News - NGSMEDICARE

Posting Date: 04/21/2023

LCD, Billing and Coding Article Updates for April and May 2023

LCD, Billing and Coding Article Updates for April and May 2023 Billing and Coding Article (A56937): Psychiatry and Psychology Services Removed sentence from article text section - “For psychotherapy s...

Posting Date: 04/21/2023

New Service Added to the Hospital Outpatient Department Prior Authorization Program - Facet Joint Interventions

New Service Added to the Hospital Outpatient Department Prior Authorization Program - Facet Joint Interventions As a reminder, effective for dates of service rendered on or after 7/1/2023, facet joint...

Posting Date: 04/20/2023

Providers Using NGSConnex to Submit Appeals and Supporting Documentation

Providers Using NGSConnex to Submit Appeals and Supporting Documentation We strongly recommend our providers use NGSConnex to submit your redetermination requests and any supporting documentation. Ple...

Posting Date: 04/20/2023

Medicare University Continuing to Experience Intermittent Issues

Medicare University Continuing to Experience Intermittent Issues We are continuing to experience intermittent outages with Medicare University. You do not need to report these issues with Medicare Uni...

Posting Date: 04/20/2023

MLN Connects® Newsletter: April 20, 2023

MLN Connects® Newsletter: April 20, 2023 News Billing Medicare Part B for Insulin with New Limits on Patient Monthly Coinsurance Medical Review & Compliance: Respond to Additional Documentation Reque...

Posting Date: 04/19/2023

Telehealth Frequently Asked Questions are Updated

Telehealth Frequently Asked Questions are Updated We’ve updated our telehealth frequently asked questions to include changes and flexibilities due to the end of the PHE on 5/11/2023. Please view these...

Posting Date: 04/18/2023

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: 04/18/2023

Attention Home Health and Hospice Providers Using NGSConnex to Submit Level One Appeals Redetermination Requests

Attention Home Health and Hospice Providers Using NGSConnex to Submit Level One Appeals Redetermination Requests National Government Services strongly recommends that all providers, including home hea...

Posting Date: 04/14/2023

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a hold on y...

Posting Date: 04/14/2023

CR13105 - Technical Revisions Only to the National Coverage Determination (NCD) Manual

Posting Date: 04/13/2023

The Advance Beneficiary Notice of Noncoverage

The Advance Beneficiary Notice of Noncoverage We’ve updated our Advance Beneficiary Notice of Noncoverage article to include examples for using an ABN for outpatient therapy and using the KX and GA mo...

Posting Date: 04/13/2023

Top Tobacco Counseling Claim Denials and How to Avoid/Correct Them

Top Tobacco Counseling Claim Denials and How to Avoid/Correct Them Providers, are your claims being denied for tobacco counseling services utilizing codes 99406 and 99407? In order to assist our provi...

Posting Date: 04/13/2023

MLN Connects® Newsletter: April 13, 2023

MLN Connects® Newsletter: April 13, 2023 News COVID-19: End of Public Health Emergency CMS Roundup (Apr. 07, 2023) Medicare Shared Savings Program: Application Toolkit Materials Inpatient Rehabilitat...

Posting Date: 04/13/2023

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS-855A Application

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS-855A Application To reduce requests for additional information, National Government Services offers several pro...

Posting Date: 04/13/2023

Registration is Open for the Part B Claim Submission Learning Day

Registration is Open for the Part B Claim Submission Learning Day Join us on Tuesday, 5/9/2023 for our Part B Claim Submission Learning Day! Our Part B POE Team is hosting a full day of educational we...

Posting Date: 04/12/2023

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a hold on y...

Posting Date: 04/12/2023

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS Enrollment Forms

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS Enrollment Forms To reduce requests for additional information, National Government Services offers several pro...

Posting Date: 04/12/2023

Home Health and Hospice Targeted Probe and Educate Resources

Home Health and Hospice Targeted Probe and Educate Resources It is imperative to keep up-to-date with all National Government Services JK and J6 HH+H TPE audit focus areas. This information can be loc...

Posting Date: 04/11/2023

NGS-ACE Enhancement Coming Soon

NGS-ACE Enhancement Coming Soon The National Government Services EDI team is pleased to share an upcoming enhancement to the 277CA (Claims Acknowledgement) transaction. Informational messages will be ...

