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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...
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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...
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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...
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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...
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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...
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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...
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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,...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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....
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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...
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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...
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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...
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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...
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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...
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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 — ...
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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....
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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 (...
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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...
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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...
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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...
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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...
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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...
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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 ...
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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...
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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...
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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 ...
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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....
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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...
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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...
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Posting Date: 06/07/2022
Modifier KX on Outpatient Physical Therapy, Occupational Therapy or Speech Language Pathology Claims
Modifier KX on Outpatient Physical Therapy, Occupational Therapy or Speech Language Pathology Claims Reminders Providers report modifier KX on a claim line(s) to confirm the medical records contain sp...
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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...
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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...
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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, &...
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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 ...
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Posting Date: 05/31/2022
Modifier KX for use with Physical Therapy, Occupational Therapy or Speech Language Pathology Claims
Modifier KX for use with Physical Therapy, Occupational Therapy or Speech Language Pathology Claims What you need to know Modifier KX is used to confirm specific required documentation is on file in a...
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Posting Date: 05/26/2022
MLN Connects® Newsletter for Thursday, May 26, 2022
MLN Connects® Newsletter for Thursday, May 26, 2022 Biosimilars: Interchangeable Products May Increase Patient Access News COVID-19: New Administration Code for Pfizer Pediatric Vaccine Booster Dose B...
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Posting Date: 05/19/2022
MLN Connects® Newsletter for Thursday, May 19, 2022
MLN Connects® Newsletter for Thursday, May 19, 2022 Biosimilars: Safe, Effective, & May Reduce Patient Costs News Biosimilars: Safe, Effective, & May Reduce Patient Costs PECOS Scroll Functionality Cl...
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Posting Date: 05/13/2022
Revised Evaluation and Management Frequently Asked Question for Teaching Environment Services
Revised Evaluation and Management Frequently Asked Question for Teaching Environment Services We’ve revised an FAQ within the Teaching Environment section of our E/M FAQs to further define documentati...
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Posting Date: 05/12/2022
Outpatient Claims with Reason Code W7120 Returned in Error
Outpatient Claims with Reason Code W7120 Returned in Error A system error caused the CMS to return the following outpatient claims with reason code W7120: Bill types 13X and 85X Designated surgical ra...
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Posting Date: 05/12/2022
MLN Connects® Newsletter for Thursday, May 12, 2022
MLN Connects® Newsletter for Thursday, May 12, 2022 Biosimilars Curriculum: Resources for Teaching Your Students News Comprehensive Error Rate Testing Documentation Center Moved on April 13 Physicians...
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Posting Date: 05/11/2022
New Evaluation and Management Frequently Asked Question for Time-Based Services
New Evaluation and Management Frequently Asked Question for Time-Based Services We’ve added a new FAQ for E/M time-based services. Please define rules for using time to level-set a service in the inpa...
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Posting Date: 05/11/2022
Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice"
Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice" The 2022 HH+H MAC Collaborative Summit: One Program, One Voice is now availab...
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Posting Date: 05/11/2022
New Evaluation and Management Frequently Asked Question for Emergency Department
New Evaluation and Management Frequently Asked Question for Emergency Department We’ve added a new frequently asked question to the Emergency Department section of our E/M FAQs to further define how t...
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Posting Date: 05/10/2022
Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow!
Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow! Medicare for You offers valuable information that is fundamental for you, as a provider, to submit claims with ...
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Posting Date: 05/06/2022
Low and No Medicare Utilization Cost Report
Low and No Medicare Utilization Cost Report No Utilization Cost Reports To comply with program cost reporting requirements, a provider that has not furnished any covered Medicare services during a cos...
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Posting Date: 05/05/2022
Chronic Disease Management and Preventive Services Learning and Action Series
Chronic Disease Management and Preventive Services Learning and Action Series A Collaborative Learning Opportunity with the Medicare Administrative Contractors National Government Services, Novitas So...
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Posting Date: 05/05/2022
MLN Connects® Newsletter for Thursday, May 5, 2022
MLN Connects® Newsletter for Thursday, May 5, 2022 COVID-19 Patients Can Get Free Over-the-Counter Tests from Participating Providers News COVID-19: Patients Can Get Free Over-the-Counter Tests from P...
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Posting Date: 05/03/2022
National Government Services: Raising Awareness about Care Management
National Government Services: Raising Awareness about Care Management According to the CDC, six in ten adults in the U.S. have a chronic disease and four in ten adults have two or more. As your Medica...
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Posting Date: 04/29/2022
Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports
Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports The CMS implemented the prior authorization of RSNAT. NGS J6 states Illinois, Minnesota, and Wisconsin were added t...
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Posting Date: 04/28/2022
MLN Connects® Newsletter for Thursday, April 28, 2022
MLN Connects® Newsletter for Thursday, April 28, 2022 Get Patient Eligibility Information for Additional Services News Patient Eligibility Information for Additional Services — Now Available Physician...
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Posting Date: 04/26/2022
April and May 2022 Billing and Coding Article Updates
April/May 2022 Billing and Coding Article Updates Billing and Coding Articles Billing and Coding: Complex Drug Administration Coding (A58620) J0248 remdesivir (Veklury®) was added under Infusions Non-...
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Posting Date: 04/21/2022
MLN Connects® Newsletter for Thursday, April 21, 2022
MLN Connects® Newsletter for Thursday, April 21, 2022 Medicare Provider Compliance News News Hospice Quality Reporting Program: Key Dates & Measure Change Ambulance Ground Transport: Comparative Billi...
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Posting Date: 04/21/2022
CMS Region 2 Office Hours
CMS Region 2 Office Hours The CMS Region 2 Office recently began conducting a series of “Office Hours” calls. The purpose of these sessions is to provide brief updates on Medicare topics of current in...
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