Frequently Asked Questions Reviewed and Updated

Frequently Asked Questions 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 available are: ASCA Appeals CAR T-cell Therapy [...]

Frequently Asked Questions Reviewed and Updated

Frequently Asked Questions 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 available are: ASCA CAR T-cell Therapy Claims EDI [...]

Frequently Asked Questions Reviewed and Updated

Frequently Asked Questions 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 available are: ASCA CAR T-cell Therapy Claims EDI [...]

Frequently Asked Questions Reviewed and Updated

Frequently Asked Questions 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 available are: ASCA CAR T-cell Therapy Claims EDI [...]

Activation of Validation Edits for Providers with Multiple Service Locations (MLN Matters Number: SE19007 Revised)

Activation of Validation Edits for Providers with Multiple Service Locations (MLN Matters Number: SE19007 Revised) Posted 7/20/2023

Multi-Jurisdictional CAC Meeting Notice on Cervical Fusion

Multi-Jurisdictional CAC Meeting Notice on Cervical Fusion Information has been posted on our website in regards to multi-jurisdictional Contractor Advisory Committee Meeting regarding Cervical Fusion to be held on 8/16/2023. For more [...]

National Government Services CAC Meeting Notice on KidneyIntelX Test

National Government Services CAC Meeting Notice on KidneyIntelX Test Information has been posted on our website in regards to the National Government Services l Contractor Advisory Committee Meeting regarding KidneyIntelX Test to be [...]

Reason Codes

Chapter I: Online System Terminology Reason Codes Purpose Reason codes direct the outcome of an edit or process within FISS—they are the traffic cops of the system. Each reason code, when assigned, sends the claim to a specific [...]

Document Control Number

Chapter I: Online System Terminology Document Control Number Purpose The FISS DDE Provider Online System refers to the claim control number as a DCN. The DCN provides a reference number for the control and monitoring of each claim. To [...]

MLN Connects® Newsletter: January 26, 2023

MLN Connects® Newsletter: January 26, 2023 News Medicare Enrollment in PECOS: Faster and Easier Application Process — Coming Summer 2023 Medicare Enrollment: Maintain the Same Owners in All Enrollment Records Hospitals: Revised [...]

MLN Connects® Newsletter: OPPS/ASC and PFS Final Payment Rules

MLN Connects® Newsletter: OPPS/ASC and PFS Final Payment Rules Final Rules   Final Rules HHS Continues Biden-Harris Administration Progress in Promoting Health Equity in Rural Care Access Through Outpatient Hospital and Surgical [...]

MLN Connects® Newsletter for Thursday, September 8, 2022

MLN Connects® Newsletter for Thursday, September 8, 2022 Prostate Cancer: Talk to Your Patients about Screening News Short-Term Acute Care Hospitals: Program for Evaluating Payment Patterns Electronic Reports Prostate Cancer: Talk to [...]

Electronic Medicare Secondary Payer Specifications for Inbound Claims

Resources Electronic Medicare Secondary Payer Specifications for Inbound Claims The following information is intended to provide you and your software vendor with a reference point for electronically billing MSP claims. Use this information [...]

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 Solutions, Wisconsin Physician Services [...]

Claims/Attachments Submenu

  Chapter II: Online Menu Functions Overview Claims/Attachments Submenu Purpose The CLAIMS/ATTACHMENTS submenu is primarily used for data entry of claims. Influenza virus vaccine, pneumococcal pneumonia vaccine and COVID-19 vaccine [...]

Medicare Fee-for-Service Claims and the Sequestration Payment Adjustment Changes

Medicare Fee-for-Service Claims and the Sequestration Payment Adjustment Changes Just a reminder: The Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare fee-for-service claims. As a result of [...]

Customer Experience Surveys

Customer Experience Surveys We are pleased to offer two new surveys for you to tell us about your experience with our Provider Contact Center. When you use our IVR system, access the survey from the main menu after you complete your [...]

Tips to Ensure an Optimal NGSMedicare.com Experience

Tips to Ensure an Optimal NGSMedicare.com Experience Most of you are probably aware, but if not, on Friday, 5/14/2021, we launched our new combined homepage. These changes were a result of your feedback. You now only need to go to [...]

Skilled Nursing Facility Patient Driven Payment Model Billing For Noncovered Days With An Occurrence Span Code 76

Skilled Nursing Facility Patient Driven Payment Model Billing For Noncovered Days With An Occurrence Span Code 76 The CR 11992 updated the CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 6, Sections 40.3.2 and 40.6 to [...]

There’s Still Time to Register – National Government Services Preventive Service Week

There’s Still Time to Register – National Government Services Preventive Service Week National Government Services Provider Outreach and Education Team is holding a Special Virtual Conference on Medicare Preventive Services. Join us on [...]

