News - NGSMEDICARE

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...

Posting Date: 07/18/2022

MLN Connects® Special Edition for Friday, July 15, 2022

MLN Connects® Special Edition for Friday, July 15, 2022 CMS Proposes Rule to Advance Health Equity, Improve Access to Care & Promote Competition and Transparency CMS is proposing actions to advance he...

Posting Date: 07/14/2022

MLN Connects® Newsletter for Thursday, July 14, 2022

MLN Connects® Newsletter for Thursday, July 14, 2022 COVID-19: FDA Authorizes Pharmacists to Prescribe PAXLOVID with Certain Limits News COVID-19: FDA Authorizes Pharmacists to Prescribe PAXLOVID with...

Posting Date: 07/13/2022

A/B MACs Team Up with DME MACs for Glucose Monitor and Supplies Webinar on August 25

A/B MACs Team Up with DME MACs for Glucose Monitor and Supplies Webinar on August 25 Local A/B MACs and the DME MACs are excited to announce a collaboration webinar coming Thursday, August 25. This we...

Posting Date: 07/08/2022

Reminder: 340B-Acquired Drug Claim Appeal Requests

Reminder: 340B-Acquired Drug Claim Appeal Requests Beginning 1/1/2018, separately payable Part B drugs (assigned status indicator “K”), other than vaccines (assigned status indicator “L” or “M”) and d...

Posting Date: 07/08/2022

Billing Not Otherwise Classified Codes

Billing Not Otherwise Classified Codes When billing NOC codes, if you give a comparable code for the service performed, please include the actual name of the surgical or medical procedure. In some cas...

Posting Date: 07/08/2022

MLN Connects® Special Edition for Thursday, July 7, 2022

MLN Connects® Special Edition for Thursday, July 7, 2022 CMS Proposes Physician Payment Rule to Expand Access to High-Quality Care On July 7, CMS issued the Calendar Year 2023 Physician Fee Schedule (...

Posting Date: 07/07/2022

MLN Connects® Newsletter for Thursday, July 7, 2022

MLN Connects® Newsletter for Thursday, July 7, 2022 Expanding Access to Emergency Care Services in Rural Communities News Taking Action to Expand Access to Emergency Care Services in Rural Communities...

Posting Date: 07/06/2022

Provider Enrollment: Reduce Development Requests for Additional Action

Provider Enrollment: Reduce Development Requests for Additional Action In an effort to reduce the request of additional information and/or documentation on provider enrollment applications, verify all...

Posting Date: 06/30/2022

MLN Connects® Newsletter for Thursday, June 30, 2022

MLN Connects® Newsletter for Thursday, June 30, 2022 No Surprises Act: Fact Sheets for Your Patients News CMS Issues Significant Updates to Improve the Safety and Quality Care for Long-Term Care Resid...

Posting Date: 06/27/2022

June/July 2022 Billing and Coding and Self-Administered Drug Article Updates

June/July 2022 Billing and Coding and Self-Administered Drug Article Updates Billing and Coding Articles Billing and Coding: Bevacizumab and biosimilars (A52370) Based on compendia review, ICD-10 code...

Posting Date: 06/27/2022

Attention Ambulance Suppliers: Important Information on Claim Denials

Attention Ambulance Suppliers: Important Information on Claim Denials If you are billing claims with either A0426 or A0428, please continue to read. National Government Services has been receiving ele...

Posting Date: 06/23/2022

MLN Connects® Newsletter for Thursday, June 23, 2022

MLN Connects® Newsletter for Thursday, June 23, 2022 Medical Records Correspondence Address News Ambulance Prior Authorization Model Expands August 1 Orthoses Referring Providers: Comparative Billing ...

Posting Date: 06/22/2022

MLN Connects® Special Edition for Tuesday, June 21, 2022

MLN Connects® Special Edition for Tuesday, June 21, 2022 Home Health & ESRD Proposed CY 2023 Payment Rules Home Health Agencies: Calendar Year 2023 Proposed Rule — Submit Comments by August 16 ESRD Fa...

Posting Date: 06/16/2022

MLN Connects® Newsletter for Thursday, June 16, 2022

MLN Connects® Newsletter for Thursday, June 16, 2022 ICD-10-CM Diagnosis Codes: Fiscal Year 2023 News Comprehensive Error Rate Testing Program Report: Sample Reduced for Reporting Year 2023 Men’s Heal...

Posting Date: 06/09/2022

MLN Connects® Newsletter for Thursday, June 9, 2022

MLN Connects® Newsletter for Thursday, June 9, 2022 Learn about the CMS National Quality Strategy News CMS National Quality Strategy: A Person-Centered Approach to Improving Quality Strategy to Streng...

Posting Date: 06/09/2022

Physicians/Practitioners Who Order Ambulance Transport: Helping Your Patients With Prior Authorization

Physicians/Practitioners Who Order Ambulance Transport: Helping Your Patients With Prior Authorization The RSNAT Prior Authorization Model is a Medicare Fee-for-Service program that was recently insti...

Posting Date: 06/09/2022

Comprehensive Error Rate Testing Program Report: Sample Reduced for Reporting Year 2023

Comprehensive Error Rate Testing Program Report: Sample Reduced for Reporting Year 2023 CMS reduced the number of claims in the Comprehensive Error Rate Testing program report for reporting year 2023....

Posting Date: 06/09/2022

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 ...

Posting Date: 06/03/2022

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

July 2022 Release "Dark Days" for the Common Working File Hosts For the upcoming July 2022 Release: For Production, CWF will be observing the Gray Day on Thursday, 6/30/2022 and Dark Days starting Fri...

Posting Date: 06/03/2022

Remote Monitoring Services

Remote Monitoring Services In response to provider inquiries about the use of remote monitoring, National Government Services has developed a comprehensive summary of information for Remote Monitoring...

Posting Date: 06/02/2022

MLN Connects® Newsletter for Thursday, June 2, 2022

MLN Connects® Newsletter for Thursday, June 2, 2022 ICD-10-PCS Procedure Codes: Fiscal Year 2023 News Medicare Shared Savings Program: Application Deadlines for January 1 Start Date Claims, Pricers, &...

Posting Date: 05/31/2022

Billing and Coding and SAD Article Updates for May/June 2022

Billing and Coding and SAD Article Updates for May/June 2022 Billing and Coding: Denosumab (Prolia ™, Xgeva ™) (A52399) The article has been corrected to remove the following statement: (calcium 1000 ...