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Posting Date: 02/17/2022
MLN Connects® Newsletter for Thursday, February 17, 2022
MLN Connects® Newsletter for Thursday, February 17, 2022 Expanded Coverage: Lung Cancer Screening with Low Dose Computed Tomography News CMS Expands Coverage of Lung Cancer Screening with Low Dose Computed Tomography There’s Still Time [...]
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Posting Date: 02/18/2022
MLN Connects® Special Edition for Friday, February 18, 2022
MLN Connects® Special Edition for Thursday, February 18, 2022 COVID-19 Monoclonal Antibodies: FDA Authorized Bebtelovimab On February 11, the FDA authorized the emergency use of the monoclonal antibody bebtelovimab for the treatment of [...]
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Posting Date: 02/24/2022
MLN Connects® Newsletter for Thursday, February 24, 2022
MLN Connects® Newsletter for Thursday, February 24, 2022 CMS Released Skilled Nursing Facility & ESRD Web Pricers News Podiatry Nail Debridement & Evaluation and Management Services: Comparative Billing Report Skilled Nursing [...]
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Posting Date: 03/17/2022
MLN Connects® Newsletter for Thursday, March 17, 2022
MLN Connects® Newsletter for Thursday, March 17, 2022 Kidney Health: Help Address Disparities News Medicare Shared Savings Program: Application Deadlines for January 1, 2023, Start Date Kidney Health: Help Address Disparities Claims, [...]
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Posting Date: 02/10/2022
MLN Connects® Newsletter for Thursday, February 10, 2022
MLN Connects® Newsletter for Thursday, February 10, 2022 COVID-19: New HCPCS Code for Convalescent Plasma in Outpatient Setting News COVID-19: New HCPCS Code for Convalescent Plasma in Outpatient Setting Long-term Care Hospital [...]
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Posting Date: 01/20/2022
MLN Connects® Newsletter for Thursday, January 20, 2022
MLN Connects® Newsletter for Thursday, January 20, 2022 COVID-19: Long-term Care, RHCs, & FQHCs News COVID-19: Vaccine Access in Long-term Care Settings There’s Still Time: Recommend the Flu Shot Chiropractic Treatment of [...]
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Posting Date: 03/03/2022
MLN Connects® Newsletter for Thursday, March 3, 2022
MLN Connects® Newsletter for Thursday, March 3, 2022 2022 Payment, Quality & Policy Changes News Ambulance Prior Authorization Model Expands April 1 Nutrition-related Health Conditions: Recommend Medicare Preventive Services [...]
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Posting Date: 03/16/2022
Place of Service 10 for Telehealth Services Not for Medicare Billing
Place of Service 10 for Telehealth Services Not for Medicare Billing National Government Services is receiving calls from providers to our call center in regard to the usage of the new Place of Service 10 code. POS 10 was established [...]
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Posting Date: 12/07/2021
Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2022
Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2022 This announcement provides information that may be helpful to clinicians in determining whether to become a Medicare participating provider, or to continue [...]
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Posting Date: 02/04/2022
Provider Compliance Virtual Focus Group - February 24, 2022
Provider Compliance Virtual Focus Group - February 24, 2022 Thursday, 2/24/2022 from 1:00–4:00 p.m. ET Register by Friday, 2/18/2022 - Registration Closed How can CMS improve its processes and eliminate unnecessary requirements for [...]
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Posting Date: 02/08/2022
2022 Gap-Fill Request for Information
2022 Gap-Fill Request for Information National Government Services, the MAC for JK and J6, is in receipt of the new laboratory test codes identified by the CMS to be gap-fill priced for 2022. The PAMA regulations instruct the MACs to establish [...]
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Posting Date: 01/28/2022
Home Health Bill Type 32A Returning With Reason Code U537I
Home Health Bill Type 32A Returning With Reason Code U537I CMS implemented HH TOB 32A for the NOA effective for period of care claims on or after 1/1/2022. The NOA is required for all HH period of care claim billing, including demand billing [...]
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Posting Date: 01/24/2022
2021 Calendar Year 1099 Form Information
2021 Calendar Year 1099 Form Information Medicare providers and beneficiaries, who are serviced by National Government Services, regardless of their location, will receive a single Part A and Part B combined Form 1099 from NGS for calendar [...]
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Posting Date: 01/21/2022
Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929)
Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929) Currently, National Government Services has LCD Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929) as well as a Draft [...]
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Posting Date: 01/21/2022
How to Avoid Costly Appeals
How to Avoid Costly Appeals National Government Services has noticed an increase in requests for claim appeals. Upon review, we have found that many of the requests are not appropriate and/or necessary for a claim appeal submission. The [...]
