Search Results
4,653 Results for
  • Posting Date: 10/19/2022
    Immunization Roster Billing

    Immunization Roster Billing Table of Contents Immunization Roster Billing Claim Submission Options for Roster Billing Electronic Claim Submissions Paper Claim Submissions Vaccine Billing and Coding Resources [Return to Top] [...]

    Read More
  • Posting Date: 10/06/2021
    Hepatitis B Virus Vaccine and Administration

    Preventive Services Guide Hepatitis B Virus Vaccine and Administration Hepatitis B is a virus that can damage the liver; it is spread through contact with infected blood or body fluids and can be transmitted through sex with an infected [...]

    Read More
  • Posting Date: 03/06/2025
    Part A Incorrect Dialysis Payments

    We have recently become aware of an issue which began on 7/15/2024 where ESRD claims with demo code 94P were finalizing with incorrect payment amounts (overpayments as well as underpayments). The incorrect payment amount is a result of FISS [...]

    Read More
  • Posting Date: 03/06/2025
    ASC Claim Hold Until 1/28/2025

    Due to a January 2025 fee schedule pricing correction, CMS has instructed Part B MACs to hold Part B ASC claims impacted by CBSA updates until 1/28/2025. ASC claims not impacted by CBSA updates may be impacted by a 10-day hold. 

    Read More
  • Posting Date: 03/07/2025
    Understanding the Strength of Medical Evidence

    Read More
  • Posting Date: 01/06/2023
    FQHC PPS Calculator

    FQHC PPS Calculator 4/1/2025-12/31/2025 1/1/2025-3/31/2025 1/1/2024-12/31/2024 2023 2022 2021 2020 2019 Revised 3/5/2025

    Read More
  • Posting Date: 03/04/2025
    New Medicare Part B Redetermination Notice Initiative – Implementation Delayed

    New Medicare Part B Redetermination Notice Initiative - Implementation Delayed As we’ve communicated recently, National Government Services will be starting a new initiative for providers who submit Medicare Part B Redetermination requests [...]

    Read More
  • Posting Date: 03/07/2023
    Modifier/Code List

    Modifier/Code List CMS established a new modifier, AB, for audiologists to use that describes: audiology service furnished personally by an audiologist without a physician/NPP order for non-acute hearing assessment unrelated to disequilibrium, [...]

    Read More
  • Posting Date: 03/07/2025
    MLN Connects® Newsletter: March 6, 2025

    MLN Connects® Newsletter: March 6, 2025 News Therapy Services: Get Updates for CY 2025 Hospitals: Apply for Additional Residency Positions by March 31 Compliance Oral Anticancer & Antiemetic Drugs: Prevent Claim Denials Claims, [...]

    Read More
  • Posting Date: 03/07/2025

    Understanding the Strength of Medical Evidence In the pursuit of evidence-based medical practice, it is essential to evaluate the quality and strength of scientific research thoroughly. The table below provides a comprehensive ranking of [...]

    Read More
  • Posting Date: 12/23/2021
    Privacy Notice Policy

    Privacy Notice Policy National Government Services, Inc. (NGS) is a contractor with the Centers for Medicare & Medicaid Services (CMS) under the authority granted in Sections 1842, 1862(b) and 1874 of Title XVIII of the Social Security Act [...]

    Read More
  • Posting Date: 03/10/2023
    Contractor Advisory Committee Meeting Records

    Contractor Advisory Committee (CAC) Meeting Records Jurisdiction 6 and Jurisdiction K CAC Meeting Records Meeting Date Audio Transcript Key Questions Bibliography 2/3/2025 - Topic: Peripheral Nerve Blocks [...]

    Read More
  • Posting Date: 04/12/2022
    New York

    New York Member Name Professional Title Association Business Name/Address Email Auster, Morris Vice President Division of Socio-Medical Economics Medical Society of the State of New York P. O. Box 5404 [...]

