Latest updates: Claims
Returned or rejected as unprocessable claims affect timely filing
A claim must be submitted to Medicare no later than one year after the date of service to be considered filed timely. Claims returned or rejected as unprocessable have not been filed successfully.
Incarcerated beneficiary
View these guidelines for a beneficiary who is incarcerated or in custody at the time items and services are furnished.
Incarcerated beneficiary
View these guidelines for a beneficiary who is incarcerated or in custody at the time items and services are furnished.
Use of JW and JZ Modifiers when Billing for Separately Payable Incident-to Supplies
Effective January 1, 2026, the application of the JW and JZ modifiers has changed for certain skin substitutes per the calendar year (CY) 2026 final rule. This article describes the changes.
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.
Avoiding hospice claim rejects
Providers billing Medicare should determine if a patient is enrolled in hospice before billing Medicare Part A. This article has tips on checking patient eligibility and avoiding hospice claim…
Tips to prevent reject reason code C7010
Read this article for tips on how to prevent reject reason code C7010.
Tips to prevent reject reason code U5233
Read this article for tips on how to prevent reject reason code U5233.
Tips to prevent claim adjustment reason code (CARC) CO 97
There are a few scenarios that exist for denial reason code CO 97, as outlined below. Please review the associated remittance advice remark code (RARC) noted on the remittance advice for your claim…
Tips to prevent claim adjustment reason code (CARC) PR 49
Read this article for tips on how to prevent claim adjustment reason code (CARC) PR 49.