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Posting Date: Thu Dec 28 00:00:00 GMT 2023
January 2024 Billing and Coding Articles Updates

January 2024 Billing and Coding Articles Updates Billing and Coding: Denosumab (Prolia ™, Xgeva ™) (A52399) Coding Information #2 has been removed based on Transmittal 12397 (CR 13468), Payment of Cod...

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Posting Date: Thu Dec 28 00:00:00 GMT 2023
Improving Customer Experience

Improving Customer Experience We are committed to improving your experience. Please watch this two-minute video that explains how each day we review comments from providers who submit surveys to let u...

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Posting Date: Tue Dec 26 00:00:00 GMT 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. Medicare Part B...

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Posting Date: Thu Dec 21 00:00:00 GMT 2023
Provider Enrollment Application Fee Amount for CY 2024

Provider Enrollment Application Fee Amount for CY 2024 The provider enrollment application fee for calendar year 2024 is $709. For more information, view CMS’ MLN Connects® Newsletter, Wednesday, Nove...

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Posting Date: Thu Dec 21 00:00:00 GMT 2023
New A/B and DME Collaborative YouTube Video

New A/B and DME Collaborative YouTube Video The A/B DME MACs are offering a YouTube video on Therapeutic Shoes for Persons with Diabetes. This video provides guidance on coverage criteria, documentati...

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Posting Date: Thu Dec 21 00:00:00 GMT 2023
MLN Connects® Newsletter: December 21, 2023

MLN Connects® Newsletter: December 21, 2023 News CMS Roundup (Dec 15, 2023) Opioid Use Disorder Screenings & Treatment: Medicare Pays for Services Opioid Treatment Programs: New Information for 2024 S...

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Posting Date: Fri Dec 15 00:00:00 GMT 2023
Knowing Where to Look for EDI Enrollment Packet Data

Knowing Where to Look for EDI Enrollment Packet Data Periodically, EDI Enrollment will be publishing articles to help eliminate the number of EDI applications that are denied. Signature is Incorrect: ...

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Posting Date: Thu Dec 14 00:00:00 GMT 2023
The Importance of Proper Documentation

The Importance of Proper Documentation The CERT contractor randomly selects claims providers submit to Medicare to determine if the claim was paid properly under Medicare coverage, coding and billing ...

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Posting Date: Thu Dec 14 00:00:00 GMT 2023
MLN Connects® Newsletter: December 14, 2023

MLN Connects® Newsletter: December 14, 2023 News CMS Releases Revised Guidance for Medicare Prescription Drug Inflation Rebate Program Medicare Part B Inflation Rebate Guidance: Use of the 340B Modifi...

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Posting Date: Thu Dec 14 00:00:00 GMT 2023
Medicare Demand Letter Rebuttals

Medicare Demand Letter Rebuttals National Government Services has seen an influx of overpayment rebuttal inquiries and here’s what you need to know. Rebuttals should be rare and only approved if NGS h...

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Posting Date: Fri Dec 08 00:00:00 GMT 2023
Reminder: OPPS Provider-Based Edits

Reminder: OPPS Provider-Based Edits Are you having issues with the recently implemented provider-based billing edits impacting OPPS facilities with multiple service locations? Certain edits were imple...

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Posting Date: Fri Dec 08 00:00:00 GMT 2023
CR13468 - Payment of Codes for Chemotherapy Administration and Nonchemotherapy Injections and Infusions

CR13468 - Payment of Codes for Chemotherapy Administration and Nonchemotherapy Injections and Infusions Posted 12/8/2023

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Posting Date: Thu Dec 07 00:00:00 GMT 2023
The Comprehensive Error Rate Testing Contractor Process

The Comprehensive Error Rate Testing Contractor Process The CERT contractor randomly selects claims providers submit to Medicare to determine if the claim was paid properly under Medicare coverage, co...

