News - NGSMEDICARE

Posting Date: 07/17/2023

Frequently Asked Questions Reviewed and Updated

Frequently Asked Questions 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 available are:...

Posting Date: 07/17/2023

Frequently Asked Questions Reviewed and Updated

Frequently Asked Questions 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 available are:...

Posting Date: 07/17/2023

Prior Authorization Outpatient Department Rejections Alert

Prior Authorization Outpatient Department Rejections Alert National Government Services has seen a significant increase in rejections due to invalid information provided on PAR cover sheets. Please ...

Posting Date: 07/14/2023

MLN Connects® Newsletter: PFS & OPPS/ASC Proposed Payment Rules – July 13, 2023

MLN Connects® Newsletter: PFS & OPPS/ASC Proposed Payment Rules – July 13, 2023 Proposed Rules CMS Physician Payment Rule Advances Health Equity CMS Proposes Policies to Expand Behavioral Health Acces...

Posting Date: 07/13/2023

MLN Connects® Newsletter: July 13, 2023

MLN Connects® Newsletter: July 13, 2023 News Hospital Outpatient Prospective Payment System: Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022 National Coverage Determinati...

Posting Date: 07/12/2023

Submitting Necessary/Appropriate Documentation

Submitting Necessary/Appropriate Documentation National Government Services has noticed an increase in the submission of improper documentation. We’ve added two new sections to our Submit Medical Reco...

Posting Date: 07/11/2023

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: 07/11/2023

Overcoming Barriers to Tobacco Counseling

Overcoming Barriers to Tobacco Counseling Healthcare providers face several challenges when implementing tobacco cessation counseling into a clinical practice routine. These various factors influence ...

Posting Date: 07/07/2023

MLN Connects® Newsletter: Broader Medicare Coverage of Leqembi Available Following FDA Traditional Approval - July 7, 2023

MLN Connects® Newsletter: Broader Medicare Coverage of Leqembi Available Following FDA Traditional Approval - July 7, 2023 News Broader Medicare coverage is now available for Biogen and Eisai’s Leqemb...

Posting Date: 07/06/2023

MLN Connects® Newsletter: July 6, 2023

MLN Connects® Newsletter: July 6, 2023 News CY 2024 Home Health Prospective Payment System Proposed Rule HHS Announces Actions to Lower Health Care Costs and Allow Medicare to Negotiate Lower Drug Pri...

Posting Date: 07/05/2023

CR13220 - Technical Revisions Only to the National Coverage Determination (NCD) Manual, Publication (Pub) 100-03

CR13220 - Technical Revisions Only to the National Coverage Determination (NCD) Manual, Publication (Pub) 100-03 Posted 7/5/2023

Posting Date: 06/29/2023

New and Improved EDI Enrollment Process Coming Soon

New and Improved EDI Enrollment Process Coming Soon We are improving our online EDI Enrollment process based on provider feedback. The new process will include ‘real time’ verification of data entered...

Posting Date: 06/29/2023

MLN Connects® Newsletter: June 29, 2023

MLN Connects® Newsletter: June 29, 2023 News CY 2024 ESRD Prospective Payment System Proposed Rule Transforming Medicare Coverage: A New Medicare Coverage Pathway for Emerging Technologies and Revampe...

Posting Date: 06/29/2023

National Government Services Proposed LCDs for Comment (6/22/2023-8/5/2023) - Update

National Government Services Proposed LCDs for Comment (6/22/2023-8/5/2023) - Update The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The ...

Posting Date: 06/28/2023

Telehealth Home Health Billing

Telehealth Home Health Billing As a reminder to all home health agencies, telehealth billing becomes mandatory on home health claims for periods of care that start on or after 7/1/2023. There is an a...

Posting Date: 06/27/2023

Billing and Coding Article Updates for July 2023

Billing and Coding Article Updates for July 2023 Billing and Coding: Bevacizumab and Biosimilars (A52370) Based on Compendia review, ICD-10 codes Z85.09 and Z85.42 have been added to the Group 1 code ...

Posting Date: 06/26/2023

Dental Services 2023

Dental Services 2023 The CMS clarified what Medicare payments may be made for medically necessary dental services that are an integral part of a covered primary medical procedure. We’ve posted this ne...

Posting Date: 06/26/2023

End of the Public Health Emergency

End of the Public Health Emergency We’ve received many questions related to end of the public health emergency and changes to waivers that CMS put in place during the COVID-19 PHE. To assist our provi...

Posting Date: 06/26/2023

Helpful Reminders on Advance Care Planning

Helpful Reminders on Advance Care Planning ACP billing codes: 99497: Advance care planning, including the first 30 minutes of face-to-face explanation and discussion (when performed) of advance direct...

Posting Date: 06/22/2023

MLN Connects® Newsletter: June 22, 2023

MLN Connects® Newsletter: June 22, 2023 News CMS Roundup (June 16, 2023) Lower Endoscopy: Comparative Billing Report in June Medicare Physician Fee Schedule Database: July Update Behavioral Health Int...

