- 4009 Hackney Springs Ln, Sachse, TX 75048
| STATES / TERRITORIES | PHONE · PORTAL | CLAIM VOLUME | BENEFICIARIES |
|---|---|---|---|
|
1-855-366-2745 · FCSO Provider Portal | ~280 million claims/year | ~4.8 million Medicare FFS |
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First Coast Service Options does not participate in the MolDX program for JN. Labs billing molecular diagnostic tests, CPT codes in the 81XXX range, or most PLA codes do not need a Palmetto GBA DEX Z-Code to submit those claims; they bill under standard CPT/ICD-10 coding per the applicable LCD instead.
| LCD | Coverage Area | Key Requirement |
|---|---|---|
| L35062 | Glycated Hemoglobin (HbA1c) | Standard quarterly policy. Florida's elderly diabetic population creates massive HbA1c volume. |
| L35095 | Vitamin D Assay | Standard documentation required. Florida's elderly population has high Vitamin D demand — without ICD-10 documentation, denial rates are high. |
| L34419 | Urinalysis | FCSO has specific guidance on urinalysis methodology coding. Automated strip UA (81003) vs. manual UA (81000/81001) must match actual methodology — a top denial source. |
| L34752 | Urine Drug Testing | Active LCD. Florida's pain management market and opioid epidemic have made drug testing a persistent compliance target. |
| L35396 | Tumor Markers | Active enforcement. Florida's large oncology market drives significant tumor marker billing. |
| Test | CPT | Frequency Limit |
|---|---|---|
| HbA1c | 83036 | Standard quarterly. FCSO monitors labs with elevated same-beneficiary frequency |
| Vitamin D | 82306 | Annual; therapeutic monitoring exception with documentation |
| Urine Drug Screen | 80305-80307 / G0480-G0483 | Per written clinical protocol; FCSO monitors labs billing more than 12 definitive tests per year per patient |
| Urinalysis with microscopy | 81001 | No fixed frequency, but daily UA without documented clinical change triggers medical review |
| Tumor markers (general) | 82378/86304/etc. | Standard quarterly/surveillance framework |
TPE activity in JN runs very high; JN is consistently one of the highest TPE-activity jurisdictions in the country:
Urinalysis methodology coding — automated strip vs. manual UA mismatches, the #1 lab denial cause in JN.
Urine drug screen frequency, given Florida’s active pain management market.
Vitamin D ICD-10 documentation and HbA1c frequency, both driven by Florida’s large elderly population.
Clinical chemistry panel miscoding, the same pattern seen across most jurisdictions.
| Area | Requirement |
|---|---|
| Provider Enrollment | CMS-855B for independent labs. FCSO provider enrollment is based in Jacksonville, FL. |
| ABN Requirements | ABN required before any test with frequency or coverage limitations. FCSO requires current ABN forms — old versions are rejected. |
| CLFS / Fee Schedule | Florida's large lab market makes CLFS rate accuracy critical. Audit FCSO remittances against CLFS quarterly given the volume. |
Labs lose revenue to preventable denials; miscoded panels, missed modifiers, payer-specific mismatches. TransLabs built its billing process around what labs actually need to get paid, coast to coast. Start with a complimentary claims audit. We’ll review your CPT/HCPCS coding, test methodology, and denial trends to show you exactly what’s recoverable.
Claims checked against your MAC's local coverage rules before submission.
Medicaid and commercial prior-auth rules built into your workflow, not discovered after denial.
Appeals strategy built from denial data across all 50 states.
A dedicated billing specialist; never a shared call queue.
Live in 24 hours. No contracts. No upfront fees.
No. First Coast Service Options does not participate in the MolDX program for JN. Labs bill molecular diagnostic tests using standard CPT codes with ICD-10 linkage — no Palmetto GBA DEX Z-Code is required.
It's billed with standard CPT/ICD-10 coding under general laboratory coverage policy. No Z-Code applies.
Florida, Puerto Rico, and the U.S. Virgin Islands.
Florida is a designated Medicare high-fraud state with the largest per-capita Medicare enrollment in the country. JN is consistently one of the highest TPE-activity jurisdictions nationally, led by urinalysis methodology coding errors.
Standard quarterly framework for stable diabetic patients. FCSO monitors labs with elevated same-beneficiary billing frequency.
CMS-855B, submitted to FCSO provider enrollment in Jacksonville, FL.
