JK Part A Overpayment Recovery Unit Voluntary Refund Form

J6 Part A Immediate Recoupment Request Form

Medicare Home Health and Hospice PWK Fax/Mail Cover Sheet

Incorrect Billing of CPT 76942 with Prostate Biopsy CPT 55700 When 76872 Billed for Same Session

Incorrect Billing of CPT 76942 with Prostate Biopsy CPT 55700 When 76872 Billed for Same Session Although AMA Guidelines state it is appropriate to bill CPT codes 76942, 77002, 77012 or 77021 if imaging is performed with 55700, NCCI lists [...]

CPT Code 92229

CPT Code 92229 For CY 2021, Medicare began making payment for CPT code 92229 (Imaging of retina for detection or monitoring of disease; with point-of-care automated analysis with diagnostic report; unilateral or bilateral). In the CY 2021 [...]

LCD and Associated Billing and Coding Article Updates for July/August 2021

LCD and Associated Billing and Coding Article Updates for July/August 2021 July 2021 Billing and Coding: Denosumab (Prolia ™, Xgeva ™) (A52399) The following clarification has been added to the Documentation Requirements for [...]

MLN Connects® Special Edition for Wednesday, June 9, 2021

MLN Connects® Special Edition for Wednesday, June 9, 2021 Biden Administration Continues Efforts to Increase Vaccinations by Bolstering Payments for At-Home COVID-19 Vaccinations for Medicare Beneficiaries As part of President Biden’s [...]

MLN Connects® Special Edition for Monday, March 15, 2021

MLN Connects® Special Edition for Monday, March 15, 2021 Biden-Harris Administration Increases Medicare Payment for Life-Saving COVID-19 Vaccine On March 15, CMS increased the Medicare payment amount for administering the COVID-19 vaccine. [...]

Behavioral Health Integration Services for Primary Care Providers

Behavioral Health Integration Services for Primary Care Providers Medicare BHI service for your patients that do not require the use of a behavioral health care team. Primary care physicians who are treating Medicare patients with [...]

Cardiac Positron Emission Tomography Pricing Change

Cardiac Positron Emission Tomography Pricing Change Effective 1/1/2020 there nine CPT codes that describe PET as noted in the lists below. Of the nine listed codes, six (group 1) are new for 2020 and are contractor priced codes for the TC and [...]

Article Updates for July 2021

Article Updates for July 2021Billing and Coding: Complex Drug Administration Coding (A58620)Under Article Text - Route of Administration Modifier revised the first sentence to read, “The use of the JA and JB modifiers is required for drugs [...]

Credit Balance Report Reminders

Credit Balance Report RemindersFor the quarter ending 6/30/2021, CBRs can be submitted starting 7/1/2021 and must be submitted within 30 days to be considered timely.FISS/DDE users who submit the 838 detail page directly over the FISS/DDE [...]

Provider Enrollment: Understand the Process to Opt Out of Medicare

Provider Enrollment: Understand the Process to Opt Out of MedicareProviders that render services to a Medicare beneficiary must enroll with Medicare and submit a claim on behalf of the beneficiary. However, select providers can stay in [...]

July 2021 Release "Dark Days" for the Common Working File Hosts

July 2021 Release "Dark Days" for the Common Working File HostsFor the upcoming July 2021 Release:For Production, CWF will be observing the Gray Day on Thursday, July 1st and Dark Days starting Friday, July 2nd through Sunday, July 4th to [...]

National Government Services Part B Medical Review Newsletter June 2021

National Government Services Part B Medical Review Newsletter June 2021We hope you are enjoying our newest service; a regular newsletter. Our goal is to help you stay up-to-date on the on the MR activities performed here at National Government [...]

National Government Services: Raising Awareness about Care Management

National Government Services: Raising Awareness about Care ManagementAccording to the Center for Disease Control (CDC), an estimated 117 million adults have one or more chronic health conditions, and one in four adults have two or more chronic [...]

Medicare Telehealth versus Telemedicine

Medicare Telehealth versus TelemedicineWe have received many questions that have indicated confusion between telehealth and telemedicine, and which rules apply to which services within these two benefit categories. While there is a perceived [...]

Billing Tip for COVID-19 Vaccine as a Mass Immunizer Roster Biller - Use the Taxonomy Code

Billing Tip for COVID-19 Vaccine as a Mass Immunizer Roster Biller - Use the Taxonomy CodeNational Government Services highly recommends that Part B providers who are credentialed as a Mass Immunizer (specialty 73) and have multiple PTANs [...]

Use NGSConnex to Submit Quarterly Credit Balance Reports

Use NGSConnex to Submit Quarterly Credit Balance ReportsWe recently posted a news article that explained the process and benefits of using NGSConnex to submit quarterly credit balance reports. Today’s article contains the resolutions for common [...]

Reminder: General Anesthesia and Conscious Sedation is Not Medically Necessary for Facet Joint Interventions

Reminder: General Anesthesia and Conscious Sedation is Not Medically Necessary for Facet Joint InterventionsOn 4/25/2021 National Government Services revised the Local Coverage Determination L35936 “Facet Joint Interventions for Pain [...]