Claim submission guidelines
Method II critical access hospital: Professional billing requirements for emergency department services
New section, Emergency department procedure codes for Method II CAH, added to the Medicare Claims Processing Manual Pub.100-04, chapter 4, section 250.18.
EDI: CMS-1450 paper claim to electronic claim crosswalk (5010)
The following article provides the requirements of the form locators within the CMS-1450 (UB-04) paper claim form and their electronic equivalents.
Submitting claims when the dollar amount exceeds $99,999.99
First Coast has seen an increase in claims for drugs, hemophilia clotting factors, and skin substitutes that exceed the dollar amounts above $99,999.99. Effective for claims received on or after…
Prevent errors on your OTP claims
Learn about the top errors First Coast has identified for Opioid Treatment Program (OTP) claims and how you can prevent the errors on your claims.
Prevent errors on your OTP claims
Learn about the top errors First Coast has identified for Opioid Treatment Program (OTP) claims and how you can prevent the errors on your claims.
Medically Unlikely Edits: Avoid denials and appeals by properly coding the first time
First Coast wants you to prevent claim denials or appeals by coding the appropriate number of units correctly the first time.
Medically Unlikely Edits: Avoid denials and appeals by properly coding the first time
First Coast wants you to prevent claim denials or appeals by coding the appropriate number of units correctly the first time.
Institutional billing resources (Addendums A, B, D1 and E*)
To bill correctly under the Outpatient Prospective Payment System (OPPS), please review the addendums* listed below.
Submitting high dollar claims for single use vials
Read this article to learn more about submitting high dollar claims for single use vials.