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Posting Date: Thu Dec 07 00:00:00 GMT 2023
Institutional Providers: Revised CMS-855A Medicare Enrollment Paper Application Required 12/17/2023

Institutional Providers: Revised CMS-855A Medicare Enrollment Paper Application Required 12/17/2023 If you don’t use PECOS, use the revised CMS-855A (Medicare Enrollment Application -Institutional Pro...

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Posting Date: Thu Dec 07 00:00:00 GMT 2023
MLN Connects® Newsletter: December 7, 2023

MLN Connects® Newsletter: December 7, 2023 News Citrix Bleed Vulnerability: Act Now Marriage and Family Therapists & Mental Health Counselors: Enroll in Medicare Now Health Professional Shortage Area:...

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Posting Date: Wed Dec 06 00:00:00 GMT 2023
National Government Services Medicare Administrative Contractor Provider Intervention Program

National Government Services Medicare Administrative Contractor Provider Intervention Program Are you aware that National Government Services has a MAC MPIP? The goal of this program is to notify you ...

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Posting Date: Mon Dec 04 00:00:00 GMT 2023
The New York Regional Office of CMS – Monthly Office Hours/Open Forum

The New York Regional Office of CMS – Monthly Office Hours/Open Forum The New York Regional Office of CMS (Region 2) conducts a monthly Office Hours/Open Forum meeting that allows physicians and their...

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Posting Date: Thu Nov 30 00:00:00 GMT 2023
MLN Connects® Newsletter: November 30, 2023

MLN Connects® Newsletter: November 30, 2023 News Quality Payment Program: Preview Your Performance Information by December 12 HIV: Screening is Knowledge Claims, Pricers, & Codes Resubmit Telehealth C...

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Posting Date: Wed Nov 29 00:00:00 GMT 2023
The CY 2024 Medicare Physician Fee Schedule Is Now Available

The CY 2024 Medicare Physician Fee Schedule Is Now Available The CY 2024 MPFS is now available. You can view the new fees using the Fee Schedule Lookup tool located on NGSMedicare.com. Posted 11/29/20...

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Posting Date: Wed Nov 29 00:00:00 GMT 2023
The Comprehensive Error Rate Testing Contractor

The Comprehensive Error Rate Testing Contractor The CERT contractor randomly selects claims providers submit to Medicare to determine if the claim was paid properly under Medicare coverage, coding and...

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Posting Date: Wed Nov 29 00:00:00 GMT 2023
Critical Access Hospitals: Bill Correctly

Critical Access Hospitals: Bill Correctly The CERT contractor randomly selects claims providers submit to Medicare to determine if the claim was paid properly under Medicare coverage, coding and bil...

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Posting Date: Wed Nov 29 00:00:00 GMT 2023
LCD and Billing and Coding Article Updates for November/December 2023

LCD and Billing and Coding Article Updates for November/December 2023 LCDs Effective 12/24/2023 Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, N...

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Posting Date: Tue Nov 28 00:00:00 GMT 2023
WellSky Home Health Claim Primary Diagnosis Coding Issue

WellSky Home Health Claim Primary Diagnosis Coding Issue WellSky has identified a software error for their HHA customers that potentially impacted claims submitted between 9/29/2021 and 10/27/2022. Th...

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Posting Date: Wed Nov 22 00:00:00 GMT 2023
MLN Connects® Newsletter: November 22, 2023

MLN Connects® Newsletter: November 22, 2023 News CMS Roundup (Nov 17, 2023) Provider Enrollment Application Fee: CY 2024 Clinical Laboratory Fee Schedule: CY 2024 Final Payment Determinations & Report...

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Posting Date: Wed Nov 22 00:00:00 GMT 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...

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Posting Date: Mon Nov 20 00:00:00 GMT 2023
January 2024 Release "Dark Days" for the Common Working File Hosts

January 2024 Release "Dark Days" for the Common Working File Hosts For the upcoming January 2024 Release: For Production, CWF will be observing the Gray Day on Thursday, 12/28/2023 and Dark Days start...

