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Posting Date: 10/19/2022
"What If" and Scenario Questions
"What If" and Scenario Questions Physician offices often contact us with different scenarios and "what if?" questions regarding coding and documentation for a particular service(s). Providers ask the contractors for a definitive response on [...]
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Posting Date: 10/19/2022
Medically Unlikely Edits Billing and Processing
Medically Unlikely Edits Billing and Processing Table of Contents Medically Unlikely Edits Billing and Processing Notes on MUE Processing Instructions MUE Program Inquires Related Content [Return to Top] Medically Unlikely Edits [...]
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Posting Date: 10/27/2022
Avoid Processing Delays by Following Proper Submission Guidelines
Avoid Processing Delays by Following Proper Submission Guidelines Table of Contents Avoid Processing Delays by Following Proper Submission Guidelines Claims Appeals Responding to an ADR Consider Submission via NGSConnex or Electronic [...]
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Posting Date: 10/27/2022
Acceptable Electronic Signatures Reminder
Acceptable Electronic Signatures Reminder Table of Contents Acceptable Electronic Signatures Reminder Examples of Acceptable Electronic Signature Examples [Return to Top] Acceptable Electronic Signatures Reminder CMS issued [...]
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Posting Date: 10/27/2022
Primary Care Exception Guidelines
Primary Care Exception Guidelines Services performed by attending physicians at teaching hospitals, in collaboration with house staff in an approved GME program, generally require evidence of direct care by the attending physician in order to [...]
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Posting Date: 10/27/2022
Cloned Documentation Could Result in Medicare Denials for Payment
Cloned Documentation Could Result in Medicare Denials for Payment Medicare providers today are faced with the challenges of providing quality healthcare while meeting ever increasing regulatory and compliance regulations. Many providers are [...]
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Posting Date: 10/27/2022
Documentation Required for Home Visits
Documentation Required for Home Visits CPT Codes 99341‒99350 As of 1/1/2019, CMS no longer requires providers to differentiate medical necessity for a home visit versus an office or outpatient visit. Providers no longer need to document [...]
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Posting Date: 10/27/2022
Referring, Monitoring and Certifying Home Health Services
Referring, Monitoring and Certifying Home Health Services Table of Contents Referring, Monitoring and Certifying Home Health Services Homebound Status Need for Skilled Services Under the Care of a Physician or Allowed Practitioner Plan [...]
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Posting Date: 10/27/2022
Scribing Medical Record Documentation
Scribing Medical Record Documentation National Government Services recognizes an increasing trend in providers’ use of scribes as assistants in medical record documentation. In these situations, a provider utilizes the services of staff to [...]
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Posting Date: 10/27/2022
Submit Medical Record Documentation Electronically
Submit Medical Record Documentation Electronically Table of Contents Submit Medical Record Documentation Electronically What do you need to get started? What are the Attachment Transactions? Who can use the Attachment Transactions? [...]
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Posting Date: 10/10/2022
Anesthesia for Pain Management Procedures
Anesthesia for Pain Management Procedures The use of moderate or deep sedation, general anesthesia, and MAC is rarely indicated for pain management procedures and is not considered reasonable and necessary. The ASA provides guidelines for [...]
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Posting Date: 11/29/2021
Remittance Advice
Remittance Advice Table of Contents General Information Electronic Remittance Advice Remittance Message Codes Standard Paper Remittance General Information Once Medicare has processed a claim, the provider will receive a notice [...]
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Posting Date: 10/19/2022
Outpatient Services for Registered Inpatients
Outpatient Services for Registered Inpatients There are occasional circumstances in which a registered inpatient may require a service that is not available at the inpatient facility. These inpatient facilities include acute-care hospitals [...]
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Posting Date: 10/19/2022
Allergen Immunotherapy Preparation (95144-95165)
Allergen Immunotherapy Preparation (95144‑95165) National Government Services will allow the preparation and provision of antigen for allergen immunotherapy, codes 95144 through 95165 when performed incident to by auxiliary personnel. However, [...]
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Posting Date: 10/19/2022
CPT Code 15830: Excision, Excess Skin and Subcutaneous Tissue; Abdomen, Infraumbilical Panniculectomy
CPT Code 15830: Excision, Excess Skin and Subcutaneous Tissue; Abdomen, Infraumbilical Panniculectomy CMS created the Medicare Physician Fee Schedule Look-up Tool for MACs to follow when processing claims. CMS listed CPT code 15830 as a [...]
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Posting Date: 10/19/2022
Fee-For-Time Compensation Arrangement and Reciprocal Billing Job Aid
Fee-For-Time Compensation Arrangement and Reciprocal Billing Job Aid Table of Contents Fee-For-Time Compensation Arrangement and Reciprocal Billing Job Aid Fee-For-Time Compensation Arrangements Reciprocal Billing Arrangements Related [...]
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Posting Date: 10/19/2022
Answers to Common Fee-for-Time Compensation Arrangements Questions
Answers to Common Fee-for-Time Compensation Arrangements Questions Does a fee-for-time compensation arrangement physician need to enroll with Medicare prior to acting as a physician? Answer: Currently, a fee-for-time compensation [...]
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Posting Date: 10/19/2022
Nonphysician Practitioners Billing for Surgical Procedures
Nonphysician Practitioners Billing for Surgical Procedures Several providers have asked about the Medicare guidance for NPPs include billing for surgical procedures. For the purpose of this education, NPPs include NPs, PA, and CNSs. State law [...]
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Posting Date: 10/20/2022
Professional Services During a Patient Hospice Election
Professional Services During a Patient Hospice Election Table of Contents Article Overview Hospice Election Medicare Payment During Hospice Election Determining the Correct Entity to Bill Separately Payable Part B Services Hospice and [...]
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Posting Date: 10/19/2022
Proper Billing for Finger and Toe Procedures
Proper Billing for Finger and Toe Procedures When billing for procedures that are performed on the fingers and/or toes, it’s essential to append the appropriate anatomical modifier for the service rendered. This allows the patient history to [...]
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