News - NGSMEDICARE

Posting Date: 09/15/2022

MLN Connects® Newsletter for Thursday, September 15, 2022

MLN Connects® Newsletter for Thursday, September 15, 2022 Make Your Voice Heard News Make Your Voice Heard Request for Information Seeks Public Comment to Promote Efficiency, Reduce Burden, & Advance ...

Posting Date: 09/12/2022

MLN Connects® Special Edition for Monday, September 12, 2022

MLN Connects® Special Edition for Monday, September 12, 2022 News Updated COVID-19 Vaccines Providing Protection Against Omicron Variant Available at No Cost Posted 9/12/2022

Posting Date: 09/08/2022

MLN Connects® Newsletter for Thursday, September 8, 2022

MLN Connects® Newsletter for Thursday, September 8, 2022 Prostate Cancer: Talk to Your Patients about Screening News Short-Term Acute Care Hospitals: Program for Evaluating Payment Patterns Electronic...

Posting Date: 09/08/2022

Don’t Let Your Flu Vaccination Claims Deny!

Don’t Let Your Flu Vaccination Claims Deny! The 2022-2023 flu vaccine season has begun. At the beginning of each flu season, National Government Services sees an increase in claim denial volume for fl...

Posting Date: 09/07/2022

Seasonal Influenza Vaccines Pricing

Seasonal Influenza Vaccines Pricing For Medicare billing purposes, the flu season runs from August to July of the following year. Medicare Part B covers one flu shot per flu season, if medically neces...

Posting Date: 09/07/2022

Billing for Qutenza Administration (REVISED)

Billing for Qutenza Administration (REVISED) Qutenza is topical high concentration (8%) capsaicin which is administered by a physician. The FDA approved this treatment for neuropathic pain associated ...

Posting Date: 09/06/2022

Billing New Monkeypox Vaccine and Laboratory Codes

Billing New Monkeypox Vaccine and Laboratory Codes On 7/23/2022, the WHO declared monkeypox a PHE. The HHS issued a statement regarding the Biden-Harris Administration’s actions to make vaccines, test...

Posting Date: 09/01/2022

MLN Connects® Newsletter for Thursday, September 1, 2022

MLN Connects® Newsletter for Thursday, September 1, 2022 Payment Allowances for Influenza Vaccine News CORRECTION: Monkeypox & Smallpox Vaccines: Include Product Code on Claims COVID-19: Novavax Vacci...

Posting Date: 09/01/2022

Prior Authorization Exemption Status Inquiry Tool Alert

Prior Authorization Exemption Status Inquiry Tool Alert National Government Services continues to see PARs submitted by exempt providers. In an effort to prevent unnecessary submission, NGS has develo...

Posting Date: 08/30/2022

Use National Government Services Self-Service Tools to Maximize your Workload

Use National Government Services Self-Service Tools to Maximize your Workload Our PCC telephone lines are busiest at the beginning and end of each month, and this creates long wait times for providers...

Posting Date: 08/26/2022

Treatment Plans for Cardiac Rehabilitation Services

Treatment Plans for Cardiac Rehabilitation Services In order for cardiac rehabilitation services to be covered under Medicare, an individualized treatment plan is required. The individualized treatmen...

Posting Date: 08/26/2022

August and September 2022 LCD, Billing and Coding Article Updates

August and September 2022 LCD, Billing and Coding Article Updates Routine Foot Care and Debridement of Nails – L33636 Under the Limitations section, the active care requirement for systemic conditions...

Posting Date: 08/25/2022

MLN Connects® Newsletter for Thursday, August 25, 2022

MLN Connects® Newsletter for Thursday, August 25, 2022 Medicare Secondary Payer: Manual Updates News Interns and Residents Information System XML Format: Updated Vendor List Claims, Pricers, & Codes I...

Posting Date: 08/25/2022

Use Our Provider Self-Service Tools To Spend Less Time on the Phone

Use Our Provider Self-Service Tools To Spend Less Time on the Phone Did you know our PCC experiences high call volumes at the beginning and the ending of each month? To avoid experiencing prolonged ho...

Posting Date: 08/25/2022

Updated fee for Fluorodeooxyglucose (F-18 FDG)

Updated fee for Fluorodeooxyglucose (F-18 FDG) Effective 10/1/2022, National Government Services will revise the amount allowed for Fluorodeooxyglucose (F-18 FDG, diagnostic, per study dose, up to 45m...

Posting Date: 08/24/2022

Provider Enrollment: Description of NPI and Link to NPPES Registry

Provider Enrollment: Description of NPI and Link to NPPES Registry We’ve added Description of NPI and a Link to NPPES Registry in the enrollment section of our website to assist with clarification of ...

Posting Date: 08/23/2022

Part A Prior Authorization Status Update Requests

Part A Prior Authorization Status Update Requests NGS has noticed an increase in calls to the NGS Provider Customer Service Department requesting an update on the status of a prior authorization reque...

