Search Results - NGSMEDICARE

Posting Date: 05/08/2025

OA-18

Avoiding/Correcting This Error A duplicate claim submission occurs when a provider resubmits a claim either on paper or electronically for a single encounter and the service is provided by the same provider to the: same beneficiary; for the [...]

Posting Date: 05/07/2025

Rural Health Clinic Billing Basics

This webinar will provide a detailed overview of the Medicare billing requirements for rural health clinics (RHC), including the definition of a qualifying visit, locations where billable RHC services can occur, claim coding guidelines and [...]

Posting Date: 05/07/2025

A/B and DME Collaborative YouTube Video

A/B and DME Collaborative YouTube Video The A/B DME MACs are offering a YouTube video on Urological Supplies. This DME video tutorial provides information about urological supply requirements. Posted 5/7/2025

Posting Date: 04/01/2025

Provider Contact Center – Make the Most of Your Call

Provider Contact Center – Make the Most of Your Call As of 5/1/2025, the Provider Contact Center (PCC) will service one PTAN/NPI combination per call. Before calling the PCC, make the most of your call by ensuring you have all authentication [...]

Posting Date: 05/09/2025

CO-16

Avoiding/Correcting This Error This rejection is the result of submitting a CPT/HCPCS code without a required modifier. You are required to research the proper modifier to report with the CPT/HCPCS code then submit a new claim. Please use [...]

Posting Date: 05/09/2025

OA-18

Avoiding/Correcting This Error A duplicate claim submission occurs when a provider resubmits a claim either on paper or electronically for a single encounter and the service is provided by the same provider to the: same beneficiary; for the [...]

Posting Date: 05/09/2025

CO-16

Avoiding/Correcting This Error The billing provider's information on the claim is missing or invalid. To avoid this error, ensure the following details are accurate and included: the billing provider's NPI, name, address, ZIP code and phone [...]

Posting Date: 05/09/2025

CO-109

Avoiding/Correcting This Error This denial is received when your Medicare patient is enrolled in an MA plan, instead of “traditional fee-for-service” Medicare. MA plans are health plans offered by private companies approved by Medicare [...]

Posting Date: 05/09/2025

CO-16

Avoiding/Correcting This Error Certain services require the name and NPI of the ordering or referring physician, depending on the service type. Definitions: Referring Physician: Requests an item or service for a Medicare beneficiary. [...]

Posting Date: 05/09/2025

Podiatry Services - Routine Foot Care and Debridement of Nails

While the Medicare Program generally excludes routine foot care services from coverage, there are specific indications or exceptions under which there are program benefits. Medicare payment may be made for routine foot care when the patient has [...]

Posting Date: 05/09/2025

Home Health Billing Coffee Break

Provider Outreach and Education is hosting a 30-minute coffee break to help answer your troublesome billing questions. This is a great opportunity to discuss areas of billing more in depth and review helpful guides and resources. Keep in mind [...]

Posting Date: 05/09/2025

Critical Care and Medicare Billing Compliance

While critical care codes did not change with the 2021 or 2023 AMA CPT updates, there are a lot of guidelines for billing these services. During this webinar, we'll discuss critical care coding, what is and is not critical care, how to [...]

Posting Date: 05/05/2025

Ambulance Services and Establishing Medical Necessity for Part B Providers

This webinar will help the ambulance community understand the importance of medical necessity as it pertains to Medicare’s coverage guidelines.

Posting Date: 05/06/2025

Understanding Medicare Fraud and Abuse

Learn about fraud and abuse affecting providers and your Medicare patients to increase your awareness of integrity issues and prevent potential fraudulent and abusive practices against the Medicare Program.

Posting Date: 05/06/2025

Reducing Unprocessable Claims

When claims are submitted with invalid, incomplete or incorrect information, our claims processing system will detect these errors and will reject claims as unprocessable. Our goal is to assist our providers in submitting claims correctly the [...]

Posting Date: 08/05/2020

Practitioners - Are You Ordering Surgical Dressings for Your Patients?

Practitioners - Are You Ordering Surgical Dressings for Your Patients? In order for a DME supplier to provide surgical dressings to your patients, there are actions you can take to make sure that all the required supporting medical record [...]

Posting Date: 03/03/2025

Clinicians: Are You Ordering Urological Supplies for Your Patients?

Clinicians: Are You Ordering Urological Supplies for Your Patients? Urological supplies are covered as part of the prosthetic device benefit as outlined in the Social Security Act, Section 1861(s)(8). Prosthetic devices (other than dental) [...]

Posting Date: 07/11/2022

Meeting Minutes

Meeting Minutes Jurisdiction 6 Illinois, Minnesota, Wisconsin Jurisdiction K Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Jurisdiction 6 and Jurisdiction K Combined Meeting 4/3/2025 12/5/2024 [...]

Posting Date: 04/30/2025

PECOS: View and Manage Reassignments through Group Enrollment

During this webinar, we’ll provide an understanding of how to view and manage reassignments through the group enrollment in Provider Enrollment, Chain and Ownership System (PECOS), including to add or terminate reassignments. Individual [...]

Posting Date: 04/30/2025

Helping Your Patients Stop Smoking

Helping Your Patients Stop Smoking Quitting Tobacco – Slips and Relapses Quitting smoking has health benefits at any age, no matter how long or how much you have smoked. If you slip or relapse, don’t be afraid to try and quit again. Each quit [...]