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Posting Date: 05/13/2022
Revised Evaluation and Management Frequently Asked Question for Teaching Environment Services
Revised Evaluation and Management Frequently Asked Question for Teaching Environment Services We’ve revised an FAQ within the Teaching Environment section of our E/M FAQs to further define documentati...
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Posting Date: 05/12/2022
CMS National Provider Enrollment Conference in Boston — August 16 & 17
CMS National Provider Enrollment Conference in Boston — August 16 & 17 Tuesday, August 16 and Wednesday, August 17 from 8:00 a.m. to 5:00 p.m. ET Boston, Massachusetts Register for the conference at t...
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Posting Date: 05/12/2022
Outpatient Claims with Reason Code W7120 Returned in Error
Outpatient Claims with Reason Code W7120 Returned in Error A system error caused the CMS to return the following outpatient claims with reason code W7120: Bill types 13X and 85X Designated surgical ra...
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Posting Date: 05/12/2022
MLN Connects® Newsletter for Thursday, May 12, 2022
MLN Connects® Newsletter for Thursday, May 12, 2022 Biosimilars Curriculum: Resources for Teaching Your Students News Comprehensive Error Rate Testing Documentation Center Moved on April 13 Physicians...
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Posting Date: 05/11/2022
Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice"
Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice" The 2022 HH+H MAC Collaborative Summit: One Program, One Voice is now availab...
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Posting Date: 05/11/2022
New Evaluation and Management Frequently Asked Question for Time-Based Services
New Evaluation and Management Frequently Asked Question for Time-Based Services We’ve added a new FAQ for E/M time-based services. Please define rules for using time to level-set a service in the inpa...
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Posting Date: 05/11/2022
New Evaluation and Management Frequently Asked Question for Emergency Department
New Evaluation and Management Frequently Asked Question for Emergency Department We’ve added a new frequently asked question to the Emergency Department section of our E/M FAQs to further define how t...
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Posting Date: 05/10/2022
Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow!
Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow! Medicare for You offers valuable information that is fundamental for you, as a provider, to submit claims with ...
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Posting Date: 05/06/2022
Low and No Medicare Utilization Cost Report
Low and No Medicare Utilization Cost Report No Utilization Cost Reports To comply with program cost reporting requirements, a provider that has not furnished any covered Medicare services during a cos...
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Posting Date: 05/05/2022
MLN Connects® Newsletter for Thursday, May 5, 2022
MLN Connects® Newsletter for Thursday, May 5, 2022 COVID-19 Patients Can Get Free Over-the-Counter Tests from Participating Providers News COVID-19: Patients Can Get Free Over-the-Counter Tests from P...
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Posting Date: 05/05/2022
Chronic Disease Management and Preventive Services Learning and Action Series
Chronic Disease Management and Preventive Services Learning and Action Series A Collaborative Learning Opportunity with the Medicare Administrative Contractors National Government Services, Novitas So...
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Posting Date: 05/03/2022
National Government Services: Raising Awareness about Care Management
National Government Services: Raising Awareness about Care Management According to the CDC, six in ten adults in the U.S. have a chronic disease and four in ten adults have two or more. As your Medica...
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Posting Date: 04/29/2022
Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports
Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports The CMS implemented the prior authorization of RSNAT. NGS J6 states Illinois, Minnesota, and Wisconsin were added t...
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Posting Date: 04/28/2022
MLN Connects® Newsletter for Thursday, April 28, 2022
MLN Connects® Newsletter for Thursday, April 28, 2022 Get Patient Eligibility Information for Additional Services News Patient Eligibility Information for Additional Services — Now Available Physician...
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Posting Date: 04/26/2022
April and May 2022 Billing and Coding Article Updates
April/May 2022 Billing and Coding Article Updates Billing and Coding Articles Billing and Coding: Complex Drug Administration Coding (A58620) J0248 remdesivir (Veklury®) was added under Infusions Non-...
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Posting Date: 04/21/2022
CMS Region 2 Office Hours
CMS Region 2 Office Hours The CMS Region 2 Office recently began conducting a series of “Office Hours” calls. The purpose of these sessions is to provide brief updates on Medicare topics of current in...