Posting Date: 04/11/2023

MLN Connects® Newsletter: CMS Proposes Policies to Improve Patient Safety and Promote Health Equity — April 10, 2023

MLN Connects® Newsletter: CMS Proposes Policies to Improve Patient Safety and Promote Health Equity — April 10, 2023 Proposed Rule CMS Proposes Policies to Improve Patient Safety and Promote Health Eq...

Posting Date: 04/11/2023

Rural Tobacco Disparity

Rural Tobacco Disparity Tobacco use and exposure to SHS remain leading causes of preventable disease, disability and mortality in the United States and are responsible for approximately 480,000 deaths...

Posting Date: 04/10/2023

Reminder: Maintaining Ownership Consistency of Multiple Medicare Enrollments with same Tax Identification Number

Reminder: Maintaining Ownership Consistency of Multiple Medicare Enrollments with same Tax Identification Number View CMS’ “Medicare Enrollment: Maintain the Same Owners in All Enrollment Records” art...

Posting Date: 04/10/2023

Home Health Diagnosis Codes Grouper Update for 4/1/2023

Home Health Diagnosis Codes Grouper Update for 4/1/2023 Effective 4/1/2023, CMS is implementing new HH Grouper edits. The HH Grouper program has various data validity edits that make sure it uses cons...

Posting Date: 04/07/2023

New Fiscal Intermediary Shared System Consistency Edit to Validate Attending Physician National Provider Identifier

New Fiscal Intermediary Shared System Consistency Edit to Validate Attending Physician National Provider Identifier Effective 4/1/2023, CMS implemented a new consistency edit to validate that the atte...

Posting Date: 04/06/2023

MLN Connects® Newsletter: April 6, 2023

MLN Connects® Newsletter: April 6, 2023 News Resources & Flexibilities to Assist with Public Health Emergency in Mississippi Due to Recent Storms Program for Evaluating Payment Patterns Electronic Re...

Posting Date: 04/06/2023

MLN Connects® Newsletter: April 6, 2023

MLN Connects® Newsletter: April 6, 2023 News Resources & Flexibilities to Assist with Public Health Emergency in Mississippi Due to Recent Storms Program for Evaluating Payment Patterns Electronic Re...

Posting Date: 04/05/2023

MLN Connects® Newsletter: 4 Proposed FY 2024 Payment Rules — April 4, 2023

MLN Connects® Newsletter: 4 Proposed FY 2024 Payment Rules — April 4, 2023 Proposed Rules FY 2024 Hospice Payment Rate Update Proposed Rule (CMS-1787-P) FY 2024 Medicare Inpatient Psychiatric Facility...

Posting Date: 04/05/2023

MLN Connects® Newsletter: 4 Proposed FY 2024 Payment Rules — April 4, 2023

MLN Connects® Newsletter: 4 Proposed FY 2024 Payment Rules — April 4, 2023 Proposed Rules FY 2024 Hospice Payment Rate Update Proposed Rule (CMS-1787-P) FY 2024 Medicare Inpatient Psychiatric Facility...

Posting Date: 04/04/2023

NGS-ACE Edits for Ophthalmology

NGS-ACE Edits for Ophthalmology We continue working on enhancing NGS-ACE for providers in Jurisdiction 6 (Illinois, Minnesota, and Wisconsin) by adding additional edits and resources. The following NG...

Posting Date: 04/04/2023

NGS-ACE Edits for Ophthalmology

NGS-ACE Edits for Ophthalmology We continue working on enhancing NGS-ACE for providers in Jurisdiction 6 (Illinois, Minnesota, and Wisconsin) by adding additional edits and resources. The following NG...

Posting Date: 04/04/2023

NGS-ACE Edits for Ophthalmology

NGS-ACE Edits for Ophthalmology We continue working on enhancing NGS-ACE for providers in Jurisdiction 6 (Illinois, Minnesota, and Wisconsin) by adding additional edits and resources. The following NG...

Posting Date: 04/04/2023

NGS-ACE Edits for Ophthalmology

NGS-ACE Edits for Ophthalmology We continue working on enhancing NGS-ACE for providers in Jurisdiction 6 (Illinois, Minnesota, and Wisconsin) by adding additional edits and resources. The following NG...

Posting Date: 03/31/2023

MLN Connects® Newsletter: March 30, 2023

MLN Connects® Newsletter: March 30, 2023 News COVID-19: Booster Dose for Children 6 months – 4 years Identity & Access Management System: Easier for Surrogates Medicare Advantage Value-Based Insurance...