Applying for an Extended Repayment Schedule

Processing Drivers and System Claim Paths

Chapter I: Online System Terminology   Processing Drivers and System Claim Paths Purpose Claims that are filed through the FISS DDE Provider Online System follow a prescribed route referred to as a system claim path. Claim paths [...]

Claim Status and Location Codes

Chapter I: Online System Terminology Claim Status and Location Codes Purpose The purpose of the status and location is to route claims through FISS. The status describes the general condition of the claim (i.e., whether paid, denied, [...]

Local Coverage Determination Open Meeting Announcement

Local Coverage Determination Open Meeting Announcement Jurisdiction 6/Jurisdiction K Part A/Part B MAC To ensure the development of LCDs occurs through a public and open process, we are soliciting scientific evidence and other [...]

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 redetermination, which is the first level of [...]

MLN Connects® Newsletter: February 23, 2023

MLN Connects® Newsletter: February 23, 2023     News Hospital Price Transparency: Progress and Commitment to Achieving Its Potential Home Infusion Therapy Services Monitoring Report Immunosuppressive Drugs: Comparative [...]

MLN Connects® Newsletter: February 9, 2023

MLN Connects® Newsletter: February 9, 2023     News DMEPOS: Get Benefit Category Determinations Nurse Practitioners and Clinical Nurse Specialists: Update to List of National Certifying Bodies Help Address Heart Health [...]

MLN Connects® Newsletter: February 2, 2023

MLN Connects® Newsletter: February 2, 2023 News Aligning Quality Measures across CMS — The Universal Foundation Medicare Ground Ambulance Data Collection System: Portal to Report is Open Skilled Nursing Facilities: Care Compare January [...]

Let's Chat About Counseling to Prevent Tobacco Use

Let's Chat About Counseling to Prevent Tobacco Use Do you have questions on how to bill Medicare for tobacco counseling? Join us on 1/24/2023 for the opportunity to ask questions about coverage and billing for Medicare’s preventative service [...]

MLN Connects® Newsletter: January 5, 2023

MLN Connects® Newsletter: January 5, 2023 News COVID-19: Updated Vaccines for Children Ages Six Months – Five Years Advisory Panel on Hospital Outpatient Payment: Request for Nominations Certificates of Medical Necessity and DME [...]

MLN Connects® Newsletter: December 15, 2022

MLN Connects® Newsletter: December 15, 2022 News Opioid Treatment Programs: New Information for 2023 Part B Immunosuppressive Drug Benefit: Check Medicare Eligibility Home Health Quality Reporting Program: Get Final OASIS-E Instrument [...]

MLN Connects® Newsletter: December 1, 2022

MLN Connects® Newsletter: December 1, 2022 News CMS Urges Timely Patient Access to COVID-19 Vaccines, Therapeutics Quality Payment Program: Preview Your Performance Information by December 20 Clinical Laboratory Fee Schedule: CY 2023 [...]

MLN Connects® Newsletter: November 23, 2022

MLN Connects® Newsletter: November 23, 2022 News Colorectal Cancer Screening Test: Reduced Coinsurance for Related Procedures Begins January 1 Ambulance Fee Schedule: CY 2023 Inflation Factor & Productivity Adjustment Medicare [...]

MLN Connects® Newsletter: September 7, 2023

MLN Connects® Newsletter: September 7, 2023     News New Version of CMS.gov HHS Proposes Minimum Staffing Standards to Enhance Safety and Quality in Nursing Homes CMS Announces Resources and Flexibilities to Assist with [...]

MLN Connects® Newsletter: September 14, 2023

MLN Connects® Newsletter: September 14, 2023     News Inflation Reduction Act Continues to Lower Out-of-Pocket Prescription Drug Costs for Drugs with Price Increases Above Inflation CMS Roundup (Sept 8, 2023) New Provider [...]

Ambulatory Surgical Center Pass-Through Devices

Ambulatory Surgical Center Pass-Through Devices What is a Pass-Through Device? Pass-through status is determined for newly FDA-approved drug and device products on an individual basis. Drugs and devices qualifying for pass-through status [...]

MLN Connects® Newsletter: COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older – September 14, 2023

MLN Connects® Newsletter: COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older – September 14, 2023     News COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older Posted 9/14/2023

URGENT: Billing Reminders for OPPS Providers with Multiple Service Locations

URGENT: Billing Reminders for OPPS Providers with Multiple Service Locations Table of Contents Urgent: Provider Compliance Required Effective 8/1/2023 Requirements Claim Filing Requirements Final Reminders Related Content [Return to [...]

MLN Connects® Newsletter: September 21, 2023

MLN Connects® Newsletter: September 21, 2023     News CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Georgia Organ Transplantation Affinity Group: Strengthening [...]

MLN Connects® Newsletter: September 28, 2023

MLN Connects® Newsletter: September 28, 2023     News CMS Statement on Current Status of Blood Tests for Organ Transplant Rejection CMS Roundup (Sept 22, 2023) Cardiovascular Disease: Talk with Your Patients about [...]