    Read More
  • Posting Date: 03/07/2025
    Save the Date! National A/B MAC Ambulance Provider/Supplier Coalition

    Save the Date! National A/B MAC Ambulance Provider/Supplier Coalition Attention Ambulance Providers As the MACs celebrate and honor the dedication and contributions to healthcare made by those who provide frontline lifesaving services to our [...]

    Read More
  • Posting Date: 11/01/2021
    Transitional Care Management

    Transitional Care Management Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99495: Moderate complexity F2F 7 to 14 days 99496: High complexity F2F 7 days [...]

    Read More
  • Posting Date: 03/10/2025
    Medicare Part B Redetermination Notice Initiative Coming Soon

    Medicare Part B Redetermination Notice Initiative Coming Soon National Government Services will discontinue issuing paper MRNs for Medicare Part B redetermination requests that are submitted electronically through our portal, NGSConnex. [...]

    Read More
  • Posting Date: 03/14/2025
    MLN Connects® Newsletter: March 13, 2025

    MLN Connects® Newsletter: March 13, 2025 News Medicare Shared Savings Program: Application Deadlines for January 1, 2026, Start Date Claims, Pricers & Codes ICD-10 Coordination & Maintenance Committee: Submit Procedure Code [...]

    Read More
  • Posting Date: 09/30/2024
    What Should Be Provided if Medical Records Are Requested for Review?

    What Should Be Provided if Medical Records Are Requested for Review? The following should be considered if applicable to the service being reviewed. This is not intended to be an all-inclusive list. Progress/visit notes Physician orders [...]

    Read More
  • Posting Date: 01/12/2024
    Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate

    Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate Table of Contents Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate Background: Standard Payment vs. [...]

    Read More
  • Posting Date: 11/09/2018
    Claims for Drugs Without a Product-Specific Code Assigned

    Claims for Drugs Without a Product-Specific Code Assigned National Government Services has noticed that when a claim RTPs for additional information to be added to the Remarks field concerning certain drugs, some providers attempt to provide [...]

    Read More
  • Posting Date: 03/13/2025
    Denials for HCPCS G2211

    NCCI editing for HCPCS G2211 code was updated on 12/05/2024 to require HCPCS G0463 as the primary code for G2211 add-on code. This has resulted in denials of claims for the add-code G2211 when billed with CPTs 99202-99205 and 99211-99215. [...]

    Read More
  • Posting Date: 04/04/2025
    Top J6 Part B Claim Errors are Available

    Top J6 Part B Claim Errors are Available We conduct a comprehensive data analysis on a quarterly basis to update and disseminate the latest insights on the most common claim errors. This initiative provides: Claim Error Reason Code [...]

    Read More
  • Posting Date: 10/05/2022
    Coverage Criteria and Frequency Limits

    Coverage Criteria and Frequency Limits Table of Contents Counseling to Prevent Tobacco Use Diagnosis Coding Cost Sharing Reimbursement Nonparticipating Providers Related Content [Return to Top] Counseling to Prevent Tobacco Use [...]

    Read More
  • Posting Date: 04/07/2025
    Counseling to Prevent Tobacco Use and Tobacco Related Diseases Job Aid

    Read More
  • Posting Date: 03/10/2025
    April 2025 EDI Front End Quarterly Release

    April 2025 EDI Front End Quarterly Release Please be advised that while the Centers for Medicare & Medicaid Services mandated release for April 2025 was installed the weekend of 4/6/2025, the code set updates included with this release [...]

    Read More
  • Posting Date: 04/07/2025
    Social Security Income Ratios

    Social Security Income Ratios The federal fiscal year 2023 SSI ratios for IPPS hospitals, IRF and LTCH were posted on the CMS website. IPPS IRF LTCH NGS will update the latest published 2023 SSI ratios in the Provider Specific File of [...]

