News - NGSMEDICARE

Posting Date: Mon Oct 21 00:00:00 GMT 2024

Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating

Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating Did you know that tobacco cessation counseling is a covered Medicare service? Brief tobacco counseling provides substantial heal...

Posting Date: Mon Oct 21 00:00:00 GMT 2024

NGSConnex: Overview, Access, Navigation and Eligibility Look Up

NGSConnex: Overview, Access, Navigation and Eligibility Look Up As we’ve communicated, beginning 11/18/2024, Beneficiary Eligibility information will not be offered on the IVR. This includes all benef...

Posting Date: Thu Oct 17 00:00:00 GMT 2024

MLN Connects® Newsletter: October 17, 2024

MLN Connects® Newsletter: October 17, 2024 News Inpatient Psychiatric Facilities: Guidance on All-Inclusive Cost Reporting No-Pay Medicare Summary Notice Mailing Frequency Changed to Every 120 Days He...

Posting Date: Mon Oct 14 00:00:00 GMT 2024

Reminder – Beginning 11/18/2024, Beneficiary Eligibility Information Not Offered on the IVR

Reminder – Beginning 11/18/2024, Beneficiary Eligibility Information Not Offered on the IVR To help protect Medicare beneficiaries against fraud, CMS is instructing all MACs to remove beneficiary elig...

Posting Date: Fri Oct 11 00:00:00 GMT 2024

Beneficiary Eligibility Information Not Offered on the IVR Beginning 11/18/2024

Beneficiary Eligibility Information Not Offered on the IVR Beginning 11/18/2024 To help protect Medicare beneficiaries against fraud, CMS is instructing all MACs to remove beneficiary eligibility info...

Posting Date: Thu Oct 10 00:00:00 GMT 2024

Jurisdiction 6 Part B Top Claim Errors are Updated

Jurisdiction 6 Part B Top Claim Errors are Updated Using data analysis we update the Top Claim Errors on a quarterly basis and provide: the error reason code; a description of the error; the error typ...

Posting Date: Thu Oct 10 00:00:00 GMT 2024

Jurisdiction K Part B Top Claim Errors are Updated

Jurisdiction K Part B Top Claim Errors are Updated Using data analysis we update the Top Claim Errors on a quarterly basis and provide: the error reason code; a description of the error; the error typ...

Posting Date: Thu Oct 10 00:00:00 GMT 2024

MLN Connects® Newsletter: October 10, 2024

MLN Connects® Newsletter: October 10, 2024 News Resources & Flexibilities to Assist with the Public Health Emergency in Florida CMS Roundup (October 4, 2024) Clinical Laboratory Fee Schedule: Reportin...

Posting Date: Thu Oct 10 00:00:00 GMT 2024

Take Advantage of Tobacco Counseling When Performing Medicare Wellness Visits

Take Advantage of Tobacco Counseling When Performing Medicare Wellness Visits Medicare providers can optimize revenue and improve patient outcomes with Medicare's Annual Wellness Visits. These visits ...

Posting Date: Mon Oct 07 00:00:00 GMT 2024

Availability of the Essential Medicines Shortage List for the Recently Finalized Separate IPPS Payment for Establishing and Maintaining Access

Availability of the Essential Medicines Shortage List for the Recently Finalized Separate IPPS Payment for Establishing and Maintaining Access On Thursday, 8/1/2024, CMS issued the FY 2025 Medicare H...

Posting Date: Fri Oct 04 00:00:00 GMT 2024

[RESOLVED] The Provider Contact Center Is Experiencing Phone Outages for All Lines of Business

[RESOLVED] The Provider Contact Center Is Experiencing Phone Outages for All Lines of Business Our Provider Contact Center Customer Services Representative phone lines were down for all lines of busin...

Posting Date: Fri Oct 04 00:00:00 GMT 2024

Accountable Care Organization Realizing Equity, Access, and Community Health Model Claims Adjusted in Error

Accountable Care Organization Realizing Equity, Access, and Community Health Model Claims Adjusted in Error CMS informed NGS of an issue that occurred on 7/26/2024 impacting some claims from 2021 – 20...

Posting Date: Thu Oct 03 00:00:00 GMT 2024

Local Coverage Determination Open Meeting

Local Coverage Determination Open Meeting National Government Services is hosting a Proposed Local Coverage Determination Open Meeting on 10/24/2024. Details are available by accessing the Local Cove...

