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Posting Date: 12/12/2024
Intermittent Issues with NGSMedicare.com on 12/15/2024
Intermittent Issues with NGSMedicare.com on 12/15/2024 We will experience intermittent outages with NGSMedicare.com on Sunday, 12/15/2024 due to maintenance. NGSMedicare.com will be fully operational on Monday, 12/16/2024. We apologize for [...]
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Posting Date: 12/12/2024
Billing and Coding: Omalizumab
Billing and Coding: Omalizumab drug A52448 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52448 J2357
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Posting Date: 12/12/2024
HCPCS 82947 RTPs End-Stage Renal Dialysis Providers
As of 1/1/2024, Medicare has covered HbA1c tests for diabetic screening (HCPCS 82947) when billed with ICD-10 Z13.1. Some of these claims submitted by ESRD providers have been RTP'd in error.
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Posting Date: 12/12/2024
End Stage Renal Disease Claims Returning to Providers with Reason Code 31773
Due to an issue with the October 2024 release, ESRD facility claims, type of bill 72X, are RTPing in error.
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Posting Date: 10/20/2022
Claim Billing Guidance
Claim Billing Guidance With the end of the PHE, as of 5/11/2023, this information no longer applies. We will keep the information available for PHE-related services that occurred prior to the expiration date that have not yet been billed. [...]
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Posting Date: 12/16/2024
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG)
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG) L39189 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39189 A58921 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58921 A59900 [...]
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Posting Date: 12/17/2024
Method II CAH Claims Not Paying Professional Services with Revenue Codes 096x-098x
Certain CAH claims (TOB 85X) with professional service revenue codes 096x – 098X did not process for payment because the fee amount was not correctly retrieved during processing. The affected claims have receipt/processed dates in October 2024.
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Posting Date: 12/18/2024
Provider Enrollment Application Fee Amount for CY 2025
Provider Enrollment Application Fee Amount for CY 2025 The provider enrollment application fee for CY 2025 is $730. For more information, view MLN Connects® Newsletter: December 12, 2024. Posted 12/18/2024
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Posting Date: 09/29/2022
Helpful Resources
Helpful Resources The absence of a local coverage determination (LCD) or Medical Policy Article does not indicate noncoverage, it means that currently, National Government Services (NGS) has not identified the service requires an associated [...]
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Posting Date: 03/21/2024
Medicare Part B Drug Coverage
Medicare Part B Drug Coverage Medicare Part B may provide coverage for medically necessary drugs/biologicals that are furnished “incident to” a physician’s service. This coverage does not apply to drugs that are usually [...]
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