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  • Posting Date: 07/16/2025
    CO-22

    Avoiding/Correcting This Error During patient registration it’s important for office staff to identify whether a beneficiary’s claims should be covered by other insurance before, or in addition to, Medicare. Providers shall use our [...]

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  • Posting Date: 07/16/2025
    MLN Connects® Newsletter: July 16, 2025

    MLN Connects® Newsletter: July 16, 2025 CY 2026 Proposed Payment Rule CMS Proposes Bold Reforms to Modernize Hospital Payments, Strengthen Transparency, and Put Patients Back in Control News CMS Expands Access to Lifesaving Gene [...]

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  • Posting Date: 07/16/2025
    A55

    Avoiding/Correcting This Error Medicare Secondary Payer (MSP) claims must include the primary insurance carrier’s payment information, plan details, and subscriber information. Incomplete or inaccurate entries will result in claim rejection. [...]

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  • Posting Date: 07/16/2025
    5WEXC

    Avoiding/Correcting This Error Ensure all Medicare coverage and medical necessity requirements are met prior to billing. When the provider determines that Medicare will not cover the services, consider submitting the charges as noncovered. [...]

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  • Posting Date: 07/16/2025
    5WEXC

    Avoiding/Correcting This Error Ensure all Medicare coverage and medical necessity requirements are met prior to billing. When the provider determines that Medicare will not cover the services, consider submitting the charges as noncovered. [...]

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  • Posting Date: 07/16/2025
    39934

    Avoiding/Correcting This Error Review each line level denial reason code(s). Follow the steps provided in that line level reason code narrative. Line level reason code(s) appear on the right view of claim page two (MAP171D). In order to access [...]

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  • Posting Date: 07/16/2025
    C7010

    Avoiding/Correcting This Error If services are unrelated to hospice stay, resubmit with condition code 07 (treatment of nonterminal illness for hospice patient). Verify hospice enrollment prior to claim submission by reviewing the CWF, the [...]

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  • Posting Date: 07/16/2025
    U5200

    Avoiding/Correcting This Error Part of the eligibility verification process should include ensuring the dates of service fall within the Medicare entitlement period. Use the FISS/DDE Provider Online System or NGSConnex to verify [...]

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  • Posting Date: 07/16/2025
    U5210

    Avoiding/Correcting This Error Each beneficiary should be screened for eligibility. Part of the eligibility verification process should include ensuring the dates of service fall within the Medicare entitlement period. Use the IVR system, the [...]

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  • Posting Date: 07/16/2025
    U5210

    Avoiding/Correcting This Error Each beneficiary should be screened for eligibility. Part of the eligibility verification process should include ensuring the dates of service fall within the Medicare entitlement period. Use the FISS Provider [...]

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