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Posting Date: 01/04/2024
MLN Connects® Newsletter: January 4, 2024

MLN Connects® Newsletter: January 4, 2024 News CMS Roundup (Dec 29, 2023) In-Home Vaccine Administration: Additional Payment Organizational Providers: Do You Need to Revalidate Your Enrollment Record ...

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Posting Date: 01/03/2024
Hospice Cap Self-Reporting Reminder for the 2023 Cap Year

Hospice Cap Self-Reporting Reminder for the 2023 Cap Year The Hospice Cap Self-Reporting for the 2023 Cap Year (10/1/2022-9/30/2023) is due no later than 2/29/2024. Hospice providers should submit the...

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Posting Date: 01/02/2024
January Code Set Update for PC Print: January 2024

January Code Set Update for PC-Print: January 2024 The PC-Print January code set update will be available on our website 1/3/2024. The update contains the following enhancements: CR13303 Implement Ope...

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Posting Date: 01/02/2024
New Version of PC-ACE: January 2024

New Version of PC-ACE: January 2024 PC-ACE Version 6.1 contains several CMS mandates and product enhancements including but not limited to the items listed below. MLN Matters® MM13248 Revised: Process...

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Posting Date: 01/02/2024
New Medicare Topic – Medicare Part B Final Rule 2024

New Medicare Topic – Medicare Part B Final Rule 2024 CMS issued the final rule on 11/2/2023, which announces finalized policy changes for Medicare payments under the PFS and other Medicare Part B issu...

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Posting Date: 12/28/2023
Micro-invasive Glaucoma Surgery Update

Micro-invasive Glaucoma Surgery Update The MIGS LCD, L37244, and Billing and Coding Article, A56588, will not become final and therefore have been removed from the Medicare Coverage Database. Accordin...

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Posting Date: 12/28/2023
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: 12/28/2023
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: 12/26/2023
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: 12/21/2023
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: 12/21/2023
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: 12/21/2023
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: 12/15/2023
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: 12/14/2023
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: 12/14/2023
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: 12/14/2023
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: 12/08/2023
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: 12/08/2023
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: 12/07/2023
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: 12/07/2023
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: 12/07/2023
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: 12/06/2023
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: 12/04/2023
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: 11/30/2023
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: 11/29/2023
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: 11/29/2023
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: 11/29/2023
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: 11/29/2023
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: 11/28/2023
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: 11/22/2023
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: 11/22/2023
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: 11/20/2023
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: 11/16/2023
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: 11/15/2023
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: 11/15/2023
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: 11/14/2023
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: 11/13/2023
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: 11/09/2023
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: 11/08/2023
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: 11/06/2023
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: 11/03/2023
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: 11/02/2023
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: 11/01/2023
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: 10/30/2023
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: 10/26/2023
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: 10/26/2023
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: 10/26/2023
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: 10/25/2023
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: 10/25/2023
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: 10/23/2023
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: 10/19/2023
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: 10/17/2023
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: 10/16/2023
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: 10/16/2023
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: 10/12/2023
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: 10/12/2023
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: 10/11/2023
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: 10/06/2023
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: 10/06/2023
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: 10/05/2023
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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