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Posting Date: 02/26/2022
View Remittance
View Remittance If you receive SPRs you will not be able to view remittance statements in NGSConnex. If you are signed up to receive an 835 ERAs or you have elected to view remittance statements through NGSConnex, you may view and print or [...]
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Posting Date: 04/15/2018
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 [...]
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Posting Date: 01/31/2019
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, [...]
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Posting Date: 01/29/2020
Inquiries Submenu
Chapter II: Online Menu Functions Overview Inquiries Submenu Purpose The INQUIRIES submenu allows providers to perform research through various file options, such as the following: Beneficiary/CWF information Claim status DRG [...]
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Posting Date: 01/29/2020
HCPCS Codes (14)
Chapter IV: Inquiries Submenu (01) HCPCS Codes (14) Purpose The purpose of the HCPC CODES option is to provide access to details related to the HCPCS codes available to be reported on a claim. HCPCS codes are five-digit alphanumeric [...]
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Posting Date: 02/25/2022
DX/Proc Codes ICD-9 (15)
Chapter IV: Inquiries Submenu (01) DX/Proc Codes ICD-9 (15) Purpose The purpose of the DX/PROC CODES ICD-9 option is to provide a reference of ICD-9-CM code(s) used to identify a specific or various diagnosis codes or inpatient surgical [...]
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Posting Date: 01/29/2020
Adjustment Reason Codes (16)
Chapter IV: Inquiries Submenu (01) Adjustment Reason Codes (16) Purpose An adjustment reason code is a two-digit alphanumeric code reported on a claim adjustment to identify the specific reason the claim is being adjusted. This option [...]
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Posting Date: 01/29/2020
Reason Codes (17)
Chapter IV: Inquiries Submenu (01) Reason Codes (17) Purpose FISS reason codes are five-digit alphanumeric codes that indicate the outcome of claim editing and processing. The REASON CODE option provides details to indicate why the claim [...]
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Posting Date: 01/30/2020
Claim Count Summary (56)
Chapter IV: Inquiries Submenu (01) Claim Count Summary (56) Purpose The CLAIM COUNT SUMMARY option provides a review of the total claim count and total dollar amount for claims pending in a specific location. This information is updated in [...]
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Posting Date: 01/30/2020
Invoice Number/DCN Translator (88)
Chapter IV: Inquiries Submenu (01) Invoice Number/DCN Translator (88) Purpose The purpose of the Invoice Number/DCN Translator screen is to allow the provider to identify a claim’s Invoice Number when the DCN is known. This option also [...]
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Posting Date: 01/30/2020
Community Mental Health Centers Services Payment Totals (1C)
Chapter IV: Inquiries Submenu (01) Community Mental Health Centers Services Payment Totals (1C) Purpose The purpose of the CMHC Payment Totals screen (MAP1D61) is to display the CMHC payment and outlier totals for current year and one [...]
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Posting Date: 01/30/2020
Provider Practice Address Query (1D)
Chapter IV: Inquiries Submenu (01) Provider Practice Address Query (1D) Purpose The purpose of the Provider Practice Address Query screen is to display the additional practice addresses for a facility; this includes off-campus, outpatient, [...]
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Posting Date: 03/23/2020
New HCPCS Screen (1E)
Chapter IV: Inquiries Submenu (01) New HCPCS Screen (1E) Purpose The purpose of the New HCPCS Screen (1E) is to provide information related to HCPCS pricing and allowable revenue codes related to HCPCS. HCPCS codes are five-digit [...]
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Posting Date: 05/23/2023
New Fiscal Intermediary Shared System Consistency Edit to Validate Attending Physician National Provider Identifier
New Fiscal Intermediary Shared System Consistency Edit to Validate Attending Physician National Provider Identifier Effective 5/16/2023, CMS implemented a new FISS consistency edit to validate the attending provider NPI. The attending provider [...]
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Posting Date: 08/28/2023
Part B Mass Adjustments Resulting in Overpayments
Part B Mass Adjustments Resulting in Overpayments In May 2023, the OIG released the final report titled “Medicare Paid Millions More for Physician Services at Higher Nonfacility Rates Rather Than at Lower Facility Rates While Enrollees Were [...]
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Posting Date: 08/29/2023
October 2023 Release "Dark Days" for the Common Working File Hosts
October 2023 Release "Dark Days" for the Common Working File Hosts For the upcoming October 2023 Release: For Production, CWF will be observing the Gray Day on Thursday, 9/28/2023 and Dark Days starting Friday, 9/29/2023 through Sunday, [...]
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Posting Date: 03/23/2020
Opioid Use Disorder (OUD) Demo 99 (1F)
Chapter IV: Inquiries Submenu (01) Opioid Use Disorder (OUD) Demo 99 (1F) Purpose The purpose of the OUD DEMO option is to provide claim information such as CAP (maximum number of claims that can be billed by the provider with HCPCS G2172), [...]
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Posting Date: 09/05/2018
Roster Bill Entry (87)
Chapter V: Claims/Attachments Submenu (02) Roster Bill Entry (87) Purpose Roster billing is a streamlined process for submitting Medicare claims for a large group of beneficiaries for influenza virus or pneumococcal vaccinations. Up [...]
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Posting Date: 11/18/2011
Summary of Reports (R1)
Chapter VII: Online Reports View Submenu (04) Summary of Reports (R1) Purpose This option allows the provider to review a list of all reports currently available to view online. Additionally, the provider will be able to view the data [...]
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