Posting Date: Thu Oct 03 00:00:00 GMT 2024

MLN Connects® Newsletter: October 3, 2024

MLN Connects® Newsletter: October 3, 2024 News HHS Releases Final Guidance for Second Cycle of Historic Medicare Drug Price Negotiation Program Resources & Flexibilities to Assist with the Public He...

Posting Date: Thu Oct 03 00:00:00 GMT 2024

Claim Denials During Hospice Elections Liability Reminder

Claim Denials During Hospice Elections Liability Reminder When a Medicare beneficiary elects hospice benefits, the hospice is required to provide all items and services needed for the hospice treatmen...

Posting Date: Mon Sep 30 00:00:00 GMT 2024

Provider Enrollment: Reduce Development Requests for Additional Action

Provider Enrollment: Reduce Development Requests for Additional Action In an effort to reduce the request of additional information and/or documentation on provider enrollment applications, verify all...

Posting Date: Mon Sep 30 00:00:00 GMT 2024

Tobacco Counseling via Telehealth

Tobacco Counseling via Telehealth Health equity in telehealth is the opportunity for everyone to receive the health care they need and deserve, regardless of social or economic status. Telehealth help...

Posting Date: Fri Sep 27 00:00:00 GMT 2024

LCD and Article Updates for September/October 2024

LCD and Article Updates for September/October 2024 A58152 Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP) The following ICD-10-CM diagnosis codes were added to Group 1- ICD-1...

Posting Date: Fri Sep 27 00:00:00 GMT 2024

Institutional Providers: Revised CMS-855A version (09/24) Medicare Enrollment Application

Institutional Providers: Revised CMS-855A version (09/24) Medicare Enrollment Application Available now is the revised CMS-855A (09/24) paper application that includes a section for SNF to comply wit...

Posting Date: Thu Sep 26 00:00:00 GMT 2024

MLN Connects® Newsletter: September 26, 2024

MLN Connects® Newsletter: September 26, 2024 News CMS Roundup (September 20, 2024) Cardiovascular Disease: Talk with Your Patients about Screening Claims, Pricers, & Codes Cardiology CPT Code 75580: I...

Posting Date: Thu Sep 26 00:00:00 GMT 2024

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a “Stay of ...

Posting Date: Thu Sep 26 00:00:00 GMT 2024

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a “Stay of ...

Posting Date: Thu Sep 19 00:00:00 GMT 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 docume...

Posting Date: Thu Sep 19 00:00:00 GMT 2024

Billing Errors on 2024/2025 Influenza Season Claims

Billing Errors on 2024/2025 Influenza Season Claims The influenza season runs from August 1st of each year until July 31st the following year. Every influenza vaccine is assigned a new NDC each season...

Posting Date: Thu Sep 19 00:00:00 GMT 2024

MLN Connects® Newsletter: September 19, 2024

MLN Connects® Newsletter: September 19, 2024 News Resources & Flexibilities to Assist with the Public Health Emergency in Louisiana Skilled Nursing Facilities: Report Your Expanded Ownership, Manageme...

Posting Date: Tue Sep 17 00:00:00 GMT 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...

Posting Date: Mon Sep 16 00:00:00 GMT 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, ...

Posting Date: Mon Sep 16 00:00:00 GMT 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 thei...

Posting Date: Fri Sep 13 00:00:00 GMT 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. Remem...

Posting Date: Thu Sep 12 00:00:00 GMT 2024

MLN Connects® Newsletter: September 12, 2024

MLN Connects® Newsletter: September 12, 2024 News COVID-19: Updated Vaccines for 2024–2025 Season Rural Emergency Hospital Provisions, Conversion Process, & Conditions of Participation: Revised Guidan...

Posting Date: Thu Sep 12 00:00:00 GMT 2024

National Government Services Medicare Part B Care Management Services September Series

National Government Services Medicare Part B Care Management Services September Series According to the CDC, six in ten adults in the U.S. have a chronic disease and four in ten adults have two or mor...

Posting Date: Tue Sep 10 00:00:00 GMT 2024

Expected Timeframes for Therapy Services

Expected Timeframes for Therapy Services CMS and CPT guidelines for provider time spent and documented on therapy services may vary, depending on the definition of the service and the context in which...

Posting Date: Mon Sep 09 00:00:00 GMT 2024

Common Working File (CWF) Host Dark Days for October 2024 Release

Common Working File Host Dark Days for October 2024 Release For the upcoming October 2024 Release: For Production, CWF will be observing the Gray Day on Thursday, 10/3/2024, and Dark Days starting Fri...

