Introduction
Introduction
General Billing
Claim Form (CMS-1500)
Advance Beneficiary Notice (ABN)
Beneficiary’s Right to Itemized Statement
Beneficiaries in State or Local Custody Under a Penal Authority
Claims Timely Filing Guidelines
Clinical Laboratory Improvement Act (CLIA)
Coinsurance and Deductibles
Comprehensive Error Rate Testing (CERT)
Disaster or Emergency-Related Claims
Elective Surgery
Electronic Prescribing
Foreign Claims
Health Professional Shortage Area (HPSA)
Incident to a Physician’s Professional Service
Limitation of Liability
Limiting Charge
Locum Tenens/Reciprocal Services
Medicare Appeals
Medigap
National Provider Identifier (NPI)
Offsets and Overpayments
Payment Areas
Physician Self-Referral Prohibition
Place of Service
Provider Enrollment
Remittance Notice (Standard)
Signature Requirements
Teaching Physicians/Facilities
Transplant Lists
Unprocessable Claims
Specialty Billing
Ambulatory Surgical Center (ASC)
Audiologists
Chiropractic Services
Clinical Nurse Specialist
Clinical Social Worker
Critical Access Hospital
Durable Medical Equipment
Independent Diagnostic Testing Facility (IDTF)
Nurse Midwife
Nurse Practitioner
Occupational Therapist
Ophthalmologist and Optometrist
Pathology
Physician Assistant
Physical Therapist
Podiatrist
Portable X-Rays
Psychiatry
Psychologists
Radiology
Correct Coding
Correct Coding Initiative
Diagnostic Coding – Basic Guidelines
Evaluation & Management (E&M) Services
ICD-9-CM Coding for Diagnostic Tests
ICD-10 Clinical Modification/Procedure Coding System (ICD-10-CM/PCS)
Injections
Modifiers
Radiation Therapy
Surgery
Indicator Bulletin
Attachment A
Attachment B
Attachment C
Coverage Issues
Abdominal Aortic Aneurysm Ultrasound Screening
Abortion Services
Acupuncture
Albunex
Aredia
Arthroscopic Lavage & Debridement
Artificial Hearts
Assisted Suicide Funding Restriction Act of 1997
Astigmatism - Correcting Intraocular Lenses
Auricular Therapy
Bariatric Surgery
Blood Brain Barrier Osmotic Disruption
Blood Clotting Factors
Bone Mass Measurements
Cardiac Pacemakers
Cardiac Rehabilitation
Cardiovascular Screening Blood Tests
Care Plan Oversight
Cavernous Nerves Electrical Stimulation
Clinical Trials Policy
Cochlear Implantation
Colorectal Cancer Screening
Computed Tomography (CT)
Consultation Services
Critical Care
Deep Brain Stimulation for Essential Tremor and Parkinson’s Disease
Dental Claims
Deported Medicare Beneficiaries
Diabetes
Diagnostic Tests
Disclosure of Physician Ownership in Hospitals
Drugs and Biologicals
Drug Administration Services
Drugs (Cancer Drugs Taken Orally)
Electrical Stimulation for the Treatment of Wounds
Electrocardiographic Services
Emergency Medical Treatment and Labor Act (EMTALA)
End Stage Renal Disease
External Counterpulsation Therapy (ECP)
Foot and Nail Care Services
Glaucoma Screening Services
Hepatitis C Testing
Home Health Services
Home Prothrombin Time International Normalized Ratio (INR) Monitoring for Anticoagulation Management
Hospice
Hospital Services
Immediate Relatives or Members of Household
Infrared Therapy Devices
Initial Preventive Physical Examination (IPPE)
Intravenous Immune Globulin
Intravenous Iron Replacement Therapy Drugs
Investigational Devices
Laboratory Specimens
Lumbar Artificial Disc Replacement (LADR)
Lung Volume Reduction Surgery
Mammograms
Mastectomy with a Biopsy
Medical Nutrition Therapy Services
Medication Management
Microvolt T-Wave Alternans Diagnostic Testing
Missed Appointments
Myocardial Perfusion Scanning
Neuromuscular Electrical Stimulation (NMES)
Nursing Facilities
Obstructive Sleep Apnea
Ocular Photodynamic Therapy (OPT)
Oxygen Equipment
Pap Smears
Percutaneous Transluminal Angioplasty (PTA)
Physician Quality Reporting Initiative (PQRI)
Positron Emission Tomography (PET) Scans
Power Mobility Devices (PMDs)
Prostate Cancer Screening
Radiation Therapy
Rehabilitation Services for Beneficiaries with Vision Impairment
Sacral Nerve Stimulation for Urinary Incontinence
Smoking and Tobacco Use Cessation Counseling
Stem Cell Transplantation
Surgery or Other Invasive Procedure Performed on Wrong Patient or Body Part
Telehealth Services
Thermal Intradiscal Procedures
Thoracic Electrical Bioimpedance (TEB)
Transplant Services
Ultrasound Diagnostic Procedures
Ultrasound Stimulation for Nonunion Fracture Healing
Undocumented Aliens
Vagus Nerve Stimulation
Program Safeguards
Fraud and Abuse
Medicare Secondary Payer (MSP)
Overview of Medical Review
Glossary
Medicare Acronyms & Abbreviations
State Specific
Ambulance
Anesthesia