Search Results - NGSMEDICARE

Posting Date: 06/11/2025

Provider Enrollment Revalidation Overview

During this webinar, learn about important changes in the revalidation process, how to determine Medicare enrollment revalidation due date and information to avoid disruption in Medicare billing.

Posting Date: 06/11/2025

PECOS: View and Manage Reassignments through Group Enrollment

During this webinar, we’ll provide an understanding of how to view and manage reassignments through the group enrollment in Provider Enrollment, Chain and Ownership System (PECOS), including to add or terminate reassignments. Individual [...]

Posting Date: 06/11/2025

Provider Enrollment: Completing the CMS-855B Paper Application

During this webinar, we'll provide an understanding of how to complete the CMS-855B provider enrollment paper application for a clinic, group or supplier.

Posting Date: 07/18/2023

Medical Review: Targeted Probe and Educate Review Topics

Jurisdiction K Part B Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Paring or Cutting of Benign Hyperkeratotic Lesion 11055, 11056, 11057 A07 – The [...]

Posting Date: 06/23/2025

Billing Telehealth Services for Part B Providers

During this webinar, we’ll provide you with insight into covered Medicare telehealth services and coverage requirements. We’ll discuss originating sites, distant sites and billing and payment guidelines.

Posting Date: 07/12/2024

Hospice Transfers

Hospice Transfers The purpose of a hospice transfer is to allow the beneficiary the opportunity to transfer to another agency without affecting the current benefit period and providing continuity of care. Instead of the beneficiary revoking [...]

Posting Date: 07/14/2024

Expanded Home Health Value-Based Purchasing Model

Expanded Home Health Value-Based Purchasing Model Overview The HHVBP Model is an initiative by CMS aimed at improving the quality of care provided by home health agencies while also fostering greater efficiency. It builds on the original [...]

Posting Date: 10/04/2021

Implementation of the Election Statement Addendum

Implementation of the Election Statement Addendum Hospice Election Statement Addendum Hospice care is a benefit under the hospital insurance program. To be eligible to elect hospice care under Medicare, the beneficiary must be entitled to [...]

Posting Date: 10/05/2022

Tips for Responding to a Hospice ADR

Tips for Responding to a Hospice ADR National Government Services performs medical review audits of services billed to Medicare to validate that the documentation supports coverage and level of services billed. If one of your claims is [...]

Posting Date: 10/22/2015

Hospice Documentation Tips

Hospice Documentation Tips Medicare coverage of hospice depends on a physician’s certification that an individual’s prognosis is a life expectancy of six months or less if the terminal illness runs its normal course. It is important that the [...]

Posting Date: 10/04/2021

Documentation Requirements for the Medicare Hospice Election Statement

Documentation Requirements for the Medicare Hospice Election Statement Election of Hospice Hospice care is a benefit under the hospital insurance program. To be eligible to elect hospice care under Medicare, the beneficiary must be entitled [...]

Posting Date: 06/01/2018

Avoiding Reason Code 38200

Avoiding Reason Code 38200 Claims are rejected with reason code 38200 when the FISS finds a previously submitted billing transaction that is a duplicate of the recently submitted billing transaction where all of the following fields on the [...]

Posting Date: 07/14/2024

Correcting Reason Code 37253

Correcting Reason Code 37253 To ensure home health claim information aligns with OASIS data, the iQIES OASIS claim data match is essential. If no matching assessment is found in iQIES when a claim is submitted, it will be returned with reason [...]

Posting Date: 05/08/2023

Home Health Billing When a New MBI is Assigned

Home Health Billing When a New MBI is Assigned A patient’s MBI number is required on all home health billing submitted to Medicare. CMS will issue a new MBI when an original MBI may have been, or has been compromised. There are times a home [...]

Posting Date: 01/13/2022

Billing the Home Health Notice of Admission Electronically

Billing the Home Health Notice of Admission Electronically Table of Contents Billing the Home Health Notice of Admission Electronically NOA Claim Page 1 NOA Claim Page 2 NOA Claim Page 3 NOA Claim Page 4 NOA Claim Page 5 [...]

Posting Date: 11/21/2024

Incarcerated or Unlawfully Present in the U.S. Claim Rejections (U538H, U538Q)

Incarcerated or Unlawfully Present in the U.S. Claim Rejections (U538H, U538Q) This stringent claim editing process helps ensure that Medicare does not make payments for services rendered to beneficiaries who are not eligible due to being [...]

Posting Date: 12/30/2022

Telehealth Home Health Services

Telehealth Home Health Services Prior to 1/1/2023, data on telecommunications technology used during a 30-day period of care at the patient level was not collected on HH claims. On 7/1/2023 reporting telecommunications G codes became [...]

Posting Date: 05/19/2022

Home Health Third Party Liability Demand Billing

Home Health Third Party Liability Demand Billing Table of Contents Background What is a Demand Bill? Requirements for Submission How to Submit a TPL Demand Bill Claim Page 1: Claim Page 2 – Covered and Noncovered Charges Claim [...]

Posting Date: 05/19/2022

Billing the Home Health Period of Care Claim - PDGM

Billing the Home Health Period of Care Claim – PDGM Table of Contents Billing the Home Health Period of Care Claim – PDGM Claim Page 1: Claim Page 2: Claim Page 3 Claim Page 4 Claim Page 5 Related Resources [Return to Top] [...]

Posting Date: 12/05/2017

Disposable Negative Pressure Wound Therapy Services Under Home Health

Disposable Negative Pressure Wound Therapy Services Under Home Health Effective for services furnished on or after 1/1/2017, Medicare will make separate payment to HHAs for dNPWT services for patients under the home health benefit. NPWT [...]