Posting Date: Mon Sep 09 00:00:00 GMT 2024

Psychotherapy Services and Targeted Probe and Educate

Psychotherapy Services and Targeted Probe and Educate We’ve added a new section to our website for Psychotherapy Services. Visit this page for informative instruction about completing a psychotherapy ...

Posting Date: Fri Sep 06 00:00:00 GMT 2024

LCD and Article Updates for August/September 2024

LCD and Article Updates for August/September 2024 Local Coverage Determinations Facet Joint Interventions for Pain Management L35936 Effective 8/1/2024 - Updated "Coverage Indications, Limitations and...

Posting Date: Thu Sep 05 00:00:00 GMT 2024

MLN Connects® Newsletter: September 5, 2024

MLN Connects® Newsletter: September 5, 2024 News Osteogenesis Stimulators: Prior Authorization Requirements Suspended Hospice Benefit: Expanding Prepayment Review in 4 States Skilled Nursing Facility ...

Posting Date: Thu Aug 29 00:00:00 GMT 2024

MLN Connects® Newsletter: August 29, 2024

MLN Connects® Newsletter: August 29, 2024 News CMS Roundup (August 23, 2024) Physicians, Teaching Hospitals, & Non-Physician Practitioners: Review Your Open Payment Data by December 31 Claims, Pricers...

Posting Date: Thu Aug 22 00:00:00 GMT 2024

MLN Connects® Newsletter: August 22, 2024

MLN Connects® Newsletter: August 22, 2024 News Commemorating the 2nd Anniversary of the Lower Cost Prescription Drug Law MolDx Local Coverage Determination Statement Hospital Price Transparency: Get R...

Posting Date: Tue Aug 20 00:00:00 GMT 2024

Electronically Submitted Claims that Exceed $99,999.99 Reminder

Electronically Submitted Claims that Exceed $99,999.99 Reminder Electronically submitted claims containing a dollar amount in excess of 99,999.99 will be rejected as a front-end EDI edit. The Standard...

Posting Date: Thu Aug 15 00:00:00 GMT 2024

Additional Development Requests for Part A Claims for CPT J9299

Additional Development Requests for Part A Claims for CPT J9299 A system error on 7/25/2024 caused ADR letters to be issued in error on Part A claims for CPT J9299 with DOS on or after 3/1/2024. The i...

Posting Date: Thu Aug 15 00:00:00 GMT 2024

MLN Connects® Newsletter: August 15, 2024

MLN Connects® Newsletter: August 15, 2024 News Negotiating for Lower Drug Prices Works, Saves Billions Resources & Flexibilities to Assist with the Public Health Emergency in Florida, Georgia, and Sou...

Posting Date: Thu Aug 08 00:00:00 GMT 2024

MLN Connects® Newsletter: August 8, 2024

MLN Connects® Newsletter: August 8, 2024 Final Payment Rule Hospital Inpatient Prospective Payment System & Long-Term Care Hospital Prospective Payment System FY 2025 Final Rule News Transitional Cove...

Posting Date: Thu Aug 08 00:00:00 GMT 2024

Supplemental Security Income Ratio Realignment for Cost Reporting Periods Starting Before 10/1/2013

Supplemental Security Income Ratio Realignment for Cost Reporting Periods Starting Before 10/1/2013 On 6/9/2023, in response to the Supreme Court’s ruling in Azar v. Allina Health Services, 139 S. Ct....

Posting Date: Wed Aug 07 00:00:00 GMT 2024

Unnecessary Adjustments for Part B Claims

Unnecessary Adjustments for Part B Claims A recent transition process at the Medicare Part B system maintainer has resulted in unnecessary and inappropriate Part B claim adjustments, impacting all MAC...

Posting Date: Mon Aug 05 00:00:00 GMT 2024

Telehealth Place of Service 02 and 10 Clarification

Telehealth Place of Service 02 and 10 Clarification National Government Services has been receiving inquiries from providers in regard to POS 02 and POS 10 for telehealth service reporting. We’ve crea...

Posting Date: Fri Aug 02 00:00:00 GMT 2024

Introducing the All-New Medicare University!

Introducing the All-New Medicare University! We encourage you to visit the new Medicare University and explore these exciting enhancements. Simply follow the directions below to check it out. Loggin...

