MLN Connects® for Thursday, April 8, 2021

MLN Connects® for Thursday, April 8, 2021 More FY20 PEPPERs Available View this edition as a: Webpage | PDF News PEPPERs for LTCHs, CAHs, IRFs, IPFs, Hospices, & SNFs Preparedness Resources: Cybersecurity & Post-Acute [...]

MLN Connects® Special Edition for Tuesday, March 30, 2021

MLN Connects® Special Edition for Tuesday, March 30, 2021 Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension In anticipation of possible Congressional action to extend the 2% sequester reduction [...]

NPPES

Modifiers

Home Health Core-Based Statistical Area Payment issue (Code 50007)

CBSA Code 50007 was loaded into the CY 2021 wage index table of the home health (HH) Pricer with an incorrect effective date. This error is causing incorrect payment on claims with CBSA 50007 in the Value Code 61 amount field by using the wrong [...]

Part A 11X Claims Returned to Provider

11X claims with DOS prior to 10/1/2021 with ICD-10 diagnosis code Z515 and POA indicator of Y have RTP with edit message 34931.

Enrollment

Enrollment

Service Specific Post Payment Review of Darbepoetin Alfa Injection, 1 microgram (Non-ESRD Use)

National Government Services Part B MR Department analyzes national and local data to identify possible improper payment for Medicare services. In an effort to reduce the Part B CERT error rate, the MR Department will be conducting a service [...]

Announcing Service Specific Post-Payment Audits of Hyperbaric Oxygen (HBO) Services for J6 A Regions: IL, WI, and MN

Edit Reason Code: 5FPJP Bill Type = 13X CPT/HCPCS/Modifiers: G0277 Overview The Medical Review Department of National Government Services will be performing service specific post-payment reviews for claims submitted to Medicare Part A. When a [...]