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Posting Date: Thu Nov 16 00:00:00 GMT 2023
MLN Connects® Newsletter: November 16, 2023

MLN Connects® Newsletter: November 16, 2023 News Unprecedented Efforts to Increase Transparency of Nursing Home Ownership Hospital Price Transparency: Use Required CMS Template Layout to Encode Hospit...

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Posting Date: Wed Nov 15 00:00:00 GMT 2023
Fraud Awareness Week and National Rural Health Day

Fraud Awareness Week and National Rural Health Day Since this week is Fraud Awareness Week and National Rural Health Day is tomorrow on 11/16/2023, we wanted to share these valuable resources with you...

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Posting Date: Wed Nov 15 00:00:00 GMT 2023
MLN Connects Newsletter: Take Our Provider Survey Today - November 15, 2023

MLN Connects® Newsletter: Take Our Provider Survey Today - November 15, 2023 You helped us before, and we want to learn more about your information needs. CMS is conducting a study to help us improve ...

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Posting Date: Tue Nov 14 00:00:00 GMT 2023
Announcement About Medicare Participation for Calendar Year 2024

Announcement About Medicare Participation for Calendar Year 2024 The Centers for Medicare & Medicaid Services has posted the Announcement About Medicare Participation for Calendar Year 2024. Posted 11...

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Posting Date: Mon Nov 13 00:00:00 GMT 2023
The Great American Smokeout is Thursday 11/16/2023 - Let's Talk About Tobacco Counseling

The Great American Smokeout is Thursday 11/16/2023 - Let's Talk About Tobacco Counseling Do you treat Medicare beneficiaries/patients who are nicotine dependent? Did you know Medicare has a preventive...

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Posting Date: Thu Nov 09 00:00:00 GMT 2023
MLN Connects® Newsletter: November 9, 2023

MLN Connects® Newsletter: November 9, 2023 News CMS Roundup (Nov 3, 2023) Marriage and Family Therapists & Mental Health Counselors: Enroll in Medicare Now American Indians or Alaska Natives: Help You...

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Posting Date: Wed Nov 08 00:00:00 GMT 2023
Provider Enrollment: Reminder for Open Enrollment and Participation Agreement

Provider Enrollment: Reminder for Open Enrollment and Participation Agreement The 2024 Annual Participation Open Enrollment Period is approaching for another year. While this is an important time (fro...

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Posting Date: Mon Nov 06 00:00:00 GMT 2023
Common Definitions for Claim Submission Types

Common Definitions for Claim Submission Types Appeals An appeal is an independent review of the initial or revised determination. Proceeding with an appeal is the responsibility of the provider. Overa...

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Posting Date: Fri Nov 03 00:00:00 GMT 2023
MLN Connects® Newsletter: PFS, OPPS/ASC, & OPPS 340B-Acquired Drug Final Rules - November 2, 2023

MLN Connects® Newsletter: PFS, OPPS/ASC, & OPPS 340B-Acquired Drug Final Rules - November 2, 2023 Final Rules CMS Finalizes Physician Payment Rule that Advances Health Equity CMS Makes Hospital Prices...

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Posting Date: Thu Nov 02 00:00:00 GMT 2023
MLN Connects® Newsletter: November 2, 2023

MLN Connects® Newsletter: November 2, 2023 News CY 2024 Home Health Prospective Payment System Final Rule CY 2024 End-Stage Renal Disease Prospective Payment System Final Rule Behavioral Health: Medic...

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Posting Date: Wed Nov 01 00:00:00 GMT 2023
MLN Connects® Newsletter: Take Our Provider Survey Today - November 1, 2023

MLN Connects® Newsletter: Take Our Provider Survey Today - November 1, 2023 News Take Our Provider Survey Today Posted 11/1/2023

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Posting Date: Mon Oct 30 00:00:00 GMT 2023
Proper Use of Modifiers JW and JZ

Proper Use of Modifiers JW and JZ National Government Services Provider Contact Center has received several inquiries regarding claim denials related to the use of the JW and JZ modifier for drugs/bio...