    Read More
  • Posting Date: 04/07/2025
    55B31

    Avoiding/Correcting This Error Review coverage guidelines and patient records to determine if all appropriate documentation was sent for review that may have supported medical necessity.  When you receive an ADR from National Government [...]

    Read More
  • Posting Date: 04/07/2025
    59132

    Avoiding/Correcting This Error RHCs should not bill codes G0108 or G0109. Related Content CMS Internet-Only Manual, Publication 100-04, Medicare Claims Processing Manual, Chapter 9, Section 70.5 - Diabetes Self-Management Training (DSMT) [...]

    Read More
  • Posting Date: 04/07/2025
    U5233

    Avoiding/Correcting This Error Verify the admission date, from, and through dates on the claim and compare the dates to the HMO entitlement dates. Verify the admission date, from, and through dates on the claim and compare the dates to the [...]

    Read More
  • Posting Date: 04/07/2025
    U5233

    Avoiding/Correcting This Error Verify the admission date, from, and through dates on the claim and compare the dates to the HMO entitlement dates. Verify the admission date, from, and through dates on the claim and compare the dates to the [...]

    Read More
  • Posting Date: 04/07/2025
    U5220

    Avoiding/Correcting This Error Verify the MBI and date(s) of service. If services were provided prior to the date the beneficiary was entitled to Medicare, no further action is necessary. Otherwise, correct and resubmit.

    Read More
  • Posting Date: 04/07/2025
    34293

    Avoiding/Correcting This Error Review your beneficiary’s enrollment in a Medicare HMO/MAO prior to providing services. A beneficiary may drop MAO coverage; review the CWF, IVR, NGSConnex, or HETS to identify a termination date for the MAO [...]

    Read More
  • Posting Date: 04/07/2025
    U538Q

    Avoiding/Correcting This Error Medicare does not pay for medical items/services furnished to an alien beneficiary who was not lawfully present in the United States on the date of service that the items/services were furnished. Related Content [...]

    Read More
  • Posting Date: 04/07/2025
    U5200

    Avoiding/Correcting This Error Part of the eligibility verification process should include ensuring the dates of service fall within the Medicare entitlement period. Use the FISS/DDE Provider Online System or NGSConnex to verify [...]

    Read More
  • Posting Date: 04/07/2025
    C7010

    Avoiding/Correcting This Error If services are unrelated to hospice stay, resubmit with condition code 07 (treatment of nonterminal illness for hospice patient). Verify hospice enrollment prior to claim submission by reviewing the CWF, the [...]

    Read More
  • Posting Date: 04/07/2025
    3/13/2025 Part B POE Advisory Group Meeting

    3/13/2025 Part B POE Advisory Group Meeting Meeting Minutes Meeting Time: 10:00 a.m.‒12:00 p.m. ET Member Attendees: Doris Barnes, Aurelia Barraco, Brenda Bedard, Sheila Bembeneck, Madelon Berger, Todd Bergstrom, Kimberly Bischel, Mollie [...]

    Read More
  • Posting Date: 04/14/2022
    Meeting Minutes

    Meeting Minutes Jurisdiction 6 and Jurisdiction K Combined Meeting 3/13/2025 Meeting 12/12/2024 Meeting 9/18/2024 Meeting 6/12/2024 Meeting

    Read More
  • Posting Date: 04/07/2025
    39929

    Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Resubmit as appropriate. Line level reason code(s) appear on the right view of claim page two [...]

    Read More
  • Posting Date: 04/07/2025
    39934

    Avoiding/Correcting This Error Review each line level denial reason code(s). Follow the steps provided in that line level reason code narrative. Line level reason code(s) appear on the right view of claim page two (MAP171D). In order to access [...]

    Read More
  • Posting Date: 04/07/2025
    39934

    Avoiding/Correcting This Error Review each line level denial reason code(s). Follow the steps provided in that line level reason code narrative. Line level reason code(s) appear on the right view of claim page two (MAP171D). In order to access [...]

    Read More