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Posting Date: 05/07/2021
MLN Connects® Special Edition for Thursday, May 6, 2021
MLN Connects® Special Edition for Thursday, May 6, 2021 CMS Increases Medicare Payment for COVID-19 Monoclonal Antibody Infusions New payment policy for at-home administration As part of the ongoing response to address the COVID-19 [...]
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Posting Date: 12/07/2021
MLN Connects® Special Edition for Monday, December 6, 2021
MLN Connects® Special Edition for Monday, December 6, 2021 Provider Requirements Under the No Surprises Act Special ODF — December 8 Wednesday, December 8, 2021 from 2:00-3:00 p.m. eastern time CMS will host a Special Open Door Forum [...]
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Posting Date: 06/04/2021
Medicare Part A and Part B Billing for the COVID-19 Vaccine and Monoclonal Antibody
Medicare Part A and Part B Billing for the COVID-19 Vaccine and Monoclonal Antibody Medicare Billing for COVID-19 Vaccine Shot Administration How to Bill for COVID-19 Shot Administration You’ll be able to bill on single claims for the [...]
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Posting Date: 01/11/2022
Home Health and Hospice December Educational Videos are Now Available On-Demand
Home Health and Hospice December Educational Videos are Now Available On-Demand The National Government Services Home Health and Hospice Provider Outreach & Education team “On-Demand Video Library” offers providers the ability to watch or [...]
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Posting Date: 01/11/2022
Removal of HCPCS Code
Removal of HCPCS Code Prior Authorization Update Effective immediately, for claims with dates of service on or after 1/7/2022, the Centers for Medicare & Medicaid Services is removing current procedural terminology code 67911 (correction [...]
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Posting Date: 01/11/2022
Coronavirus Resources for Home Care and Hospice
Coronavirus Resources for Home Care and Hospice At National Government Services, the health and well-being of our beneficiary and provider communities is our top priority. The Centers for Medicare & Medicaid Services’ COVID-19 web page is [...]
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Posting Date: 01/10/2022
Home Health Bill Type 32A Returning with Reason Code 32114
Home Health Bill Type 32A Returning with Reason Code 32114 The Centers for Medicare & Medicaid Services implemented new home health bill type 32A effective 1/1/2022. An issue with ZIP codes submitted on EMC claims has been identified, [...]
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Posting Date: 12/23/2021
December 2021-January 2022 LCD and Billing and Coding Article Updates
December 2021-January 2022 LCD and Billing and Coding Article Updates Billing and Coding: Autonomic Function Testing (A57024) Due to the annual CPT/HCPCS code updates, effective 1/1/2022, CPT code 95943 has been deleted from the CPT/HCPCS [...]
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Posting Date: 11/18/2021
MLN Connects® Newsletter for Thursday, November 18, 2021
MLN Connects® Newsletter for Thursday, November 18, 2021 COVID-19: Changes to Nursing Home Visitation & Survey Activities News CMS Repeals MCIT/R&N; Will Consider Other Coverage Pathways to Enhance Access to Innovative [...]
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Posting Date: 11/04/2021
MLN Connects® Newsletter for Thursday, November 4, 2021
MLN Connects® Newsletter for Thursday, November 4, 2021 COVID-19: Changes for Medicare Advantage Plan Claims Starting January 1 News COVID-19 Vaccines for Children COVID-19 Vaccine & Monoclonal Antibody Products: Changes for [...]
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Posting Date: 09/24/2021
MLN Connects® Special Edition for Friday, September 24, 2021
MLN Connects® Special Edition for Friday, September 24, 2021 CMS Will Pay for COVID-19 Booster Shots, Eligible Consumers Can Receive at No Cost Coverage without cost-sharing available for eligible people with Medicare, Medicaid, CHIP, and [...]
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Posting Date: 09/30/2021
MLN Connects® Newsletter for Thursday, September 30, 2021
MLN Connects® Newsletter for Thursday, September 30, 2021 Flu Season is Here: Protect Your Patients, Yourself, & Your Loved Ones View this edition as a: Webpage | PDF News Flu Season is Here: Protect Your Patients, Yourself, [...]
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Posting Date: 09/20/2021
MLN Connects® Special Edition for Monday, September 20, 2021
MLN Connects® Special Edition for Monday, September 20, 2021 Help CMS Improve Your Experience with Provider Resources CMS is conducting a study to help us improve your experience with resources about the Medicare program and correct billing. [...]
