News - NGSMEDICARE

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...

Posting Date: 05/18/2023

MLN Connects® Newsletter: May 18, 2023

MLN Connects® Newsletter: May 18, 2023 News COVID-19: Public Health Emergency Ended May 11 End of COVID-19 Public Health Emergency FAQs Advancing Health Equity Through The CMS Innovation Center: Firs...

Posting Date: 05/11/2023

MLN Connects® Newsletter: May 11, 2023

MLN Connects® Newsletter: May 11, 2023 News CMS Roundup (May 5, 2023) Medicare Ground Ambulance Data Collection System: Report Information Compliance Bill Correctly: Power Mobility Devices Repairs ML...

Posting Date: 05/11/2023

National Government Services: Raising Awareness About Care Management

National Government Services: Raising Awareness about Care Management According to the Center for Disease Control, six in ten adults in the U.S. have a chronic disease and four in ten adults have two ...

Posting Date: 05/10/2023

Medicare Part A CMS Data Center Migration – Rescheduled May 2023 Dark Days for Data Center Migration

May 2023 Dark Days for CMS Data Center Migration – Rescheduled May 2023 Dark Days for Data Center Migration As we previously communicated, the Medicare Part A CMS Data Center Migration was postponed. ...

Posting Date: 05/09/2023

Urgent News: May 2023 Dark Days for Data Center Migration Postponed

Urgent News: May 2023 Dark Days for Data Center Migration Postponed The Medicare Part A CMS Data Center Migration scheduled for 5/12/2023 to 5/15/2023 has been postponed. All systems and IVR will be a...

Posting Date: 05/08/2023

[URGENT] Part A DDE is Available!

[URGENT] Part A DDE is Available! Part A DDE is available and can be accessed by Part A, HHH and FQHC providers. The issue of providers not being able to sign is due to an unexpected change in the Dat...

Posting Date: 05/05/2023

New versus Established Patients

New versus Established Patients We’ve updated this frequently asked question based on recent clarification from CMS. Please clarify appropriate billing for outpatient/office services when a consulting...

Posting Date: 05/05/2023

Oxygen and Oxygen Equipment: A/B and DME Collaborative Presentation

Oxygen and Oxygen Equipment: A/B and DME Collaborative Presentation View the A/B and DME Oxygen and Oxygen Equipment YouTube video for information on oxygen. Posted 5/5/2023

Posting Date: 05/05/2023

Proper Taxonomy Code for Ambulatory Surgical Center

Proper Taxonomy Code for Ambulatory Surgical Center National Government Services has been testing new edits to implement into our Advance Communication Engine System Edit Module (NGS-ACE) front end ed...

Posting Date: 05/05/2023

Provider Enrollment: Resumed Revalidation Activities

Provider Enrollment: Resumed Revalidation Activities Attention: Provider Enrollment and Credentialing Departments Activities have resumed with revalidation due dates starting with 1/31/2022. Don’t wai...

Posting Date: 05/04/2023

MLN Connects® Newsletter: May 4, 2023

MLN Connects® Newsletter: May 4, 2023 News FAQs on CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency Guidance for the Expiration of the COVID-19 Public Health Emergency ...

Posting Date: 05/04/2023

Get PECOS Access to Maintain Medicare Provider Enrollment Records

Get PECOS Access to Maintain Medicare Provider Enrollment Records Do you need to work on behalf of an individual provider and/or entity to update or submit Medicare enrollment information through PECO...

Posting Date: 05/04/2023

Provider Enrollment: Resumed Revalidation Activities

Provider Enrollment: Resumed Revalidation Activities Attention: Provider Enrollment and Credentialing Departments Activities have resumed with revalidation due dates starting with 1/31/2022. Don’t wai...

Posting Date: 04/27/2023

MLN Connects® Newsletter: April 27, 2023

MLN Connects® Newsletter: April 27, 2023 News Hospital Price Transparency Enforcement Updates For the First Time, HHS Is Making Ownership Data for All Medicare-Certified Hospice and Home Health Agenc...

Posting Date: 04/27/2023

KX Modifier on Outpatient Physical Therapy, Occupational Therapy or Speech Language Pathology Claims

KX Modifier on Outpatient Physical Therapy, Occupational Therapy or Speech Language Pathology Claims Reminders Providers report KX modifier on a claim line(s) to confirm the medical records contain sp...

Posting Date: 04/26/2023

NGS Cost Report Submission Reminders

NGS Cost Report Submission Reminders We strongly encourage filing of the cost report via the Medicare Cost Report E‐Filing (MCReF) System. If the cost report is submitted via MCReF, it does not need t...

Posting Date: 04/26/2023

EDI Enrollment Spotlights Packet Completion Times

EDI Enrollment Spotlights Packet Completion Times We ask that you allow seven – ten business days for processing of all requests. All requests are worked in the order in which they are received. Curre...

Posting Date: 04/26/2023

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: 04/24/2023

End of the Public Health Emergency: Over The Counter COVID-19 Test Kits

End of the Public Health Emergency: Over The Counter COVID-19 Test Kits With the end of the PHE on 5/11/ 2023, coverage for COVID-19 testing for Americans will change. Medicare beneficiaries who are e...

