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Posting Date: 12/12/2024
HCPCS 82947 RTPs End-Stage Renal Dialysis Providers
As of 1/1/2024, Medicare has covered HbA1c tests for diabetic screening (HCPCS 82947) when billed with ICD-10 Z13.1. Some of these claims submitted by ESRD providers have been RTP'd in error.
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Posting Date: 12/12/2024
End Stage Renal Disease Claims Returning to Providers with Reason Code 31773
Due to an issue with the October 2024 release, ESRD facility claims, type of bill 72X, are RTPing in error.
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Posting Date: 10/20/2022
Claim Billing Guidance
Claim Billing Guidance With the end of the PHE, as of 5/11/2023, this information no longer applies. We will keep the information available for PHE-related services that occurred prior to the expiration date that have not yet been billed. [...]
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Posting Date: 12/16/2024
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG)
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG) L39189 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39189 A58921 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58921 A59900 [...]
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Posting Date: 12/18/2024
Provider Enrollment Application Fee Amount for CY 2025
Provider Enrollment Application Fee Amount for CY 2025 The provider enrollment application fee for CY 2025 is $730. For more information, view MLN Connects® Newsletter: December 12, 2024. Posted 12/18/2024
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Posting Date: 09/29/2022
Helpful Resources
Helpful Resources The absence of a local coverage determination (LCD) or Medical Policy Article does not indicate noncoverage, it means that currently, National Government Services (NGS) has not identified the service requires an associated [...]
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Posting Date: 03/21/2024
Medicare Part B Drug Coverage
Medicare Part B Drug Coverage Medicare Part B may provide coverage for medically necessary drugs/biologicals that are furnished “incident to” a physician’s service. This coverage does not apply to drugs that are usually [...]
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Posting Date: 03/21/2024
Allergen Immunotherapy: Coding and Billing CPT 95165
Allergen Immunotherapy: Coding and Billing CPT 95165 CPT 95165 is defined as “Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of [...]
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Posting Date: 12/18/2024
[REVISED UPDATE] Hospice Claims Rejected with Reason Code 17729
Claim rejections for TOB 081X and 082X with RC 17729 have occurred due to a file error. These claims did comply with CMS-required entry of the correct certifying physician in the “Attending” field, which did match the PECOS Enrolled [...]
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Posting Date: 12/19/2024
Reminder for Correcting Hospice Edits for Certifying Physicians (17729, 17730)
Reminder for Correcting Hospice Edits for Certifying Physicians (17729, 17730) Reason Codes 17729 and 17730: Refer to specific hospice claim edits related to certifying physicians. Adjustments: Should be submitted for correcting input [...]
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Posting Date: 02/26/2022
Initiate Eligibility Lookup
Initiate Eligibility Lookup Click the Eligibility Lookup button from the NGSConnex homepage. In the Select a Provider panel, click the Select button next to the applicable provider account. In the Select a [...]
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Posting Date: 12/19/2024
MLN Connects® Newsletter: December 19, 2024
MLN Connects® Newsletter: December 19, 2024 News MBI Lookup Tools: CMS Seeks Input by February 17 CMS Roundup (December 13, 2024) Long-Term Care Hospital Provider Preview Reports: Review by January 15 Inpatient Rehabilitation Facility [...]
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Posting Date: 12/20/2024
Attention FQHCs: Who Is Your MAC?
Attention FQHCs: Who Is Your MAC? National Government Services serves as the CMS Jurisdiction 6 and K MAC for FQHCs in 44 states, Washington D.C. and the five United States Territories of American Samoa, Guam, Northern Mariana Islands, Puerto [...]
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Posting Date: 02/23/2017
What is NGSConnex?
What is NGSConnex? NGSConnex is a free, secure, web-based application developed by National Government Services just for you! NGSConnex provides access to a wide array of self-service functions that save you time and money, such as: Obtain [...]
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Posting Date: 12/20/2024
Fraud and Abuse_Part A_B_FQHC_HHH
Fraud & Abuse Fraud & Abuse Medicare fraud can cost the United States government hundreds of millions of dollars each year and the dollars lost increase the strain on the Medicare Trust Fund. CMS works with other government contractors and law [...]
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Posting Date: 12/20/2024
What Is Fraud_Part A_B_FQHC_HHH
What Is Fraud? What Is Medicare Fraud? Medicare Fraud is intentionally submitting false information to a government contractor to receive money or a benefit by knowingly and willfully executing a scheme to defraud this health care benefit [...]
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Posting Date: 12/20/2024
What Is Abuse_Part A_B_FQHC_HHH
What Is Abuse? What Is Abuse? Abuse describes incidents or practices that are: not medically necessary as defined by Medicare guidelines; or inconsistent with accepted sound medical, business or fiscal practices. Abuse occurs when individuals [...]
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Posting Date: 12/20/2024
How Do I Report Suspected Fraud_Part A_B_FQHC_HHH
How Do I Report Suspected Fraud? How Do I Report Suspected Fraud? Table of Contents How Do I Report Suspected Fraud? Department of Health and Human Services OIG CMS Fraud Prevention Tools Instructions for Accessing the Medscape Modules [Return [...]
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Posting Date: 06/02/2023
Billing Original Fee-for-Service Medicare? You Can Help STOP Assignment Violations!
Billing Original Fee-for-Service Medicare? You Can Help STOP Assignment Violations! Table of Contents Billing Original Fee-for-Service Medicare? You can Help STOP Assignment Violations! What is the Definition of Medicare Assignment? [...]
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Posting Date: 12/20/2024
Part A Fall 2024 Virtual Conference Playback
Part A Fall 2024 Virtual Conference Playback As part of our efforts to educate our provider community, we have posted all 16 educational sessions from our recent Part A Fall 2024 Virtual Conference: Keeping Compliant with Medicare Starts [...]
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