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Medicare Medicare Claims Processing Manual

King & Spalding

CMS Updates Manual and Releases MLN Matters Article Regarding Appeals of Claims Decisions

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CMS recently issued a Medicare Learning Network (MLN) Matters article in connection with Change Request 11042 released on April 12, 2019 (the Change Request), which revises the Medicare Claims Processing Manual (Publication...more

Baker Donelson

Selected CMS Guidance for Billing for Skilled Nursing Facility Services

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Skilled nursing facilities (SNFs) should take note of the updates and clarifications set forth in Medlearn Matters article 8997, issued by the CMS on March 13, 2015. Medlearn Matters article 8997 updates the chapters in the...more

King & Spalding

Clinical Trial Number Required on Medicare Claims Effective January 1, 2014

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Effective January 1, 2014, CMS will require providers and suppliers to report an 8-digit clinical trial number on claims for items or services furnished pursuant to clinical trials that qualify for coverage as set forth in...more

Baker Donelson

Revision to CMS Manual Related to Anatomic Pathology Raises Additional Global Billing Issues

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The Centers for Medicare & Medicaid Services (CMS) recently amended Medicare Claims Processing Manual (MCPM) provisions related to payment for anatomic pathology services to specifically address submission of such claims on a...more

Baker Donelson

Expect Increased Medicare Denials for Incarcerated Beneficiaries and Unlawful Aliens

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The Department of Health and Human Services’ Office of Inspector General (OIG) recently published two reports finding Medicare improperly paid providers millions of dollars for incarcerated beneficiaries and unlawful aliens...more

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