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Posting Date: Thu Oct 26 00:00:00 GMT 2023
MLN Connects® Newsletter: October 26, 2023

MLN Connects® Newsletter: October 26, 2023 News Help CMS Improve Provider Resources — Respond by November 9 CMS Roundup (Oct 20, 2023) Nursing Facility Evaluation and Management Visits: Comparative Bi...

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Posting Date: Thu Oct 26 00:00:00 GMT 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:...

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Posting Date: Thu Oct 26 00:00:00 GMT 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...

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Posting Date: Thu Oct 26 00:00:00 GMT 2023
Coming Soon ‒ The CY 2024 Medicare Physician Fee Schedule

Coming Soon - The CY 2024 Medicare Physician Fee Schedule The CY 2024 MPFS will soon be available on the Fee Schedule Lookup tool located on NGSMedicare.com, after the CY 2024 physician fee schedule r...

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Posting Date: Wed Oct 25 00:00:00 GMT 2023
Credit Balance Report Reminder

Credit Balance Report Reminder CBRs for the quarter ending 9/30/2023 are now due. CBRs must be submitted within 30 days of the end of the quarter to be considered timely. FISS DDE users who submit the...

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Posting Date: Wed Oct 25 00:00:00 GMT 2023
You Can Help Your Patients Quit Tobacco Use - The Great American Smokeout Is Coming!

You Can Help Your Patients Quit Tobacco Use - The Great American Smokeout Is Coming! Join us for our webinar series on Medicare’s preventative services, "Counseling to Prevent Tobacco Use" and “Telehe...

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Posting Date: Mon Oct 23 00:00:00 GMT 2023
November is Lung Cancer Awareness Month

November is Lung Cancer Awareness Month Lung cancer is the leading cause of cancer death in the United States and worldwide. Although education, research and treatment options for lung cancer have dra...

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Posting Date: Mon Oct 23 00:00:00 GMT 2023
Portable X-ray Payment – 2023 Request for Cost Information

Portable X-ray Payment – 2023 Request for Cost Information In accordance with CMS requirements, National Government Services is conducting a full rate review and a five-year rate update for portable X...

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Posting Date: Thu Oct 19 00:00:00 GMT 2023
MLN Connects® Newsletter: October 19, 2023

MLN Connects® Newsletter: October 19, 2023 News 2024 Medicare Parts A & B Premiums and Deductibles Help CMS Improve Provider Resources — Respond by November 9 CMS Health Information Handler Helps ...

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Posting Date: Tue Oct 17 00:00:00 GMT 2023
Update: End Stage Renal Disease Claim Adjustments Needed Due to CWF Error in Date of First Dialysis

Update: End Stage Renal Disease Claim Adjustments Needed Due to CWF Error in Date of First Dialysis As of 7/18/2023, CMS has identified that the CWF continues to have some inaccurate dates for the fir...

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Posting Date: Mon Oct 16 00:00:00 GMT 2023
Tips for Documenting Homebound Status

Tips for Documenting Homebound Status Comprehensive and accurate documentation is crucial to providing safe and effective care to Medicare beneficiaries. National Government Services' medical review t...

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Posting Date: Mon Oct 16 00:00:00 GMT 2023
Physicians and Nonphysician Practitioners: Revised CMS-855I Medicare Enrollment Application Required November 1 (Combined CMS-855I and CMS-855R)

Physicians and Nonphysician Practitioners: Revised CMS-855I Medicare Enrollment Application Required November 1 (Combined CMS-855I and CMS-855R) If you don’t use PECOS, use the revised CMS-855I (Medic...

