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Posting Date: 11/12/2021
Evaluation and Management Documentation Guidelines
Evaluation and Management Documentation Guidelines Health care professionals may use the most current documentation guidelines for the date of service performed. Refer to these resources for guidance: CMS Evaluation and Management AMA [...]
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Posting Date: 11/12/2021
Federal Register
Federal Register The OFR provides access to the official text of: Federal laws Presidential documents Administrative regulations and notices The ACFR oversees the functions of the Federal Register publications system. For more [...]
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Posting Date: 11/12/2021
Health Insurance Portability and Accountability Act of 1996
Health Insurance Portability and Accountability Act of 1996 The HIPAA was signed in to law to improve and simplify the administration of the Medicare Program under title XVIII of the Social Security Act, the Medicaid program under title XIX [...]
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Posting Date: 11/12/2021
Limitation of Liability (Advance Beneficiary Notice of Noncoverage)
Limitation of Liability (Advance Beneficiary Notice of Noncoverage) Services denied as not reasonable and medically necessary, under section 1862(a) (1) of the Social Security Act, are subject to the Limitation of Liability (ABN) provision. [...]
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Posting Date: 11/12/2021
Medically Unlikely Edits
Medically Unlikely Edits In January 2007, CMS developed MUEs to reduce the paid claims error rate for Part B claims. An MUE for a HCPCS /CPT code is the maximum units of service that a provider would report under most circumstances for a [...]
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Posting Date: 11/12/2021
Medicare Coverage Database
Medicare Coverage Database The Medicare Coverage Database is an administrative and educational tool to assist providers, physicians and suppliers in submitting correct claims for payment. The Medicare Coverage Database features LCDs developed [...]
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Posting Date: 11/12/2021
Medicare Electronic Data Interchange
Medicare Electronic Data Interchange Information about how providers can communicate electronically with the Medicare Program can be found on the CMS website at Medicare Electronic Billing & EDI Transactions. This web page contains EDI [...]
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Posting Date: 11/12/2021
Medicare Fraud and Abuse
Medicare Fraud and Abuse As the CMS MAC for J6 and JK, National Government Services fully supports the CMS initiative for program safeguards and shares the following information for your use: Fraud is the intentional deception or [...]
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Posting Date: 11/12/2021
Medicare Learning Network®
Medicare Learning Network® You will see the MLN logo on our website. The MLN is a registered trademark of the CMS and the brand name for official information health care professionals can trust. CMS’ Catalog of products is available on the [...]
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Posting Date: 11/12/2021
Medicare Provider-Supplier Enrollment with NGS
Medicare Provider-Supplier Enrollment with NGS A Medicare enrollment application would follow the NPI application. CMS is responsible for NPI application processes and NGS is responsible for processing enrollment applications for [...]
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Posting Date: 11/12/2021
NGS Internet Resources
NGS Internet Resources The NGSMedicare.com website was established by National Government Services in response to the increased usage of the internet as a learning resource for health care professionals. This website is designed to provide [...]
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Posting Date: 10/21/2024
NGSConnex: Overview, Access, Navigation and Eligibility Look Up
NGSConnex: Overview, Access, Navigation and Eligibility Look Up As we’ve communicated, beginning 11/18/2024, Beneficiary Eligibility information will not be offered on the IVR. This includes all beneficiary eligibility information that was [...]
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Posting Date: 02/26/2022
Medicare Advantage
Medicare Advantage Select Medicare Advantage from the left-side navigation. Information will display if the beneficiary is currently enrolled in a Part C Medicare Advantage plan, also commonly referred to as a Medicare HMO or Medicare [...]
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Posting Date: 04/06/2022
Medicare Secondary Payer
Medicare Secondary Payer Select Medicare Secondary Payer from the left-side navigation. The Medicare Secondary Payer section will display information about other insurance coverage the beneficiary may have, that is primary to Medicare. The [...]
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Posting Date: 02/26/2022
Qualified Medicare Beneficiary
Qualified Medicare Beneficiary Select Qualified Medicare Beneficiary from the left-side navigation. People with Medicare who are in the QMB program are also enrolled in Medicaid and get help with their Medicare premiums and cost-sharing. [...]
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Posting Date: 02/26/2022
Home Health Plan
Home Health Plan Select Home Health Plan from the left-side navigation. The Home Health Plan information section will display information if the beneficiary is currently in a home health episode of care. The Home Health Plan information will [...]
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Posting Date: 02/26/2022
Inpatient and SNF Spell History
Inpatient and SNF Spell History Select Inpatient and SNF Spell History from the left-side navigation. The Inpatient and SNF Spell History section will display information if the beneficiary is currently receiving inpatient or SNF care or has [...]
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Posting Date: 02/26/2022
End Stage Renal Disease
End Stage Renal Disease Select End Stage Renal Disease (ESRD) from the left-side navigation. The ESRD information panel provides information when a beneficiary is eligible for Medicare due to ESRD. This information is important because some [...]
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Posting Date: 02/26/2022
Preventive Services
Preventive Services Select Preventive Services from the left-side navigation. The Preventive Services section provides a list of Medicare-covered preventive services that are eligible for coverage for the beneficiary and when they are next [...]
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