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Posting Date: 01/24/2024
LCD and Billing and Coding Article Updates January/February 2024

LCD and Billing and Coding Article Updates January/February 2024 Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG) (A59105) A list of labeled and compendia approved diagnoses hav...

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Posting Date: 01/23/2024
Credit Balance Report Reminder: Due Date Approaching

Credit Balance Report Reminder: Due Date Approaching For the quarter ending 12/31/2023, CBRs can be submitted starting 1/1/2024 and must be submitted within 30 days to be considered timely. The easies...

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Posting Date: 01/22/2024
2024 Annual Update to the Therapy Code List: Caregiver Training Codes

2024 Annual Update to the Therapy Code List: Caregiver Training Codes The CMS annual update to the therapy code list includes three new caregiver training “sometimes therapy” codes to include caregive...

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Posting Date: 01/22/2024
2024 Annual Update to the Therapy Code List: Remote Therapeutic Monitoring

2024 Annual Update to the Therapy Code List: Remote Therapeutic Monitoring CMS is updating Disposition 10, in addition to other modifications, to clarify that, for RTM services, physical and occupatio...

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Posting Date: 01/22/2024
The Part B Top Claim Errors Have Been Reviewed and Updated

The Part B Top Claim Errors Have Been Reviewed and 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 avoi...

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Posting Date: 01/19/2024
Medicare Requirements for Marriage and Family Therapists and Mental Health Counselors

Medicare Requirements for Marriage and Family Therapists and Mental Health Counselors Effective 1/1/2024, Medicare added two new nonphysician specialties. To enroll with Medicare, all the requirements...

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Posting Date: 01/19/2024
Teaching Physician Virtual Supervision in 2024 Clarification

Teaching Physician Virtual Supervision in 2024 Clarification This article is to clarify virtual supervision provided by the teaching physician for the key portions of the service of a resident. There ...

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Posting Date: 01/18/2024
MLN Connects® Newsletter: January 18, 2024

MLN Connects® Newsletter: January 18, 2024 News CMS Finalizes Rule to Expand Access to Health Information and Improve the Prior Authorization Process Acute Hospital Care at Home Data Release CMS Round...

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Posting Date: 01/18/2024
Telehealth Changes for 2024 – Modifier 95 and Place of Service Codes

Telehealth Changes for 2024 – Modifier 95 and Place of Service Codes National Government Services has received many questions regarding the use of modifier 95 going forward. CMS implemented the usage ...

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Posting Date: 01/18/2024
Frequently Asked Questions Have Been Reviewed and Updated

Frequently Asked Questions Have Been Reviewed and Updated We’ve reviewed and updated our educational FAQs. Visit our Help and FAQs page located within the Education section of our website. Topics avai...

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Posting Date: 01/11/2024
MLN Connects® Newsletter: January 11, 2024

MLN Connects® Newsletter: January 11, 2024 News Marriage and Family Therapist & Mental Health Counselor Services: Overpayments to Critical Access Hospitals Billing under Method II Medicare Part A Cost...

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Posting Date: 01/11/2024
MLN Matters® MM13331: Incorporation of Recent Provider Enrollment Regulatory Changes into Chapter 10 of CMS Publication (Pub.) 100-08 - Physician Fee Schedule (PFS) Final Rule

MLN Matters® MM13331 - Incorporation of Recent Provider Enrollment Regulatory Changes into Chapter 10 of CMS Publication (Pub.) 100-08 - Physician Fee Schedule (PFS) Final Rule Revised 1/12/2024

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Posting Date: 01/10/2024
Revised: Interactive Voice Response System Feature Ending Soon

Revised: Interactive Voice Response System Feature Ending Soon It was announced on 1/10/2024 that the following function will no longer be available on our IVR System as of 2/16/2024. This change is c...

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Posting Date: 01/05/2024
340B Drug Payment Policy Remedy Payment for CY 2018 to CY 2022

340B Drug Payment Policy Remedy Payment for CY 2018 to CY 2022 On 6/15/2022, the Supreme Court held in American Hospital Association v. Becerra that because CMS had not conducted a survey of hospitals...

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Posting Date: 01/04/2024
Correct Coding Reminder for Breast Imaging

Correct Coding Reminder for Breast Imaging When there are no abnormal and inconclusive findings on mammography and the only finding is dense breast tissue (ICD-10-CM codes R92.30-R92.34), the provisio...

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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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