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Posting Date: Thu Oct 12 00:00:00 GMT 2023
MLN Connects® Newsletter: October 12, 2023

MLN Connects® Newsletter: October 12, 2023 News CMS Roundup (Oct 6, 2023) Protect Your Patients: Give Them a Flu Shot Publications Direct Data Entry: 10-Digit Screen Expansion Medicare Preventive ...

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Posting Date: Thu Oct 12 00:00:00 GMT 2023
Let’s Get Ready for The Great American Smokeout on 11/16/2023!

Let’s Get Ready for The Great American Smokeout on 11/16/2023! For more than 40 years, the American Cancer Society has hosted the Great American Smokeout on the third Thursday of November. This yearly...

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Posting Date: Wed Oct 11 00:00:00 GMT 2023
Notification of the 2024 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review

Notification of the 2024 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review The amount that must remain in controve...

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Posting Date: Fri Oct 06 00:00:00 GMT 2023
Update on proposed LCD for Transesophageal Echocardiography

Update on proposed LCD for Transesophageal Echocardiography The LCD for Transesophageal Echocardiography (TEE) was published for comment and presented at an Open Meeting in July 2023. NGS is continuin...

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Posting Date: Fri Oct 06 00:00:00 GMT 2023
MLN Connects® Newsletter: October 6, 2023

MLN Connects® Newsletter: October 6, 2023 News COVID-19: Updated Novavax COVID-19 Vaccine, Adjuvanted for Patients 12 & Older Posted 10/6/2023

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Posting Date: Thu Oct 05 00:00:00 GMT 2023
MLN Connects® Newsletter: October 5, 2023

MLN Connects® Newsletter: October 5, 2023 News Administration Moves Forward with Medicare Drug Price Negotiations to Lower Prescription Drug Costs for People with Medicare CMS Requests Public Inpu...

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Posting Date: Thu Oct 05 00:00:00 GMT 2023
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: Tue Oct 03 00:00:00 GMT 2023
Fiscal Intermediary Standard System Direct Data Entry Screen Changes – October 2023

Fiscal Intermediary Standard System Direct Data Entry Screen Changes – October 2023 The October 2023 quarterly system release was implemented on 10/2/2023 and includes the FISS DDE screen changes iden...

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Posting Date: Mon Oct 02 00:00:00 GMT 2023
Collaborative A/B/DME Therapeutic Shoes for Persons with Diabetes Webinar

Collaborative A/B/DME Therapeutic Shoes for Persons with Diabetes Webinar Providers – Do you need assistance in understanding what is needed when ordering diabetic shoes? This collaborative webinar on...

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Posting Date: Thu Sep 28 00:00:00 GMT 2023
MLN Connects® Newsletter: September 28, 2023

MLN Connects® Newsletter: September 28, 2023 News CMS Statement on Current Status of Blood Tests for Organ Transplant Rejection CMS Roundup (Sept 22, 2023) Cardiovascular Disease: Talk with Your P...

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Posting Date: Tue Sep 26 00:00:00 GMT 2023
Decrease Burden and Combine Multiple PDFs into One Before Responding to Additional Documentation Requests Using NGSConnex

Decrease Burden and Combine Multiple PDFs into One Before Responding to Additional Documentation Requests Using NGSConnex Recently, National Government Services has seen an increase in providers submi...

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Posting Date: Mon Sep 25 00:00:00 GMT 2023
Don't Miss Out - Register Today! National Government Services: Medicare Part B Care Management Tuesdays

Don't Miss Out - Register Today! National Government Services: Medicare Part B Care Management Tuesdays According to the CDC, six in ten adults in the U.S. have a chronic disease and four in ten adult...

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Posting Date: Fri Sep 22 00:00:00 GMT 2023
LCD and Billing and Coding Article Update for October 2023

LCD and Billing and Coding Article Update for October 2023 Billing and Coding: Autonomic Function Testing (A57024) Due to the annual ICD-10 Code updates, ICD-10 code G20 has been deleted and the follo...