Posting Date: 03/31/2023

CR12669 - Instructions Relating to the Evaluation of Section 1115 Waiver Days in the Calculation of Disproportionate Share Hospital Reimbursement

Posting Date: 03/31/2023

CR13122 - Implementation of Consolidated Appropriations Act (CAA) of 2023, Section 4143: Waiver of Cap on Annual Payments for Nursing and Allied Health Education Payments

Posting Date: 03/31/2023

EDI Enrollment Spotlights Top Rejections

EDI Enrollment Spotlights Top Rejections Part A, Part B and DDE Periodically, EDI enrollment will publish articles to help eliminate the number of EDI applications that are denied. This month we are ...

Posting Date: 03/30/2023

Change in Pricing for Electroencephalogram Long-Term Monitoring Effective 4/1/2023

Change in Pricing for Electroencephalogram Long-Term Monitoring Effective 4/1/2023 After reviewing Medicare claims data for EEG continuous recording (CPT codes 95700 through 95718) as well as seeking ...

Posting Date: 03/29/2023

LCD, Billing and Coding Article Updates for March and April 2023

LCD, Billing and Coding Article Updates for March and April 2023 Pain Management (L33622) Effective 3/19/2023 The LCD has been revised to remove all references to sacroiliac joint injections. Please r...

Posting Date: 03/27/2023

Changes in G2066 Pricing Effective April 1, 2023

Changes in G2066 Pricing Effective April 1, 2023 After reviewing Medicare claims data for G2066 (Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic moni...

Posting Date: 03/23/2023

DDE Logon ID and Password Reminders

DDE Logon ID and Password Reminders CMS’ information security policy strictly prohibits the sharing or loaning of Medicare assigned IDs and passwords. Users should take appropriate measures to prevent...

Posting Date: 03/23/2023

Knee Orthosis: A/B and DME Collaborative Presentation

Knee Orthosis: A/B and DME Collaborative Presentation View the A/B and DME Knee Orthosis YouTube video for information on knee orthosis. Posted 3/23/2023

Posting Date: 03/23/2023

Resolved: Home Health Claims Editing for Reason Codes U5210/U5220

Resolved: Home Health Claims Editing for Reason Codes U5210/U5220 Some home health NOAs and claims were incorrectly hitting reason codes U5210 and U5220. These reason codes state there is no Medicare ...

Posting Date: 03/23/2023

MLN Connects® Newsletter: March 23, 2023

MLN Connects® Newsletter: March 23, 2023 News Additional Residency Positions: Apply by March 31 Laboratory Testing Urinalysis: Comparative Billing Report in March Long-Term Care Hospital Provider Prev...

Posting Date: 03/22/2023

Hierarchy of Medicare Regulations

Hierarchy of Medicare Regulations Have you wondered how Medicare determines what is covered? Below you will find the hierarchy of how Medicare regulations are created. Social Security Act Title XVIII ...

Posting Date: 03/22/2023

Appealing a Denied Claim

Appealing a Denied Claim At times, providers submit a claim that ends up being denied; the denial may include appeal rights. Providers can appeal all of their overpayment claims on one request for red...

Posting Date: 03/16/2023

MLN Connects® Newsletter: March 16, 2023

MLN Connects® Newsletter: March 16, 2023 News HHS Releases Initial Guidance for Historic Medicare Drug Price Negotiation Program for Price Applicability Year 2026 Quality Payment Program: 2021 Care Co...

Posting Date: 03/15/2023

MLN Connects® Newsletter: March 15, 2023

MLN Connects® Newsletter: March 15, 2023 News Inflation Reduction Act Tamps Down on Prescription Drug Price Increases Above Inflation Posted 3/15/2023

Posting Date: 03/14/2023

Provider Enrollment: Verify Bank Account Information to Prevent Interruption in Medicare Payment

Provider Enrollment: Verify Bank Account Information to Prevent Interruption in Medicare Payment National Government Services receives numerous electronic funds transfer banking rejections each year d...

Posting Date: 03/14/2023

Sacroiliac Joint Injections and Procedures Frequently Asked Questions

Sacroiliac Joint Injections and Procedures Frequently Asked Questions We’ve added frequently asked questions related to New Local Coverage Determination for Sacroiliac Joint Injections and Procedures...

Posting Date: 03/14/2023

Provider Enrollment: Verify Bank Account Information to Prevent Interruption in Medicare Payment

Provider Enrollment: Verify Bank Account Information to Prevent Interruption in Medicare Payment National Government Services receives numerous electronic funds transfer banking rejections each year d...