Search Results - NGSMEDICARE

Posting Date: 04/18/2025

Part A Summit- Skilled Nursing Facility: Coverage and Documentation

During this collaborative education session between Case Management and Medical Review, attendees will learn documentation requirements for skilled nursing facility (SNF) coverage, how to properly respond to Additional Documentation Requests [...]

Posting Date: 04/18/2025

Part A Summit Let’s Chat: Prior Authorization for Certain Hospital Outpatient Department Services

This Let’s Chat session focuses on Prior Authorization for certain hospital outpatient department (OPD) services and is an informal opportunity for you to chat with our staff about the selected topic. During the session, you may ask us [...]

Posting Date: 04/18/2025

Part A Summit -Need Answers? The Options to Consider Before Calling or Writing into Medicare

During this session, we will review top trends on why providers are reaching out to Medicare and the best options to resolve those inquires. Plus, valuable tips and resources to help get the most out of Medicare.

Posting Date: 04/18/2025

Part A Summit- Medicare Secondary Payer: Preventing Rejections of Your Medicare Primary Claims

Increase your cash flow by preventing rejections of your Medicare primary claims! In this webinar, we review why claims reject for Medicare Secondary Payer and explain how to prevent these rejections by reporting information on your claims that [...]

Posting Date: 04/18/2025

Part A Summit- Navigating Billing and Documentation for Behavioral Health Services in Federally Qualified Health Centers

Unlock the secrets to effective billing and documentation for behavioral health services within Federally Qualified Health Centers. This collaborative webinar will include insights from Medical Review and is designed to help healthcare [...]

Posting Date: 04/18/2025

Part A Summit – How to Submit an Appeal Request

Join us for a comprehensive session focused on understanding the appeal submission process within National Government Service. This presentation is designed to guide participants through each step of submitting an appeal, ensuring clarity and [...]

Posting Date: 04/18/2025

Part A Summit - Exploring the NGS TPE Process

Join us to explore essential strategies for a successful Targeted Probe and Educate review. We'll cover the purpose of TPE and best practices, roles and responsibilities of National Government Service and providers under review. Gain practical [...]

Posting Date: 04/18/2025

Part A Summit - NGSConnex: User Pain Points Examples/Solutions

Are you experiencing issues while utilizing NGSConnex? Join this informative session to learn what user pain points are and how to resolve these issues from an NGSConnex Agile Product Owner. This session will encompass issues with [...]

Posting Date: 04/18/2025

Part A Summit - World of Medicare Contractors

Medicare Administrative Contractors are responsible for processing claims, managing policy and payment, and establishing regional policy guidelines. Centers for Medicare & Medicaid Services also uses several additional contractors to manage [...]

Posting Date: 04/18/2025

Part A Summit - Maintaining Your Provider Files

This virtual webinar will aid in maintaining accurate provider enrollment files for the internet-based Centers for Medicare & Medicaid Services systems: Identity & Access Management System, National Plan & Provider Enumeration System and the [...]

Posting Date: 04/18/2025

Part A Summit- Navigating NGS and CMS Websites

Join us for this informative session where we will review how to find helpful Medicare references and resources on the National Government Services website (www.NGSMedicare.com) and the Centers for Medicare & Medicaid Services website [...]

Posting Date: 04/18/2025

Part A Summit - Provider Outreach and Education Roundtable

Join us for an interactive and insightful roundtable discussion with the Provider Outreach and Education Manager and team. This session is designed to offer a comprehensive look into the future of POE and explore innovative strategies for [...]

Posting Date: 01/08/2018

Urgent Care

Urgent Care Please explain the concepts of split/shared and incident to E/M services in the urgent care setting. Answer: The urgent care setting is defined by CMS as a nonfacility setting. This means the split/shared concept does not [...]

Posting Date: 01/28/2021

Transitional Care Management

Transitional Care Management Please clarify responsibility for the TCM interactive contact. Can this be performed by a hospital-employed nurse prior to discharge? Answer: The provider who is billing the TCM service is responsible for the [...]

Posting Date: 05/11/2022

Time-Based Services

Time-Based Services Please define rules for using time to level-set a service. Answer: In both the office and observation/inpatient setting, the provider’s time is calculated based on pre-visit, intra-visit, and post-visit activities [...]

Posting Date: 01/28/2022

Telehealth Services

Telehealth Services Please explain Medicare’s definition of a telehealth service. Answer: Medicare defines a telehealth service as a service provided by a Medicare-enrolled practitioner from an approved distant site for a beneficiary who [...]

Posting Date: 06/09/2017

Smoking Cessation

Smoking Cessation Please clarify appropriate codes for smoking cessation services. Answer: CPT codes 99406 and 99407 may be used for smoking and tobacco-use cessation counseling visits. Please clarify what constitutes a session which [...]

Posting Date: 01/04/2023

Skilled Nursing Facility Services

Skilled Nursing Facility Services Please define rules for initial and subsequent SNF services, when the same provider has treated the patient at another site on the same date of service. Answer: This depends on the site of the prior [...]

Posting Date: 08/29/2017

Separately Identifiable Service

Separately Identifiable Service Please define the appropriate use of modifier 57 to identify a separately payable E/M with an initial decision for surgery. Answer: Modifier 57 is added to an E/M service that resulted in an initial [...]

Posting Date: 01/28/2022

Provider Specialty

Provider Specialty Should each MD in the same practice bill with two different taxonomy codes based on whether functioning as a cardiologist or electrophysiologist? Answer: Yes, providers should be billing with their taxonomy codes. The [...]