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Office Managers, Medical Billers and Medical Coders
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TOOL BOX (Useful Forms, Guidelines, Policies and Procedures)

 

Sample Form for Verification of Medical Benefits and Eligibility (can also be used for
Motor Vehicle and Workers Compensation)

Medicare Enrollment Form CMS 855i (07/11) For Physicians and Non-Physician
Practitioners (Downloaded from CMS Website)

Medicare Enrollment Form CMS 855r (07/11) For Reassignment of Medicare
Benefits (Downloaded from CMS Website)

Medicare Enrollment Form CMS 855b (07/11) For Clinics/Group Practices and
Certain Other Suppliers (Downloaded from CMS Website)

Medicare Enrollment Form CMS 855s (01/13) For Durable Medical Equipmen,
Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers (Downloaded from CMS
Website)

Medicare Enrollment  Form CMS-855O Registration for Eligible Ordering and
Referring Physicians and Non-Physician Practitioners (Downloaded from CMS Website)

Medicare Participating Physician or Supplier Agreement CMS-460 (04/10)
(Downloaded from CMS Website)

Medicare Electronic Funds Trandsfer EFT Authorization Agreement CMS-588
(09/13) (Downloaded from CMS Website)

ABN Form English CMS-R-131 (03/11) (Downloaded from CMS Website)

ABN Form Spanish CMS-R-131 (03/11) (Downloaded from CMS Website)

ABN Form Instructions - Learn How to Use it and Fill out the Form (Downloaded from
CMS Website)


Medicare Guidelines and Manuals:

ICD-10-CM Official Guidelines for Coding and Reporting 2014

Chapter 1 - General Billing Requirements - Medicare Claims Processing Manual
(Rev. 2921, 04-04-14) (Downloaded from CMS Website)

Chapter 5 - Part B Outpatient Rehabilitaton and CORF/OPT Services (Rev. 2868,
02-06-14) Medicare Claims Processing Manual (Downloaded from CMS Website)

Chapter 12 - Physicians / NonPhysician Practitioners - Medicare Claims
Processing Manual (Rev. 2997, 07-25-14) - Reimbursement Question? Learn
more on how you should properly bill and code for your services.
(Downloaded from
CMS Website)

Chapter 15 - Covered Medical and Other Health Services - Medicare Benefit
Policy Manual (Rev. 192, 08-01-14). Learn more information on covered medical
services.
(Downloaded from CMS Website)

Chapter 26 - Completing and Processing Form CMS-1500 Data Set (Rev. 2842,
12-27-13) (Downloaded from CMS Website)

Chapter 30 - Financial Liability Protections Medicare Claims Processing Manual
(Rev. 2878, 02-21-14) (Downloaded from CMS Website)

All About the Advance Beneficiary Notice of Non-Coverage (ABN) (August 2014)
(Downloaded from CMS Website)

Understanding The Remittance Advice - A Guide for Medical Providers,
Physicians, Suppliers and Billers (October 2010) (Download from CMS Website)

Durable Medicare Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
Accreditation Fact Sheet (Downloaded from CMS Website)

Billing and Coding Guidelines for Nerve Conduction Studies and
Electromyography L31346

MLN Matters (Medicare Learning
Network) - Guidelines and Learning
Tools:

Evaluation and Management Services Guide (December 2010) (Downloaded from
CMS Website)

How to Use the Medicare National Correct Coding Initiative (NCCI) Tools
(January 2013) (Downloaded from CMS Website)

Full Implementation of Edits on the Ordering/Referring Providers in Medicare Part
B, DME and Part A Home Health Agency (HHA) Claims (Change Requests 6417, 6421,
6696 and 6856) Rev February 06, 2014 (Downloaded from CMS Website)


OIG (Office of the Inspector General)
Compliance Guidance for:

Individual and Small Group Physician Practices

Clinical Laboratories

Nursing Facilities

Ambulance Providers

Third Party Medical Billing Companies

Durable Medical Equipment Prosthetics Orthotics and Suppliers
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