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Posting Date: 04/21/2022
MLN Connects® Newsletter for Thursday, April 21, 2022
MLN Connects® Newsletter for Thursday, April 21, 2022 Medicare Provider Compliance News News Hospice Quality Reporting Program: Key Dates & Measure Change Ambulance Ground Transport: Comparative Billi...
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Posting Date: 04/19/2022
Ambulatory Surgical Center Pass-Through Devices
Ambulatory Surgical Center Pass-Through Devices What is a Pass-Through Device? Pass-through status is determined for newly FDA-approved drug and device products on an individual basis. Drugs and devic...
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Posting Date: 04/19/2022
MLN Connects® Special Edition for Monday, April 18, 2022
MLN Connects® Special Edition for Monday, April 18, 2022 CMS Proposes Policies to Advance Health Equity & Maternal Health, Support Hospitals On April 18, CMS issued a proposed rule for inpatient and l...
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Posting Date: 04/18/2022
Medicare Coverage of Over-the-Counter COVID-19 Tests
Medicare Coverage of Over-the-Counter COVID-19 Tests Beginning 4/4/2022 and continuing through the end of the COVID-19 PHE, people with Medicare Part B, including those enrolled in a MA plan, are elig...
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Posting Date: 04/18/2022
2022 Home Health and Hospice Medicare Administrative Contractors Collaborative Summit
Early Bird Registration is Now Open for the 2022 Home Health and Hospice Medicare Administrative Contractors Collaborative Summit The 2022 HH+H MACs Collaborative Summit: One Program, One Voice is now...
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Posting Date: 04/15/2022
Increased Volume of Appeal Status Inquiries
Increased Volume of Appeal Status Inquiries National Government Services has seen an increase in pending reopenings and redetermination levels, resulting in cases being completed beyond the 60 calenda...
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Posting Date: 04/14/2022
MLN Connects® Newsletter for Thursday, April 14, 2022
MLN Connects® Newsletter for Thursday, April 14, 2022 COVID-19: New Codes for Moderna Vaccine Booster Doses News Launch of the Cross-Cutting Initiatives Value-Based Insurance Design Model: Medicare Ad...
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Posting Date: 04/12/2022
MLN Connects® Special Edition for Monday, April 11, 2022
MLN Connects® Special Edition for Monday, April 11, 2022 HHS Takes Actions to Promote Safety & Quality in Nursing Homes On April 11, CMS issued its FY 2023 SNF PPS proposed rule, which includes asking...
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Posting Date: 04/11/2022
Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport
Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport The Repetitive, Scheduled Nonemergent Ambulance Transport Prior Authorization Model establishes a process through w...
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Posting Date: 04/08/2022
MLN Connects® Special Edition for Thursday, April 7, 2022
MLN Connects® Special Edition for Thursday, April 7, 2022 Returning to Certain Pre-COVID-19 Policies & Coverage of Monoclonal Antibodies for Alzheimer's Disease Stakeholder Call CMS Returning to Certa...
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Posting Date: 04/07/2022
MLN Connects® Newsletter for Thursday, April 7, 2022
MLN Connects® Newsletter for Thursday, April 7, 2022 Improve the Health of Minority Populations with Covered Preventive Services News Fiscal Year 2021 Program for Evaluating Payment Patterns Electroni...
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Posting Date: 04/07/2022
Provider Action To Be Taken Following the Provider-Based Mid-Build Audit
Provider Action To Be Taken Following the Provider-Based Mid-Build Audit The off-campus PBDs that were “mid-build” prior to 11/2/2015 received mid-build determination letters in January 2021 from the ...
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Posting Date: 04/06/2022
MLN Connects® Special Edition for Wednesday, April 6, 2022
MLN Connects® Special Edition for Monday, April 6, 2022 Eligible Individuals Can Receive Second COVID-19 Booster Shot at No Cost On April 6, CMS announced it will pay for a second COVID-19 booster sho...
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Posting Date: 04/06/2022
Tips to Find Local Coverage Determinations and Billing and Coding Instructions (REVISED 4/6/2022)
Tips to Find Local Coverage Determinations and Billing and Coding Instructions (REVISED 4/6/2022) We often receive suggestions through our website surveys to make it easier to find LCDs and the associ...
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Posting Date: 04/04/2022
MLN Connects® Special Edition for Monday, April 4, 2022
MLN Connects® Special Edition for Monday, April 4, 2022 Biden-Harris Administration Announces a New Way for Medicare Beneficiaries to Get Free Over-the-Counter COVID-19 Tests On April 4, The Biden-Har...
