News - NGSMEDICARE

Posting Date: Thu Dec 28 00:00:00 GMT 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...

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...

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...

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...

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...

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...

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...

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: ...

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 ...

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...

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...

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...

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

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...

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...

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:...

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 ...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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 ...

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...

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...

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...

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...

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...

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...

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...

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

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...

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...

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...

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...

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...

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...

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...

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...

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 ...

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...

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...

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...