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Medicare Billing: CMS-1500 & 837P

Lesson 4 Summary

  • The CMS-1500 and 837P require codes like ICD-10, CPT, HCPCS, and any necessary modifiers
  • Medicare reimburses for specific items or services only when authorized physicians or health care professionals order or refer them
  • You must report specific events about your enrollment record to CMS within 30 days
  • You must correctly report patient names and Medicare numbers as shown on the Medicare card
  • Medicare pays claims for certain providers or suppliers only on an assigned basis
  • Medigap insurers can use automatic or claim-based crossovers for processing claims