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Posting Date: 04/01/2022
MLN Connects® Special Edition for Thursday, March 31, 2022
MLN Connects® Special Edition for Thursday, March 31, 2022 IPF & IRF Proposed FY 2023 Payment Rules Inpatient Psychiatric Facilities: Fiscal Year 2023 Proposed Rule — Submit Comments by May 31 Inpatie...
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Posting Date: 04/01/2022
New Evaluation and Management Frequently Asked Questions for Prolonged Services
New Evaluation and Management Frequently Asked Questions for Prolonged Services We’ve added new frequently asked questions to the Prolonged Services section of our E/M FAQs to clarify proper billing f...
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Posting Date: 03/31/2022
MLN Connects® Newsletter for Thursday, March 31, 2022
MLN Connects® Newsletter for Thursday, March 31, 2022 Continuous Glucose Monitor: Provide Supplies for a Calendar Month News Home Health Providers: Services Provided Data for April 2022 Refresh Contin...
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Posting Date: 03/31/2022
Medicare Fee-for-Service Claims and the Sequestration Payment Adjustment Changes
Medicare Fee-for-Service Claims and the Sequestration Payment Adjustment Changes Just a reminder: The Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare...
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Posting Date: 03/31/2022
MLN Connects® Special Edition for Wednesday, March 30, 2022
MLN Connects® Special Edition for Wednesday, March 30, 2022 Fiscal Year 2023 Hospice Payment Rate Update Proposed Rule - Comment by May 31 On March 30, CMS issued a proposed rule (CMS-1773-P) that wou...
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Posting Date: 03/29/2022
Molecular Pathology Procedures Reminder
Molecular Pathology Procedures Reminder National Government Services has been receiving many claims submitted for redetermination that were submitted for Group 3 Molecular Pathology Procedures. The Gr...
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Posting Date: 03/29/2022
We’ve Rebranded!
We’ve Rebranded! National Government Services is excited to share we’ve refreshed our brand! Our new brand line Where Next Begins reflects Our Mission: Improving Lives and Communities. Simplifying Hea...
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Posting Date: 03/28/2022
New Edits for National Government Services Advance Communication Engine System
New Edits for National Government Services Advance Communication Engine System We are continuously implementing new edits for Jurisdiction 6 (Illinois, Wisconsin and Minnesota) Medicare Part B to take...
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Posting Date: 03/25/2022
Award of Medicare Administrative Contractor Contract for Jurisdiction K
Award of Medicare Administrative Contractor Contract for Jurisdiction K CMS selected National Government Services to retain the JK MAC contract. As a result, there will be no changes to your service o...
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Posting Date: 03/25/2022
April 2022 LCD and Billing and Coding Article Updates
April 2022 LCD and Billing and Coding Article Updates LCDs Effective 4/1/2022 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) (L33559/A56737) The LCD was returned...
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Posting Date: 03/24/2022
MLN Connects® Newsletter for Thursday, March 24, 2022
MLN Connects® Newsletter for Thursday, March 24, 2022 ICD-10: Comment on Proposed Procedure and Diagnosis Codes News Additional Residency Positions: Apply by March 31 Long-term Care Hospitals: March P...
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Posting Date: 03/22/2022
Reopening Not Appropriate to Change Diagnosis on Paid Claims
Reopening Not Appropriate to Change Diagnosis on Paid Claims National Government Services periodically receives reopening requests to change the diagnosis on a paid claim. Submitting a new, or correc...
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Posting Date: 03/21/2022
National Government Services Medicare Spring 2022 Virtual Conference
National Government Services Medicare Spring 2022 Virtual Conference Medicare For You Wednesday, 5/11/2022 – Thursday, 5/12/2022 The NGS Provider Outreach and Education Team is holding our latest bi-a...
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Posting Date: 03/17/2022
MLN Connects® Newsletter for Thursday, March 17, 2022
MLN Connects® Newsletter for Thursday, March 17, 2022 Kidney Health: Help Address Disparities News Medicare Shared Savings Program: Application Deadlines for January 1, 2023, Start Date Kidney Health:...
