Medicare/Medi-Cal Crossover Claims: Long Term Care Billing ...
When completing claims, do not enter the decimal points in ICD-10-CM codes or dollar . amounts. If requested information does not fit neatly in the Explanations area of the 25-1, type it on an 8½ x 11-inch sheet of paper and attach it to the claim. ... On line 1, the gross amount of $3789.68 (Box 17) is the Medicare covered charges less the ... ................
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