Lesson 5 Summary
- Use Loop 2300 HI / item 10d exclusively for Medicaid information
- When reporting NOC codes, enter the drug’s name and dosage
- Electronic billers can submit required documentation using the PWK segment in the 837P to indicate claim-related documentation is coming
- Enter the patient’s diagnosis or condition using ICD-10-CM codes
- Use HCPCS Level I and II codes to code procedures on all claims
- Level I CPT codes describe medical procedures and professional services
- Level II HCPCS is a standardized coding system for naming products, supplies, and services not included in Level I CPT codes
- Medicare limits the charges non-participating providers can bill for certain services like diagnostic tests and outpatient therapies, but these limits don’t apply to DMEPOS claims