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Posting Date: 08/19/2021
MLN Connects® Newsletter for Thursday, August 19, 2021
MLN Connects® Newsletter for Thursday, August 19, 2021 COVID-19: Vaccinate Your Patients View this edition as a: Webpage | PDF News Immunization: Medicare Covers Vaccines Compliance Chiropractic Services: Comply with Medicare [...]
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Posting Date: 08/26/2021
MLN Connects® Newsletter for Thursday, August 26, 2021
MLN Connects® Newsletter for Thursday, August 26, 2021 Health Care Code Sets: ICD-10 — Revised View this edition as a: Webpage | PDF News Impact of the PHE on Telehealth: Comparative Billing Report in August COVID-19 Monoclonal [...]
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Posting Date: 09/09/2021
MLN Connects® Newsletter for Thursday, September 9, 2021
MLN Connects® Newsletter for Thursday, September 9, 2021 SNF: WBT & COVID-19 Reminder View this edition as a: Webpage | PDF News PEPPERs for Short-term Acute Care Hospitals Outpatient Clinic Visit Services at [...]
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Posting Date: 08/13/2021
MLN Connects® Special Edition for Friday, August 13, 2021
MLN Connects® Special Edition for Friday, August 13, 2021 COVID-19 Vaccine Additional Dose Medicare stands ready to pay for administering an additional dose of COVID-19 vaccine consistent with the FDA EUA. We’ll pay the same amount to [...]
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Posting Date: 07/15/2021
MLN Connects® Newsletter for Thursday, July 15, 2021
MLN Connects® Newsletter for Thursday, July 15, 2021 View this edition as a: Webpage | PDF News Cognitive Assessment: Resources for Providers CMS Opens National Coverage Determination Analysis on Treatment for Alzheimer’s Disease [...]
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Posting Date: 07/29/2021
MLN Connects® Newsletter for Thursday, July 29, 2021
MLN Connects® Newsletter for Thursday, July 29, 2021 Hospital Price Transparency Stakeholder Webinar — August 11 View this edition as a: Webpage | PDF Compliance Ambulance Services & SNF Consolidated Billing Requirements: Avoid [...]
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Posting Date: 07/14/2021
MLN Connects® Special Edition for Tuesday, July 13, 2021
MLN Connects® Special Edition for Tuesday, July 13, 2021 CMS Proposes Physician Payment Rule to Improve Health Equity, Patient Access CMS is proposing changes to address the widening gap in health equity highlighted by the COVID-19 Public [...]
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Posting Date: 07/20/2021
MLN Connects® Special Edition for Monday, July 19, 2021
MLN Connects® Special Edition for Monday, July 19, 2021 CMS Proposes Rule to Increase Price Transparency, Access to Care, Safety & Health Equity CMS is proposing actions to address the health equity gap, ensure consumers have the [...]
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Posting Date: 03/24/2022
MLN Connects® Newsletter for Thursday, March 24, 2022
MLN Connects® Newsletter for Thursday, March 24, 2022 ICD-10: Comment on Proposed Procedure and Diagnosis Codes News Additional Residency Positions: Apply by March 31 Long-term Care Hospitals: March Preview Period Ends April 6 [...]
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Posting Date: 03/25/2022
April 2022 LCD and Billing and Coding Article Updates
April 2022 LCD and Billing and Coding Article Updates LCDs Effective 4/1/2022 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) (L33559/A56737) The LCD was returned for comment from 6/3/2021 through [...]
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Posting Date: 03/31/2022
MLN Connects® Special Edition for Wednesday, March 30, 2022
MLN Connects® Special Edition for Wednesday, March 30, 2022 Fiscal Year 2023 Hospice Payment Rate Update Proposed Rule - Comment by May 31 On March 30, CMS issued a proposed rule (CMS-1773-P) that would provide routine updates to [...]
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Posting Date: 04/01/2022
New Evaluation and Management Frequently Asked Questions for Prolonged Services
New Evaluation and Management Frequently Asked Questions for Prolonged Services We’ve added new frequently asked questions to the Prolonged Services section of our E/M FAQs to clarify proper billing for CPT codes 99354-99356, 99358-99359, and [...]
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Posting Date: 04/04/2022
MLN Connects® Special Edition for Monday, April 4, 2022
MLN Connects® Special Edition for Monday, April 4, 2022 Biden-Harris Administration Announces a New Way for Medicare Beneficiaries to Get Free Over-the-Counter COVID-19 Tests On April 4, The Biden-Harris Administration announced that more [...]