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Posting Date: 03/16/2022
Place of Service 10 for Telehealth Services Not for Medicare Billing
Place of Service 10 for Telehealth Services Not for Medicare Billing National Government Services is receiving calls from providers to our call center in regard to the usage of the new Place of Servic...
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Posting Date: 03/14/2022
Understanding Revalidation Application Requirement of Submission
Understanding Revalidation Application Requirement of Submission The 42 Code of Federal Regulations Section 424.515(b): requires that a provider/supplier must submit a CMS-855 application with complet...
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Posting Date: 03/10/2022
MLN Connects® Newsletter for Thursday, March 10, 2022
MLN Connects® Newsletter for Thursday, March 10, 2022 COVID-19 Monoclonal Antibodies: Revised Emergency Use Authorization for EVUSHELD News >COVID-19 Monoclonal Antibodies: Revised Emergency Use Autho...
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Posting Date: 03/09/2022
Save the Dates: National Government Services 2022 Spring Virtual Conference!
Save the Dates! National Government Services 2022 Spring Virtual Conference! Medicare for You 5/11/2022 – 5/12/2022 “Seasons change, and so do we.” - Nikkiche We also see many changes occur in Medicar...
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Posting Date: 03/04/2022
2022 CMS Evaluation and Management Regulation Modifications
2022 CMS Evaluation and Management Regulation Modifications On 2/23 and 2/24/2022, National Government Services presented webinars titled “2022 CMS Evaluation and Management Regulation Modifications”....
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Posting Date: 03/03/2022
MLN Connects® Newsletter for Thursday, March 3, 2022
MLN Connects® Newsletter for Thursday, March 3, 2022 2022 Payment, Quality & Policy Changes News Ambulance Prior Authorization Model Expands April 1 Nutrition-related Health Conditions: Recommend Medi...
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Posting Date: 03/02/2022
April 2022 Release "Dark Days" for the Common Working File Hosts
April 2022 Release "Dark Days" for the Common Working File Hosts For the upcoming April 2022 Release: For Production, CWF will be observing the Gray Day on Thursday, 3/31/2022 and Dark Days starting F...
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Posting Date: 03/02/2022
Chronic Care Management with Transitional Care Management Clarification
Chronic Care Management with Transitional Care Management Clarification TCM policy indicates that it is billable in the same month that CCM services are performed. MLN® Booklet Transitional Care Manag...
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Posting Date: 03/02/2022
Social Security Income Ratios
Social Security Income Ratios The federal fiscal year 2020 SSI ratios for IPPS hospitals, IRFs and LTCHs were posted on the CMS website. IPPS IRF LTCH We will update the latest published 2020 SSI rati...
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Posting Date: 03/01/2022
Proper Billing for Patient Supplied Drugs
Proper Billing for Patient Supplied Drugs Drugs, including biologicals, must represent an expense to the physician or legal entity billing for the services or supplies. In some instances, the patient ...
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Posting Date: 03/01/2022
Medicare Advantage Plan Beneficiaries Receiving the COVID-19 Vaccine and Monoclonal Antibody
Medicare Advantage Plan Beneficiaries Receiving the COVID-19 Vaccine and Monoclonal Antibody Effective 1/1/2022, claims for COVID-19 vaccinations or monoclonal antibody treatment provided to patients ...
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Posting Date: 02/24/2022
February and March 2022 Billing and Coding Article Updates
February and March 2022 Billing and Coding Article Updates Billing and Coding: Peripheral Nerve Blocks (A57452) This article has been updated due to a provider request to add diagnosis code G58.0 to G...
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Posting Date: 02/24/2022
MLN Connects® Newsletter for Thursday, February 24, 2022
MLN Connects® Newsletter for Thursday, February 24, 2022 CMS Released Skilled Nursing Facility & ESRD Web Pricers News Podiatry Nail Debridement & Evaluation and Management Services: Comparative Billi...
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Posting Date: 02/18/2022
MLN Connects® Special Edition for Friday, February 18, 2022
MLN Connects® Special Edition for Thursday, February 18, 2022 COVID-19 Monoclonal Antibodies: FDA Authorized Bebtelovimab On February 11, the FDA authorized the emergency use of the monoclonal antibod...
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Posting Date: 02/17/2022
MLN Connects® Newsletter for Thursday, February 17, 2022
MLN Connects® Newsletter for Thursday, February 17, 2022 Expanded Coverage: Lung Cancer Screening with Low Dose Computed Tomography News CMS Expands Coverage of Lung Cancer Screening with Low Dose Com...
