32072

Avoiding/Correcting This Error The attending physician reported on your claim must be active in PECOS to be considered a valid attending physician for the home health patient.

37236

Avoiding/Correcting This Error Verify eligibility of the attending/ordering physicians in PECOS. Print that verification and make it part of the medical record. If applicable, submit a reopen request to the Appeals Department indicating error [...]

55H1L

Avoiding/Correcting This Error Clinical progress notes should show evidence of a steady decline or downward trajectory in the beneficiary’s clinical status over time. Documentation should be objective, measurable and must support a life [...]

55H1R

Avoiding/Correcting This Error Review coverage and billing guidelines for the NOE to ensure that your NOEs are accurately billed. Related Content CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 9, Section [...]

Frequently Asked Questions Have Been Reviewed and Updated

Frequently Asked Questions Have Been 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 [...]

Part A Fundamentals of Medicare Online Guide

Part A Fundamentals of Medicare Online Guide Attention Part A Providers and Support Staff:  National Government Services produces the Fundamentals of Medicare online guide to help build understanding of the Original Medicare [...]

Medicare Participating Physicians Directory

Medicare Participating Physicians Directory The 2025 MEDPARD is now available. It includes all Part B providers in Jurisdiction 6 and Jurisdiction K who have agreed to accept assignment on all Medicare-covered services. The updated list [...]

New Medicare Part B Redetermination Notice Initiative

New Medicare Part B Redetermination Notice Initiative  National Government Services is excited to announce a new initiative for providers who submit Medicare Part B appeals using our portal, NGSConnex.  Starting 3/3/2025, NGS [...]

Take Advantage of Tobacco Counseling When Performing Medicare Wellness Visits 

Take Advantage of Tobacco Counseling When Performing Medicare Wellness Visits Medicare providers have a valuable opportunity to optimize revenue and improve patient outcomes through Medicare's Annual Wellness Visits. These visits help identify [...]

EDI Gateway Outage

The National Government Services EDI gateway was unavailable for all submitters. 

J6 Part B Applying for an Extended Repayment Schedule

Diabetes Screening

Preventive Services Guide Diabetes Screening Table of Contents Diabetes Screening Coverage Criteria and Frequency Limits HCPCS/CPT Coding Diagnosis Coding Cost Sharing Reimbursement Nonparticipating Providers Common Claim [...]

KX Modifier Threshold

KX Modifier Threshold The Bipartisan Budget Act of 2018 repealed application of the Medicare outpatient therapy caps but retains the former cap amounts as a threshold above which claims must include the KX modifier as a confirmation that [...]

Discarded Drugs/Wastage and JW, JZ Modifier

Discarded Drugs/Wastage and JW, JZ Modifier Medicare may pay for discarded drugs or wasted drugs and biologicals when: The provider/supplier must discard the remainder of a single-dose container after administering a dose or quantity to a [...]

Medicare Part B Independent Physical, Occupational and Speech Therapy Providers

Medicare Part B Independent Physical, Occupational and Speech Therapy Providers National Government Services is addressing providers who frequently submit clerical error reopenings to add the KX modifier to Medicare Part B claims for physical, [...]

New Medicare Part B Redetermination Notice Initiative

New Medicare Part B Redetermination Notice Initiative As we’ve communicated, beginning 3/3/2025, National Government Services will only issue electronic versions of the MRN when a Medicare Part B Redetermination request is electronically [...]

Methods for Responding to an ADR

Methods for Responding to an ADR Table of Contents Submitting Documentation NGSConnex Mailing an ADR CD/DVD esMD Fax [Return to Top] Submitting Documentation NGSConnex is the preferred method of submission. National [...]

Fee Schedules Description

Fee Schedule Lookup To initiate a search, select a fee schedule type from the drop-down menu, complete all required fields, then select Search. Note: If your search does not display the fee schedule or effective date (range) you enter, [...]

Create an Account - Local Security Officer

Create an Account — Local Security Officer Table of Contents Create an Account — Local Security Officer (LSO) Step 1 – Account Step 2 – Individual Step 3 – Business [Return to Top] Create an Account — Local Security [...]

Create an Account - Standard

Create an Account – Standard Table of Contents Create an Account – Standard Step 1 – Account Step 2 – Individual Step 3 – Business [Return to Top] Create an Account – Standard An NGSConnex Standard Account holder will [...]