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Posting Date: 09/13/2024
Credit Balance Reporting Reminder: Submissions for Quarter Ending 9/30/2024 Start Soon!
Credit Balance Reporting Reminder: Submissions for Quarter Ending 9/30/2024 Start Soon! CBR submissions can be submitted starting on 10/1/2024 and are due within 30 days to be considered timely. Remember, even if no monies are owed to Medicare [...]
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Posting Date: 10/26/2021
Introduction to Podiatry Services
Podiatry Billing Guide Introduction to Podiatry Services Foot Care Table of Contents Treatment of Subluxation of Foot Exclusions from Coverage Exceptions to Routine Foot Care Exclusion Systemic Conditions That Might Justify Coverage [...]
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Posting Date: 10/26/2022
Podiatry Local Coverage Determinations
Podiatry Billing Guide Podiatry Local Coverage Determinations Table of Contents LCD for Routine Foot Care and Debridement of Nails (L33636) LCD for Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory [...]
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Posting Date: 10/26/2022
Podiatry National Coverage Determinations
Podiatry Billing Guide Podiatry National Coverage Determinations The following are in reference to CMS IOM Publication 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1. Part 1 Section 20.29 [...]
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Posting Date: 10/26/2022
Modifier Usage
Podiatry Billing Guide Modifier Usage 25 – Significant, Separately Identifiable E/M Service by the Same Physician on the Same Day of the Procedure or Other Service Medicare allows payment for an E/M service performed on the same [...]
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Posting Date: 10/26/2022
Podiatry Coding Tips
Podiatry Billing Guide Podiatry Coding Tips Coding Information Procedure codes may be subject to NCCI edits or OPPS packaging edits. Refer to CCI and OPPS requirements prior to billing Medicare. For services requiring a [...]
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Posting Date: 10/26/2022
Advance Beneficiary Notice of Noncoverage/National Correct Coding Initiative
Podiatry Billing Guide Advance Beneficiary Notice of Noncoverage/National Correct Coding Initiative ABN Services denied as not reasonable and medically necessary, under Section 1862(a) (1) of the Social Security Act, are subject to [...]
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Posting Date: 10/26/2021
Related Content
Related Content CMS IOM Publication 100-01, Medicare General Information, Eligibility and Entitlement, Chapter 5, Section 70.3 CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 290: Foot Care CMS [...]
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Posting Date: 10/26/2021
Biopsy to Prove Onychomycosis in Routine Foot Care
Biopsy to Prove Onychomycosis in Routine Foot Care National Government Services has been made aware of a situation where podiatrists have been approached by laboratories stating that they need to biopsy their patients to make sure they have [...]
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Posting Date: 09/16/2024
Third Quarter Top Ten EDI Part B Edits
Third Quarter Top Ten EDI Part B Edits Using data analysis we’ve updated the Top Ten EDI Edits for the third quarter. Visit Quarterly Top Ten EDI Part B Edits to view the edits and their description, and learn how you can quickly identify the [...]
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Posting Date: 09/16/2024
Third Quarter Top Ten EDI Institutional Edits
Third Quarter Top Ten EDI Institutional Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the third quarter. Visit Quarterly Top Ten EDI Institutional Edits to view the edits and their description, and learn how you can [...]
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Posting Date: 01/02/2024
Medicare Part B Final Rule 2024
Medicare Part B Final Rule 2024 CMS announced finalized policy changes for Medicare payments under the PFS, and other Medicare Part B topics, effective on or after 1/1/2024. The CY 2024 PFS final rule is one of several final rules that [...]
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Posting Date: 11/07/2022
Who Can Bill for Diabetes Self-Management and Medical Nutrition Therapy?
Who Can Bill for Diabetes Self-Management and Medical Nutrition Therapy? Table of Contents Who Can Bill for Diabetes Self-Management and Medical Nutrition Therapy? Who Can Bill for DSMT Billable Codes for Diabetes Self-Management Training [...]
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Posting Date: 11/07/2022
Common Questions for Diabetes Self-Management Program Accreditation
Common Questions for Diabetes Self-Management Program Accreditation Does my organization need to be accredited to bill for DSMT services? Answer: Yes. In order to bill Medicare for DSMT services, your organization’s DSMT program must be [...]
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Posting Date: 11/07/2022
Medical Nutrition Therapy Tool for Billing
Medical Nutrition Therapy Tool for Billing CMS considers DSMT and MNT complementary services. This means Medicare will cover both DSMT and MNT without decreasing either benefit as long as the referring physician determines that both are [...]
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Posting Date: 06/13/2022
Remote Physiological Monitoring and Cardiovascular Monitoring Service and Billing Information
Remote Physiological Monitoring and Cardiovascular Monitoring Service and Billing Information Table of Contents Remote Physiological Monitoring Services CPT Codes: 99091, 99453, 99454, 99457, 99458 Remote Physiological Monitoring [...]
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Posting Date: 09/17/2024
National Government Services Contractor Advisory Committee Meeting
National Government Services Contractor Advisory Committee Meeting There will be a multi-jurisdictional CAC meeting held on Thursday 10/17/2024 at 3:00-5:00 p.m. ET, 2:00-4:00 p.m. CT. Meeting details can be found on the National Government [...]
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Posting Date: 09/19/2024
Laboratory and Diagnostic Services: Documentation Responsibilities
Laboratory and Diagnostic Services: Documentation Responsibilities When National Government Services is conducting a pre-pay or post-pay review of claims and services, we may request additional documentation. The billing provider must obtain [...]
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Posting Date: 11/01/2021
Global Surgery
Global Surgery Table of Contents Definition of a Global Surgical Package Where can I find the postoperative periods for covered surgical procedures? What services are included in the global surgery payment? What services are not [...]
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Posting Date: 08/10/2023
Duplicate Claim Editing Information
Duplicate Claim Editing Information Part B Duplicate Claim Edit National Government Services implemented a Part B duplicate claim edit in our EDI front-end processing system for Part B providers. Providers are notified that a claim is a [...]
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