Posting Date: 08/23/2022

Physical, Occupational and Speech and Language Pathology Therapy Services: Prevent Easily Avoidable Errors

Physical, Occupational and Speech and Language Pathology Therapy Services: Prevent Easily Avoidable Errors Evaluation/Plan of Care Documentation Elements The POC must contain, at a minimum, the follow...

Posting Date: 08/23/2022

New YouTube Video: Medical Documentation: A/B and DME Collaborative Presentation Now Available

New YouTube Video: Medical Documentation: A/B and DME Collaborative Presentation Now Available The A/B and DME MACs YouTube Video: Medical Documentation: A/B and DME Collaborative Presentation is avai...

Posting Date: 08/22/2022

Advance Communication Engine (NGS-ACE) System Edit Module for Electronic Claim Submission

Advance Communication Engine (NGS-ACE) System Edit Module for Electronic Claim Submission We are diligently working on enhancing NGS-ACE for providers in Jurisdiction 6 (Illinois, Wisconsin and Minnes...

Posting Date: 08/18/2022

MLN Connects® Newsletter for Thursday, August 18, 2022

MLN Connects® Newsletter for Thursday, August 18, 2022 Discontinuing Use of Certificates of Medical Necessity & Durable Medical Equipment Information Forms News CMS Discontinuing the Use of Certifi...

Posting Date: 08/18/2022

MLN Connects® Special Edition for Thursday, August 18, 2022

MLN Connects® Special Edition for Thursday, August 18, 2022 Creating a Roadmap for the End of the COVID-19 Public Health Emergency News Creating a Roadmap for the End of the COVID-19 Public Health Eme...

Posting Date: 08/18/2022

New Gamification Course Now Available in Medicare Arcades!

New Gamification Course Now Available in Medicare Arcades! Medicare University is expanding with a new gamification course in Medicare Arcades. You can now find the course, Introduction to Hospice B...

Posting Date: 08/17/2022

Medicare Mobile Has Expanded

Medicare Mobile Has Expanded We’ve expanded Medicare Mobile so you can stay up-to-date on the latest Medicare news. Joining is simple, text NEWS to 37702 to receive exclusive notifications straight to...

Posting Date: 08/17/2022

CMS Identifies National System Issue

CMS Identifies National System Issue CMS identified a national system issue, which may have inadvertently adjusted previously processed Part B claims with dates of service (DOS) on or after January 1,...

Posting Date: 08/15/2022

New Enrollment Articles Added to Authorization and Accreditation

New Enrollment Articles Added to Authorization and Accreditation We’ve added Eligible Institutional Providers and Eligible Method II Providers articles to our website to provide clarification of Insti...

Posting Date: 08/15/2022

Staying Up To Date on Vaccines

Staying Up To Date on Vaccines It's important to stay up to date on vaccines. Vaccines protect your patients from serious illness and can keep them out of the hospital. Talk with your patients about w...

Posting Date: 08/11/2022

MLN Connects® Newsletter for Thursday, August 11, 2022

MLN Connects® Newsletter for Thursday, August 11, 2022 Monkeypox & Smallpox Vaccines: New Product Codes News Monkeypox & Smallpox Vaccines: New Product Codes Payment Allowance Update for COVID-19 Mono...

Posting Date: 08/10/2022

October 2022 Release "Dark Days" for the Common Working File Hosts

October 2022 Release "Dark Days" for the Common Working File Hosts For the upcoming October 2022 Release: For Production, CWF will be observing the Gray Day on Thursday, September 29th and Dark Days s...

Posting Date: 08/09/2022

Psychiatric and Psychology Services

Psychiatric and Psychology Services Psychiatric Evaluations The psychiatric diagnostic evaluation is an integrated psychosocial assessment, including history, mental status and recommendations. The ev...

Posting Date: 08/04/2022

MLN Connects® Newsletter for Thursday, August 4, 2022

MLN Connects® Newsletter for Thursday, August 4, 2022 ICD-10-CM Code Files: Fiscal Year 2023 News Hospices: Volunteer to Test Hospice Outcomes & Patient Evaluation Instrument Immunization: Protect You...

Posting Date: 08/04/2022

Medicare Part B Coverage and Billing Guidance for Breast Ultrasound

Medicare Part B Coverage and Billing Guidance for Breast Ultrasound Breast ultrasound uses sound waves to produce pictures of the inside of the breast and can show changes that are more difficult to s...

Posting Date: 08/03/2022

Provider Enrollment: Obtaining and Verifying State License

Provider Enrollment: Obtaining and Verifying State License Providers must contact their State agency when initially enrolling or making a change to a current Medicare enrollment for certification mate...

