Skip to Main Content
ngsTabIndex: 14 Content Path: NGSMedicareContentNEW/NGSMedicareNEW/Menus/Enrollment MM/Index
ngsTabIndex: 33 Content Path: NGSMedicareContentNEW/NGSMedicareNEW/Menus/ClaimsAndAppeals MM/Index
ngsTabIndex: 46 Content Path: NGSMedicareContentNEW/NGSMedicareNEW/Menus/PolicyAndMedicalReview MM/Index
ngsTabIndex: 61 Content Path: NGSMedicareContentNEW/NGSMedicareNEW/Menus/Education MM/Index

Let’s Chat About Modifiers 76/77/59

Feb 19, 10:00 AM – 11:30 AM EST

PECOS: View and Manage Reassignments through Group Enrollment

Feb 19, 10:00 AM – 11:00 AM EST

Let's Chat About Provider Enrollment Revalidation

Feb 19, 1:00 PM – 2:00 PM EST
 
 
 
Web Content Viewer

Welcome to

NGSMedicare.com for Part B providers and suppliers

Medicare Part B providers administer medically-necessary and preventive services for beneficiaries by diagnosing and treating medical conditions or preventing illness or detecting it at an early stage.

Web Content Viewer
Part B Homepage Image

Go to All News Articles

Contractor Advisory Committee Meeting

Posted Feb 15, 2019


Billing for Multiple Anti-Markup Diagnostic Tests

Posted Feb 15, 2019


April 2019 Release Dark Days for the Common Working File Hosts

Posted Feb 15, 2019


MLN Connects® for Thursday, February 14, 2019

Posted Feb 14, 2019


Effective Date for Frequency of Hemodialysis LCD

Posted Feb 14, 2019

Go to All Production Alerts

System Edit Causing Claims to Deny Containing Procedure Codes 93880 and 93882


Date Reported

1/29/19

Status

Open

Provider Type(s) Impacted

JK and J6 Part B Providers

Date Resolved

Reason Code(s)

Group code: C0 16, remark code: M76

Claim Coding Impact

Procedure codes 93880 and 93882

Description of Issue

A system edit has erroneously denied claims containing procedure codes 93880 and 93882.

National Government Services Action

CMS has asked all MACs to reprocess all affected claims.

Provider Action

Please continue to check the Production Alerts section of our website and Email Updates for additional status information.

Proposed Resolution/Fix

NGS will identify and reprocess all claims that were denied in error. Please do not submit appeal requests. This alert will be updated to notify providers when the claims are being reprocessed.

CPT Code 84153 Has Been Inappropriately Denied



Date Reported

12/31/18

Status

Open

Provider Type(s) Impacted

All Part A and Part B Providers

Date Resolved

Reason Code(s)

N/A

Claim Coding Impact

CPT code 84153

Description of Issue

CPT code 84153 which is included in the biomarker testing (prior to initial biopsy) for Prostate Cancer Diagnosis LCD (L37733) has been inappropriately denied as a result of a system issue for dates of service 12/1/2018 through 12/30/2018. The issue has now been corrected.


National Government Services Action

Update 1/7/2019:A mass adjustment is planned for impacted claims but has not yet been initiated.

Update 1/9/2019: Mass adjustment for impacted claims has been delayed and is now expected to be completed in early February. Please continue to monitor this site for further details as they become available.

Update 1/22/2019: CPT 84153 continues to edit on NCD 190.31. Providers are advised to consult the NCD guidelines on this code, rather than the NGS LCD.

Update 02/01/2019: Mass adjustment on denied claims has been initiated. Please continue to monitor this site for a notice indicating completed adjustments.

Update 2/4/2019: Adjustments have been completed on impacted claims; the issue is now closed.

Update 2/5/2019: Previous notice of completed adjustments was incorrect; adjustments are now pending initiation. Please continue to monitor this site for notice of completion on the adjustment process.

Update 2/11/2019: Mass adjustment on denied claims have now been initiated. Please continue to monitor this site for a notice indicating completed adjustments.

Provider Action

No provider action is necessary at this time.

Proposed Resolution/Fix

Please continue to check the Production Alerts section of our website and Email Updates for additional status information.

Go to All Upcoming Education

Feb 19

10:00 AM – 11:30 AM EST
Let’s Chat About Modifiers 76/77/59

Feb 19

10:00 AM – 11:00 AM EST
PECOS: View and Manage Reassignments through Group Enrollment

Feb 19

1:00 PM – 2:00 PM EST
Let's Chat About Provider Enrollment Revalidation

Feb 19

1:00 PM – 2:30 PM EST
Physical Therapy and Targeted Probe and Educate Reviews

Feb 19

2:00 PM – 3:30 PM EST
NGSConnex New User Orientation
Complementary Content