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Posting Date: Fri Sep 22 00:00:00 GMT 2023
Register Today! National Government Services Fall 2023 Medicare Virtual Conference: Understanding Medicare Compliance for Part B Providers

Register Today! National Government Services Fall 2023 Medicare Virtual Conference: Understanding Medicare Compliance for Part B Providers This three full-day virtual conference will offer a variety o...

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Posting Date: Thu Sep 21 00:00:00 GMT 2023
MLN Connects® Newsletter: September 21, 2023

MLN Connects® Newsletter: September 21, 2023 News CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Georgia Organ Transplantation Affinity Group:...

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Posting Date: Mon Sep 18 00:00:00 GMT 2023
Direct Data Entry Users May Need to Adjust Screen Size

Direct Data Entry Users May Need to Adjust Screen Size CMS recently issued Change Request 13138 “Implementation to Expand Monetary Amount Fields Related to Billing and Payment to Accommodate 10-Digits...

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Posting Date: Fri Sep 15 00:00:00 GMT 2023
New YouTube Video: Surgical Dressings and Supplies: Part A/B and DME Collaborative Presentation

New YouTube Video: Surgical Dressings and Supplies: Part A/B and DME Collaborative Presentation The Part A/B and DME MACs are offering a YouTube video on Surgical Dressings and Supplies. This video of...

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Posting Date: Fri Sep 15 00:00:00 GMT 2023
Save the Dates! National Government Services Fall 2023 Virtual Conference for Medicare Part A Providers

Save the Dates! National Government Services Fall 2023 Virtual Conference for Medicare Part A Providers Ending 2023 on a Strong Medicare Note 11/1/2023-11/2/2023 The National Government Services POE T...

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Posting Date: Thu Sep 14 00:00:00 GMT 2023
Dental Services: Billing and Coding Article A59543 is Available

Dental Services: Billing and Coding Article A59543 is Available The information in this article contains billing, coding or other guidelines that support the implementation of the CY 2023 Medicare Phy...

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Posting Date: Thu Sep 14 00:00:00 GMT 2023
MLN Connects® Newsletter: September 14, 2023

MLN Connects® Newsletter: September 14, 2023 News Inflation Reduction Act Continues to Lower Out-of-Pocket Prescription Drug Costs for Drugs with Price Increases Above Inflation CMS Roundup (Sept ...

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Posting Date: Thu Sep 14 00:00:00 GMT 2023
MLN Connects® Newsletter: COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older – September 14, 2023

MLN Connects® Newsletter: COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older – September 14, 2023 News COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older Posted 9/14/2023

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Posting Date: Thu Sep 14 00:00:00 GMT 2023
Save the Dates! National Government Services Fall 2023 Virtual Conference for Part B Providers

Save the Dates! National Government Services Fall 2023 Virtual Conference for Part B Providers Understanding Medicare Compliance 11/6/2023-11/8/2023 We’re excited to announce our Medicare Part B 2023 ...

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Posting Date: Fri Sep 08 00:00:00 GMT 2023
Don’t Let Your Flu Vaccination Claims Deny!

Don’t Let Your Flu Vaccination Claims Deny! The 2023-2024 flu vaccine season has begun. At the beginning of each flu season, National Government Services sees an increase in claim denial volume for fl...

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Posting Date: Thu Sep 07 00:00:00 GMT 2023
MLN Connects® Newsletter: September 7, 2023

MLN Connects® Newsletter: September 7, 2023 News New Version of CMS.gov HHS Proposes Minimum Staffing Standards to Enhance Safety and Quality in Nursing Homes CMS Announces Resources and Flexibili...

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Posting Date: Tue Sep 05 00:00:00 GMT 2023
National Government Services CAC Meeting Notice on Botulinum Toxins

National Government Services CAC Meeting Notice on Botulinum Toxins Information has been posted on our website in regards to the National Government Services l Contractor Advisory Committee Meeting re...

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