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Posting Date: 04/06/2022
MLN Connects® Special Edition for Wednesday, April 6, 2022
MLN Connects® Special Edition for Monday, April 6, 2022 Eligible Individuals Can Receive Second COVID-19 Booster Shot at No Cost On April 6, CMS announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna [...]
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Posting Date: 04/11/2022
Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport
Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport The Repetitive, Scheduled Nonemergent Ambulance Transport Prior Authorization Model establishes a process through which a request for provisional affirmation [...]
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Posting Date: 04/15/2022
Increased Volume of Appeal Status Inquiries
Increased Volume of Appeal Status Inquiries National Government Services has seen an increase in pending reopenings and redetermination levels, resulting in cases being completed beyond the 60 calendar-day timeframe. We are sharing some [...]
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Posting Date: 04/19/2022
MLN Connects® Special Edition for Monday, April 18, 2022
MLN Connects® Special Edition for Monday, April 18, 2022 CMS Proposes Policies to Advance Health Equity & Maternal Health, Support Hospitals On April 18, CMS issued a proposed rule for inpatient and long-term hospitals that builds on the [...]
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Posting Date: 07/30/2021
MLN Connects® Special Edition for Thursday, July 29, 2021
MLN Connects® Special Edition for Thursday, July 29, 2021 4 Final FY 2022 Payment Rules Hospice Payment Rate Update: FY 2022 Final Rule IRF Prospective Payment System: FY 2022 Final Rule IPF Prospective Payment System: FY 2022 Final Rule [...]
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Posting Date: 04/01/2022
MLN Connects® Special Edition for Thursday, March 31, 2022
MLN Connects® Special Edition for Thursday, March 31, 2022 IPF & IRF Proposed FY 2023 Payment Rules Inpatient Psychiatric Facilities: Fiscal Year 2023 Proposed Rule — Submit Comments by May 31 Inpatient Rehabilitation Facilities: [...]
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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 time can be used as a factor in billing [...]
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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 inpatient setting. Answer: In [...]
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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 available for early bird registration. This huge [...]
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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, Teaching Hospitals, Physician [...]
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Posting Date: 03/29/2022
We’ve Rebranded!
We’ve Rebranded! National Government Services is excited to share we’ve refreshed our brand! Our new brand line Where Next Begins reflects Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More. Over the [...]
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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 ranges 10000-69999 or 0000T-9999T [...]
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Posting Date: 08/03/2021
MLN Connects® Special Edition for Monday, August 2, 2021
MLN Connects® Special Edition for Monday, August 2, 2021 CMS Final Rule Improves Health Equity, Access to Treatment, Hospital Readiness, and COVID-19 Vaccination Data Reporting of Hospital Workers Hospital Inpatient Prospective Payment System [...]
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Posting Date: 06/21/2021
New Version of PC-ACE: July 2021
New Version of PC-ACE: July 2021 PC-ACE Version 5.1 contains several CMS mandates and product enhancements including but not limited to the items listed below. 12206 – FFS Coverage of Costs for Kidney Acquisitions in MW Hospitals for [...]
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Posting Date: 06/10/2021
Medicare University Scheduled Maintenance
Medicare University Scheduled Maintenance Due to scheduled maintenance, Medicare University will be unavailable beginning Tuesday, 6/15/2021 from 8:00 p.m–11:00 p.m. ET. As a result, the Medicare University will not be accessible. We [...]
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Posting Date: 03/25/2021
Billing and Coding for Tempus Next Generation Sequencing Panel
Billing and Coding for Tempus Next Generation Sequencing Panel The Tempus Next Generation Sequencing Panel must be submitted with CPT code 81479. CPT 81479 (unlisted molecular pathology procedure) will be individually reviewed. Posted [...]
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Posting Date: 05/04/2021
COVID-19 Accelerated and Advanced Payment YouTube Video
COVID-19 Accelerated and Advanced Payment YouTube Video National Government Services developed the Part B COVID-19 Accelerated and Advanced Payment, Repayment and Recoupment Process YouTube Video to address common questions we are receiving. [...]
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Posting Date: 07/15/2021
Proper Billing Units for HCPCS Code J7320
Proper Billing Units for HCPCS Code J7320 National Government Services has noticed improper billing units used for HCPCS code J7320, Hyaluronan or derivative, GenVisc 850, for intra-articular injection, 1 mg. GenVisc 850 is indicated for the [...]
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Posting Date: 04/22/2021
Oxygen Coverage and Documentation Requirements
Oxygen Coverage and Documentation Requirements Please review this YouTube video that was developed from the A/B and DME MAC’s collaborative webinar titled ‘Oxygen Coverage and Documentation Requirements’. This video is a collaborative [...]
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