Posting Date: 08/02/2022

MLN Connects® Special Edition for Monday, August 1, 2022

MLN Connects® Special Edition for Monday, August 1, 2022 New CMS Rule Increases Payments for Acute Care Hospitals & Advances Health Equity, Maternal Health On August 1, CMS issued a final rule for inp...

Posting Date: 08/02/2022

Provider Enrollment Authorization and Accreditation

Provider Enrollment Authorization and Accreditation Provider Enrollment added articles State License and Registrations for Certified Providers and Suppliers and Certified Provider and State Survey Age...

Posting Date: 08/02/2022

Top Claim Errors

Top Claim Errors Did you know we publish the top claim errors on our website? This information provides you with: the error reason code; a description of the error; the error type; details that includ...

Posting Date: 08/01/2022

MLN Connects® Special Edition for Friday, July 29, 2022

MLN Connects® Special Edition for Friday, July 29, 2022 Skilled Nursing Facilities: Final FY 2023 Payment Rule Skilled Nursing Facilities: Learn What’s New for Fiscal Year 2023 CMS Seeks Public Feedba...

Posting Date: 08/01/2022

Upcoming Annual Logon ID Recertification

Upcoming Annual Logon ID Recertification Upcoming Annual Logon ID Recertification for Maine, Vermont, New Hampshire, Massachusetts, Rhode Island and JK HH+H Regions. Beginning the week of 9/12/2022, t...

Posting Date: 08/01/2022

Health and Human Services Office of Inspector General Telehealth and Potential Fraud

Health and Human Services Office of Inspector General Telehealth and Potential Fraud The DHHS, of whom the CMS reports to, published a brief last week from the OIG regarding telehealth and the PHE exp...

Posting Date: 08/01/2022

Understanding your Remittance Advice for Merit-Based Incentive Payment System Adjustments

Understanding your Remittance Advice for Merit-Based Incentive Payment System Adjustments National Government Services has seen an increase in invalid overpayment requests related to the MIPS program....

Posting Date: 07/29/2022

Targeted Probe and Educate Letters – An Informational Overview

Targeted Probe and Educate Letters – An Informational Overview As part of our contractual obligation with the CMS, NGS, your Jurisdiction 6 or K MAC performs TPE to analyze provider compliance with CM...

Posting Date: 07/28/2022

MLN Connects® Special Edition for Wednesday, July 27, 2022

MLN Connects® Special Edition for Wednesday, July 27, 2022 3 Final FY 2023 Payment Rules: Hospices, Inpatient Psychiatric Facilities, & Inpatient Rehabilitation Hospices: Learn What’s New for Fiscal Y...

Posting Date: 07/28/2022

MLN Connects® Newsletter for Thursday, July 28, 2022

MLN Connects® Newsletter for Thursday, July 28, 2022 Enhanced Nursing Home Rating System News CMS Enhances Nursing Home Rating System with Staffing & Turnover Data Clinical Laboratory Improvement Amen...

Posting Date: 07/26/2022

July and August 2022 Billing and Coding Article Updates

July/August 2022 Billing and Coding Article Updates Billing and Coding Articles Billing and Coding: Botulinum Toxins (A52848) Based on comments received, ICD-10-CM codes N39.41 and N39.46 have been ad...

Posting Date: 07/25/2022

New Medical Review Frequently Asked Questions

New Medical Review Frequently Asked Questions We’ve added Medical Review Frequently Asked Questions to our website. Visit our Help and FAQs web page for common questions and answers related to Medical...

Posting Date: 07/21/2022

MLN Connects® Newsletter for Thursday, July 21, 2022

MLN Connects® Newsletter for Thursday, July 21, 2022 988 Suicide & Crisis Lifeline Available Nationwide News 988 Suicide & Crisis Lifeline Available Nationwide COVID-19: Novavax Vaccine, Adjuvanted — ...

Posting Date: 07/21/2022

Non-Appealable Situations with Medicare Advantage Plans - Make Sure Your Staff is Aware

Non-Appealable Situations with Medicare Advantage Plans - Make Sure Your Staff is Aware When a Medicare Beneficiary enrolls in a MA Plan, that MA plan takes the place of Traditional Medicare benefits....

Posting Date: 07/20/2022

You Asked – We Listened: Locating our Contact Information

You Asked – We Listened: Locating our Contact Information We often receive comments through our customer experience surveys that providers are not able to find our contact information. NGS contact inf...

Posting Date: 07/20/2022

Changing or Resetting Your EDI Gateway Password

Changing or Resetting Your EDI Gateway Password The EDI Gateway Self-Service Password Portal is a simple/secure, web-based process for changing or resetting passwords for EDI Trading Partners. There a...

Posting Date: 07/19/2022

Your Feedback In Action – Medical Policies

Your Feedback In Action – Medical Policies We frequently receive comments through our customer experience surveys that providers cannot find an associated LCD or billing and coding article for a speci...