Posting Date: 04/21/2023

Telligen QIN-QIO Hosting Chronic Kidney Disease Topics with National Kidney Foundation

Telligen QIN-QIO Hosting Chronic Kidney Disease Topics with National Kidney Foundation Chronic kidney disease (CKD) affects more than 1 in 7 U.S. adults—an estimated 37 million Americans. For American...

Posting Date: 04/21/2023

LCD, Billing and Coding Article Updates for April and May 2023

LCD, Billing and Coding Article Updates for April and May 2023 Billing and Coding Article (A56937): Psychiatry and Psychology Services Removed sentence from article text section - “For psychotherapy s...

Posting Date: 04/21/2023

New Service Added to the Hospital Outpatient Department Prior Authorization Program - Facet Joint Interventions

New Service Added to the Hospital Outpatient Department Prior Authorization Program - Facet Joint Interventions As a reminder, effective for dates of service rendered on or after 7/1/2023, facet joint...

Posting Date: 04/20/2023

Providers Using NGSConnex to Submit Appeals and Supporting Documentation

Providers Using NGSConnex to Submit Appeals and Supporting Documentation We strongly recommend our providers use NGSConnex to submit your redetermination requests and any supporting documentation. Ple...

Posting Date: 04/20/2023

Medicare University Continuing to Experience Intermittent Issues

Medicare University Continuing to Experience Intermittent Issues We are continuing to experience intermittent outages with Medicare University. You do not need to report these issues with Medicare Uni...

Posting Date: 04/20/2023

MLN Connects® Newsletter: April 20, 2023

MLN Connects® Newsletter: April 20, 2023 News Billing Medicare Part B for Insulin with New Limits on Patient Monthly Coinsurance Medical Review & Compliance: Respond to Additional Documentation Reque...

Posting Date: 04/19/2023

Telehealth Frequently Asked Questions are Updated

Telehealth Frequently Asked Questions are Updated We’ve updated our telehealth frequently asked questions to include changes and flexibilities due to the end of the PHE on 5/11/2023. Please view these...

Posting Date: 04/18/2023

Part B Top Claim Errors Are Updated

Part B Top Claim Errors Are Updated Our top claim errors are updated on a quarterly basis to reflect current information. Visit Top Claim Errors to learn what you can do to avoid claim processing dela...

Posting Date: 04/18/2023

Attention Home Health and Hospice Providers Using NGSConnex to Submit Level One Appeals Redetermination Requests

Attention Home Health and Hospice Providers Using NGSConnex to Submit Level One Appeals Redetermination Requests National Government Services strongly recommends that all providers, including home hea...

Posting Date: 04/14/2023

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 hold on y...

Posting Date: 04/14/2023

CR13105 - Technical Revisions Only to the National Coverage Determination (NCD) Manual

Posting Date: 04/13/2023

The Advance Beneficiary Notice of Noncoverage

The Advance Beneficiary Notice of Noncoverage We’ve updated our Advance Beneficiary Notice of Noncoverage article to include examples for using an ABN for outpatient therapy and using the KX and GA mo...

Posting Date: 04/13/2023

Top Tobacco Counseling Claim Denials and How to Avoid/Correct Them

Top Tobacco Counseling Claim Denials and How to Avoid/Correct Them Providers, are your claims being denied for tobacco counseling services utilizing codes 99406 and 99407? In order to assist our provi...

Posting Date: 04/13/2023

MLN Connects® Newsletter: April 13, 2023

MLN Connects® Newsletter: April 13, 2023 News COVID-19: End of Public Health Emergency CMS Roundup (Apr. 07, 2023) Medicare Shared Savings Program: Application Toolkit Materials Inpatient Rehabilitat...

Posting Date: 04/13/2023

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS-855A Application

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS-855A Application To reduce requests for additional information, National Government Services offers several pro...

Posting Date: 04/13/2023

Registration is Open for the Part B Claim Submission Learning Day

Registration is Open for the Part B Claim Submission Learning Day Join us on Tuesday, 5/9/2023 for our Part B Claim Submission Learning Day! Our Part B POE Team is hosting a full day of educational we...

Posting Date: 04/12/2023

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 hold on y...

Posting Date: 04/12/2023

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS Enrollment Forms

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS Enrollment Forms To reduce requests for additional information, National Government Services offers several pro...

Posting Date: 04/12/2023

Home Health and Hospice Targeted Probe and Educate Resources

Home Health and Hospice Targeted Probe and Educate Resources It is imperative to keep up-to-date with all National Government Services JK and J6 HH+H TPE audit focus areas. This information can be loc...

Posting Date: 04/11/2023

NGS-ACE Enhancement Coming Soon

NGS-ACE Enhancement Coming Soon The National Government Services EDI team is pleased to share an upcoming enhancement to the 277CA (Claims Acknowledgement) transaction. Informational messages will be ...

Posting Date: 04/11/2023

MLN Connects® Newsletter: CMS Proposes Policies to Improve Patient Safety and Promote Health Equity — April 10, 2023

MLN Connects® Newsletter: CMS Proposes Policies to Improve Patient Safety and Promote Health Equity — April 10, 2023 Proposed Rule CMS Proposes Policies to Improve Patient Safety and Promote Health Eq...