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Posting Date: 10/28/2021
Other Audit Contractor ADRs
Other Audit Contractor Additional Development Requests An ADR may be requested from one of the contractors listed below. If you receive correspondence from any one of these contractors, please follow the instructions within their letter. [...]
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Posting Date: 10/28/2021
Overpayments Due to Contractor Audit Reviews
Overpayments Due to Contractor Audit Reviews If you do not agree with any CMS contractor audits determination and you are a provider practicing in JK (CT, MA, ME, NH, NY, RI, VT) or J6 (IL, MN, WI), you may use the Medicare appeals process [...]
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Posting Date: 10/08/2021
Bone Mass Measurements
Preventive Services Guide Bone Mass Measurements Table of Contents Bone Mass Measurements Risk Factors Coverage Guidelines and Frequency Limits Coverage Criteria HCPCS/CPT Coding HCPCS/CPT Codes ICD-10 Codes Diagnosis [...]
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Posting Date: 09/26/2024
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a “Stay of Enrollment” or claim rejections which may [...]
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Posting Date: 09/26/2024
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a “Stay of Enrollment” or claim rejections which may [...]
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Posting Date: 10/06/2021
Hepatitis B Virus Screening
Preventive Services Guide Hepatitis B Virus Screening Hepatitis B is a virus that can damage the liver, it is spread through contact with infected blood or body fluids and can be transmitted through sex with an infected person or by sharing [...]
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Posting Date: 10/06/2021
Screening for Sexually Transmitted Infections and HIBC to Prevent STIs
Preventive Services Guide Screening for Sexually Transmitted Infections and HIBC to Prevent STIs Table of Contents Screening for Sexually Transmitted Infections Coverage Criteria High/Increased Risk Factors Frequency Limits [...]
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Posting Date: 05/14/2018
Hospice Claim Reporting Requirements for Attending and Certifying Physicians
Hospice Claim Reporting Requirements for Attending and Certifying Physicians Under CMS' current guidelines, the hospice medical director or the hospice physician and the attending physician (if the beneficiary has one), must initially [...]
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Posting Date: 09/27/2024
LCD and Article Updates for September/October 2024
LCD and Article Updates for September/October 2024 A58152 Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP) The following ICD-10-CM diagnosis codes were added to Group 1- ICD-10-CM Codes That Support Medical necessity [...]
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Posting Date: 10/08/2021
Cardiovascular Disease Screening Tests
Preventive Services Guide Cardiovascular Disease Screening Tests Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Table of [...]
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Posting Date: 10/06/2021
Counseling to Prevent Tobacco Use
Preventive Services Guide Counseling to Prevent Tobacco Use Smoking is the leading preventable cause of disease, disability and death in the United States. It harms nearly every organ in the body and causes about one in every five deaths. [...]
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Posting Date: 11/10/2021
Depression Screening
Preventive Services Guide Depression Screening Also Known as Screening for Depression in Adults Coverage Criteria Covered annually At least 11 months must have passed since last depression screening G0444: Annual depression [...]
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Posting Date: 10/06/2021
Glaucoma Screening
Preventive Services Guide Glaucoma Screening Glaucoma is a group of eye diseases in which damage to the optic nerve results in loss of eyesight. Medicare beneficiaries over the age of 60 have an increased risk of developing glaucoma. CMS has [...]
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Posting Date: 10/06/2021
Hepatitis C Virus Screening
Preventive Services Guide Hepatitis C Virus Screening Hepatitis C is a virus that can damage the liver; it is transmitted through infected blood or body fluids. The most common way people get infected is by sharing needles used to inject [...]
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Posting Date: 10/08/2021
Human Immunodeficiency Virus Screening
Preventive Services Guide Human Immunodeficiency Virus Screening HIV attacks cells that help the body fight infection making a person vulnerable to other infections. Nearly 1.2 million Americans are now living with HIV infection and about [...]
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Posting Date: 10/11/2021
Intensive Behavioral Therapy for Cardiovascular Disease
Preventive Services Guide Intensive Behavioral Therapy for Cardiovascular Disease CVD generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain or stroke. CMS has determined [...]
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Posting Date: 10/11/2021
Intensive Behavioral Therapy for Obesity
Preventive Services Guide Intensive Behavioral Therapy for Obesity In 2003, the United States Preventive Services Task Force found good evidence that BMI “is reliable and valid for identifying adults at increased risk for mortality and [...]
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Posting Date: 11/07/2022
Medical Nutrition Therapy
Preventive Services Guide Medical Nutrition Therapy MNT is a dietary intervention that is used to prevent or treat health conditions that are caused by or made worse by unhealthy eating habits. Table of Contents Eligibility Criteria [...]
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Posting Date: 10/14/2021
Prostate Cancer Screening
Preventive Services Guide Prostate Cancer Screening Prostate cancer is the second most common cancer in men in the United States, after skin cancer. Older men, African-American men and men who have a family history of prostate cancer have a [...]
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Posting Date: 03/15/2019
Screening for Cervical Cancer with Human Papillomavirus Tests
Preventive Services Guide Screening for Cervical Cancer with Human Papillomavirus Tests Cervical cancer is commonly caused by the HPV. The USPSTF found that regular screening greatly reduces the rate of cervical cancer and the number of [...]
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