikely Edits (MUE) that lists the maximum units of service that a provider would report by NCPCS/CPT codes?	8/15/2008 1:53 PM
If a patient in a covered SNF stay goes to the emergency department and stays there past midnight, can you count this as a utilization day?	8/15/2008 1:53 PM
Based on the changes as of January 1, 2008, when would a therapy recertification be due when there has been a change to the plan of care?	8/15/2008 1:52 PM
Why is my claim denying as a non-payable diagnosis when the policy I have indicates it is a payable diagnosis?	8/15/2008 1:49 PM
Can a Nurse Practitioner, Physician Assistant or other auxiliary personnel perform services "incident to" in a hospital setting?	8/15/2008 1:48 PM
If an appeal has been requested, and the 60 days have passed, what is the next step for the provider?	8/15/2008 1:48 PM
Where can I find the Medically Unlikely Edits (MUE) that lists the maximum units of service that a provider would report by NCPCS/CPT codes?	8/15/2008 1:48 PM
Is Arkansas or Louisiana the appropriate state where RI Part B providers should send their 855 applications for processing?	8/15/2008 1:47 PM
Is it true that providers can not send an 855 application any sooner than 3 weeks prior to the provider's effective date?	8/15/2008 1:46 PM
Can there be a standing order for observation services?	6/20/2008 1:13 PM
How will the 2007 Physician Quality Reporting Initiative (PQRI) 1.5 percent bonus be calculated, and when will it be paid?	6/20/2008 1:12 PM
Has the required timing of therapy recertifications changed from 30 days to 90 days?	6/20/2008 1:12 PM
Where can a provider find a list of Medicare denial codes and explanations?	6/20/2008 1:11 PM
I received a Remittance Advice (RA) from my carrier with a denial indicating that PQRI quality data codes are not payable. Will the quality data codes still be counted for PQRI bonus calculation?	6/20/2008 1:11 PM
How many records can be placed in an envelope when medical records are requested and then scanned by POWER (Paperless Operational Workflow Electronic Routing System)?	6/20/2008 1:10 PM
Will POWER (Paperless Operational Workflow Electronic Routing System) accept an “electronic medical record”? If so, how would that be sent to POWER?	6/20/2008 1:10 PM
I heard a nine-digit zip code is now required when billing anesthesia, could you explain?	6/20/2008 1:09 PM
Relating to the Initial Preventive Physical Exam (a preventive service available as of January 1, 2005), is there a specific diagnosis that must be used to identify it as the IPPE?	6/20/2008 1:07 PM
Has the required timing of therapy recertifications changed from 30 days to 90 days?	6/20/2008 1:05 PM
Can there be a standing order for observation services?	6/20/2008 1:05 PM
When does the 30-day transfer period start for patients that are admitted to a Skilled Nursing Facility?	6/20/2008 1:04 PM
Why was a Medicare Fee-for Service informational claim for a Medicare Advantage beneficiary paid by Medicare?	6/20/2008 1:04 PM
What HCPCS code should be used if one can not be found for the medication that is being administered?	6/20/2008 1:04 PM
How should medications be billed?	6/20/2008 1:04 PM
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