Posting Date: 06/15/2023

MLN Connects® Newsletter: June 15, 2023

MLN Connects® Newsletter: June 15, 2023 News Inflation Reduction Act Continues to Lower Out-of-Pocket Prescription Drug Costs for Drugs with Price Increases Above Inflation CMS Announces Multi-State I...

Posting Date: 06/15/2023

Strengthening Security

Strengthening Security Periodically, EDI Enrollment will be publishing articles to help eliminate the number of EDI applications that are denied. This month we are spotlighting Strengthening Security....

Posting Date: 06/15/2023

Reactivating Reason Code 31755

Reactivating Reason Code 31755 As of 1/3/2023, reason code 31755 was reactivated per CMS instructions. This means the revenue code 0023 line-item date of service must match the date of service for the...

Posting Date: 06/15/2023

Claims Department Requires Additional Information for Processing Certain Services

Claims Department Requires Additional Information for Processing Certain Services Are you having difficulty with what must be provided when we ask for additional information to process your claim? If ...

Posting Date: 06/12/2023

Drugs and Biologicals Frequently Asked Questions

Drugs and Biologicals Frequently Asked Questions We’ve added new frequently asked questions to our website. We encourage our providers to view answers to common questions about Drugs and Biologicals t...

Posting Date: 06/12/2023

End of the Public Health Emergency Frequently Asked Questions

End of the Public Health Emergency Frequently Asked Questions We’ve added new frequently asked questions to our website. We encourage our providers to view answers to questions about the End of the Pu...

Posting Date: 06/12/2023

Government Efforts to Combat Cancer Deaths Related to Tobacco

Government Efforts to Combat Cancer Deaths Related to Tobacco Tobacco use is the leading preventable cause of cancer and cancer deaths. Lung cancer is what normally is thought of when talking about to...

Posting Date: 06/08/2023

MLN Connects® Newsletter: June 8, 2023

MLN Connects® Newsletter: June 8, 2023 News CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the Territory of Guam Due to Recent Typhoon CMS Roundup (June 2, 202...

Posting Date: 06/07/2023

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...

Posting Date: 06/07/2023

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...

Posting Date: 06/02/2023

July 2023 Release "Dark Days" for the Common Working File Hosts

July 2023 Release "Dark Days" for the Common Working File Hosts For the upcoming July 2023 Release: For Production, CWF will be observing the Gray Day on Thursday, 6/29/2023 and Dark Days starting Fri...

Posting Date: 06/01/2023

MLN Connects® Newsletter: June 1, 2023

MLN Connects® Newsletter: June 1, 2023 News CMS Announces Plan to Ensure Availability of New Alzheimer’s Drugs COVID-19 Health Care Staff Vaccination Final Rule Medicare Secondary Payer Accident-Relat...

Posting Date: 05/31/2023

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: 05/25/2023

MLN Connects® Newsletter: May 25, 2023

MLN Connects® Newsletter: May 25, 2023 News DMEPOS Competitive Bidding Program: Temporary Gap Period Starts January 1 CMS Roundup (May 19, 2023) Medicare Providers: Deadlines for Joining an Accountab...

Posting Date: 05/25/2023

Billing and Reimbursement for Penile Pressure Cuff

Billing and Reimbursement for Penile Pressure Cuff Effective 6/1/2023, when billing for penile pressure cuff used for the provision of a voiding pressure study, please submit using CPT code 55899 (unl...

Posting Date: 05/24/2023

Billing and Coding Article Updates for May and June 2023

Billing and Coding Article Updates for May and June 2023 Self-Administered Drug Exclusion List: Medical Policy Article A53021 (JK) and A53022 (J6) The article has been updated to add: Adalimumab-aacf ...

Posting Date: 05/23/2023

Accessing the NGS FISS DDE System

Accessing the NGS FISS DDE System As we previously communicated via the May 2023 Dark Days for CMS Data Migration - Rescheduled May 2023 Dark Days for Data Center Migration, the Medicare Part A CMS Da...

Posting Date: 05/23/2023

New Fiscal Intermediary Shared System Consistency Edit to Validate Attending Physician National Provider Identifier

New Fiscal Intermediary Shared System Consistency Edit to Validate Attending Physician National Provider Identifier Effective 5/16/2023, CMS implemented a new FISS consistency edit to validate the att...

Posting Date: 05/19/2023

Local Coverage Determination Open Meeting Announcement

Local Coverage Determination Open Meeting Announcement Jurisdiction 6/Jurisdiction K Part A/Part B MAC To ensure the development of LCDs occurs through a public and open process, we are soliciting sci...

Posting Date: 05/18/2023

Medical Review: Targeted Probe and Educate Review Topics Updated

Medical Review: Targeted Probe and Educate Review Topics Updated The Medical Review: TPE Review Topics page on our website has been updated. This page lists the topics and CPT codes under review by th...