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Posting Date: 02/10/2022
MLN Connects® Newsletter for Thursday, February 10, 2022
MLN Connects® Newsletter for Thursday, February 10, 2022 COVID-19: New HCPCS Code for Convalescent Plasma in Outpatient Setting News COVID-19: New HCPCS Code for Convalescent Plasma in Outpatient Sett...
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Posting Date: 02/10/2022
National Government Services Proposed LCDs for Comment
National Government Services Proposed LCDs for Comment The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends ...
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Posting Date: 02/08/2022
2022 Gap-Fill Request for Information
2022 Gap-Fill Request for Information National Government Services, the MAC for JK and J6, is in receipt of the new laboratory test codes identified by the CMS to be gap-fill priced for 2022. The PAMA...
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Posting Date: 02/04/2022
Provider Compliance Virtual Focus Group - February 24, 2022
Provider Compliance Virtual Focus Group - February 24, 2022 Thursday, 2/24/2022 from 1:00–4:00 p.m. ET Register by Friday, 2/18/2022 - Registration Closed How can CMS improve its processes and elimina...
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Posting Date: 02/03/2022
MLN Connects® Newsletter for Thursday, February 3, 2022
MLN Connects® Newsletter for Thursday, February 3, 2022 Provider Compliance Virtual Focus Group — February 24 News COVID-19: Letter to Health Care Facility Administrators on Health Care Worker Vaccina...
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Posting Date: 02/03/2022
MLN Connects® Special Edition for Thursday, February 3, 2022
MLN Connects® Special Edition for Thursday, February 3, 2022 Biden-Harris Administration Will Cover Free Over-the-Counter COVID-19 Tests Through Medicare CMS Developing Initiative to Enable Access to ...
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Posting Date: 01/28/2022
Home Health Bill Type 32A Returning With Reason Code U537I
Home Health Bill Type 32A Returning With Reason Code U537I CMS implemented HH TOB 32A for the NOA effective for period of care claims on or after 1/1/2022. The NOA is required for all HH period of car...
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Posting Date: 01/27/2022
MLN Connects® Newsletter for Thursday, January 27, 2022
MLN Connects® Newsletter for Thursday, January 27, 2022 COVID-19: Tools to Determine if Vaccine Requirements Apply News COVID-19: Tools to Determine if Vaccine Requirements Apply COVID-19 Vaccine Co...
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Posting Date: 01/27/2022
National Government Services Advance Communication Engine System
National Government Services Advance Communication Engine Providers in Jurisdiction 6 (Illinois, Wisconsin, and Minnesota) will soon be able to take advantage of our new National Government Services A...
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Posting Date: 01/26/2022
Skilled Nursing Facility Consolidated Billing Services Reminder
Skilled Nursing Facility Consolidated Billing Services Reminder For Medicare beneficiaries in a covered Part A stay, these separately payable, or excluded, services include select items or services in...
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Posting Date: 01/25/2022
January and February 2022 LCD and Billing and Coding Article Updates
January and February 2022 LCD and Billing and Coding Article Updates Colon Capsule Endoscopy (CCE) (L38571) LCD revised effective 2/15/2022: coverage criteria expanded to include blood-based biomarker...
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Posting Date: 01/24/2022
2021 Calendar Year 1099 Form Information
2021 Calendar Year 1099 Form Information Medicare providers and beneficiaries, who are serviced by National Government Services, regardless of their location, will receive a single Part A and Part B c...
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Posting Date: 01/21/2022
Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929)
Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929) Currently, National Government Services has LCD Transvenous Phrenic Nerve Stimulation in the Treatment of Central...
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Posting Date: 01/21/2022
How to Avoid Costly Appeals
How to Avoid Costly Appeals National Government Services has noticed an increase in requests for claim appeals. Upon review, we have found that many of the requests are not appropriate and/or necessar...
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Posting Date: 01/20/2022
MLN Connects® Newsletter for Thursday, January 20, 2022
MLN Connects® Newsletter for Thursday, January 20, 2022 COVID-19: Long-term Care, RHCs, & FQHCs News COVID-19: Vaccine Access in Long-term Care Settings There’s Still Time: Recommend the Flu Shot Ch...
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