Billing Information

For billing instructions on many subjects, check out the Educational Articles page.

The following references will assist you in billing claims to Medicare.

Reference Materials

• CCI Ordering Information

  Download the files free of charge directly from CMS by going to http://www.cms.hhs.gov/NationalCorrectCodInitEd/

  OR

  Order them, in hard copy or via CD-ROM, from the National Technical Information Service (NTIS). For ordering information, go to their website at http://www.ntis.gov/products/families/cci/index.asp?loc=4-3-3.

• Claim Adjustment Reason Codes (links to Washington Publishing Company Web site)
• CMS Coordination of Benefits Contractor (COBC) Medigap Information/List
• Current Procedural Terminology (CPT) - CPT® codes and descriptions are copyrighted by the American Medical Association (AMA). Resources are available on the AMA website.
• FAQs
• Fee Schedule Database
• HCPCS Added Codes - 2007
• HCPCS Deleted Codes - 2007
• Mammography Centers - Certified
• Medigap Transitional Announcement & Information
• MSP and Non-MSP Immediate Offset Request Form

  This form is used to request an immediate offset for MSP and Non-MSP existing accounts receivables.

  Please submit a copy of the first page of the original demand letter and/or (if applicable) the spreadsheet.

  To ensure  proper processing/handling or your request(s), this form must be completed in its entirety. Also, to prevent any additional charges, such as interest accrual, please submit this form to us within 30 days.

  This form should only be used to request an immediate offset on an already existing Accounts Receivable. All other requests must be directed to the appropriate department to ensure a timely response.

• Overpayment Refund Form

  This form should be used: 

  • To return an unsolicited/ voluntary refund. Please complete and forward this form, so that receipt of your check is properly recorded and applied.
  • When a Provider/ Supplier discovers an overpayment  and is not submitting a refund check.   

  Note: Indicate in the Refund Information box if you wish to request an immediate offset.

• Place of Service Codes
• Remittance Advice Reason Codes and Remark Codes (links to  Washington Publishing Company Web site)
  CMS is the national maintainer of the remittance advice remark code list. Under the Health Insurance Portability and Accountability Act (HIPAA), all payers, including Medicare, have to use reason and remark codes approved by X12 recognized maintainers instead of proprietary codes to explain any adjustment in the payment.

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05/01/2009