Posting Date: Thu Aug 01 00:00:00 GMT 2024

MLN Connects® Newsletter: August 1, 2024

MLN Connects® Newsletter: August 1, 2024 Final Payment Rules Skilled Nursing Facility FY 2025 Final Rule Inpatient Rehabilitation Facility FY 2025 Final Rule Inpatient Psychiatric Facility FY 2025 Fin...

Posting Date: Wed Jul 31 00:00:00 GMT 2024

CLIA Number Processing Issue

CLIA Number Processing Issue National Government Services has been made aware of an issue with CLIA lab claims processing. CLIA numbers were not loaded through CWF, resulting in claim denials as CLIA ...

Posting Date: Mon Jul 29 00:00:00 GMT 2024

LCD and Article Updates for August 2024

LCD and Article Updates for August 2024 Articles L33394/A52423 – Drugs and Biologicals Provided off-label coverage of Infliximab for microscopic colitis and retirement of Bortezomib article, effective...

Posting Date: Thu Jul 25 00:00:00 GMT 2024

MLN Connects® Newsletter: July 25, 2024

MLN Connects® Newsletter: July 25, 2024 News CMS Announces Resources & Flexibilities to Assist with Public Health Emergency in Texas CMS Oral Health Cross-Cutting Initiative Fact Sheet Doctors & Clini...

Posting Date: Thu Jul 25 00:00:00 GMT 2024

National Government Services Will Send Email Updates from a New Email Address Beginning 8/7/2024

National Government Services Will Send Email Updates from a New Email Address Beginning 8/7/2024 Starting 8/7/2024, National Government Services will send email updates to you from a new email address...

Posting Date: Wed Jul 24 00:00:00 GMT 2024

Health Benefits of Quitting Smoking and Helping Your Patients Kick the Habit

Health Benefits of Quitting Smoking and Helping Your Patients Kick the Habit Smoking leads to multiple diseases and potentially death, but it is preventable! Anyone at any age can benefit from quittin...

Posting Date: Tue Jul 23 00:00:00 GMT 2024

Frequently Asked Questions Have Been Reviewed and Updated

Frequently Asked Questions Have Been Reviewed and Updated We’ve reviewed and updated our educational FAQs. Visit our Help and FAQs page located within the Education section of our website. Please take...

Posting Date: Mon Jul 22 00:00:00 GMT 2024

Frequently Asked Questions Have Been Reviewed and Updated

Frequently Asked Questions Have Been Reviewed and Updated We’ve reviewed and updated our educational FAQs. Visit our Help and FAQs page located within the Education section of our website. Topics avai...

Posting Date: Thu Jul 18 00:00:00 GMT 2024

A/B DME MAC Collaborative Webinar: Positive Airway Pressure Devices

A/B DME MAC Collaborative Webinar: Positive Airway Pressure Devices Physicians/Practitioners! Are you Ordering PAP Devices for Your Patients? This is your opportunity to hear directly from the Medicar...

Posting Date: Thu Jul 18 00:00:00 GMT 2024

MLN Connects® Newsletter: July 18, 2024

MLN Connects® Newsletter: July 18, 2024 News Final Part Two Guidance to Help People with Medicare Prescription Drug Coverage Manage Prescription Drug Costs Medicare Ground Ambulance Data Collection Sy...

Posting Date: Thu Jul 18 00:00:00 GMT 2024

“Payer Only” Codes Submitted on Part A Medicare Claims

“Payer Only” Codes Submitted on Part A Medicare Claims This article is to inform Part A providers of an editing change impacting claims submitted with “payer only” codes. As of 7/3/2024, new edits cau...

Posting Date: Wed Jul 17 00:00:00 GMT 2024

Top Claim Errors Reviewed and Updated

Top Claim Errors Reviewed and Updated Using data analysis, we review and update the Top Claim Errors on a quarterly basis and provide: the error reason code; a description of the error; the error type...

Posting Date: Tue Jul 16 00:00:00 GMT 2024

Hospice Quality Reporting Letters

Hospice Quality Reporting Letters CMS notified MACs of hospice providers that either chose not to participate in the Hospice QRP or failed to meet the Hospice QRP reporting requirements for the data c...

Posting Date: Thu Jul 11 00:00:00 GMT 2024

MLN Connects® Newsletter: July 11, 2024

MLN Connects® Newsletter: July 11, 2024 Proposed Rules Physician Fee Schedule CY 2025 Proposed Rule Hospital Outpatient Prospective Payment System & Ambulatory Surgical Center Payment System CY 2025 P...