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Posting Date: 01/03/2025
Noninvasive Vascular Studies
Noninvasive Vascular Studies NonInvasive, leg, clot, plethysmography, duplex scan, Doppler, cerebrovascular, arterial, venous, hemodialysis L33627 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33627 A56758 [...]
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Posting Date: 01/03/2025
Off-Label Use of Intravenous Immune Globulin (IVIG)
Off-Label Use of Intravenous Immune Globulin (IVIG) L39314 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39314 A59105 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59105 A59251 [...]
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Posting Date: 01/03/2025
Outpatient Physical and Occupational Therapy Services
Outpatient Physical and Occupational Therapy Services maintenance, restorative, skilled, modality, therapeutic, exercise, manual, cast, splint, biofeedback L33631 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33631 A56566 [...]
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Posting Date: 01/03/2025
Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane)
Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™) drug A52450 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52450 J9264, J9267
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Posting Date: 01/03/2025
Psychiatric Partial Hospitalization Programs
Psychiatric Partial Hospitalization Programs mental illness, family counseling, vocational training L33626 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33626 A56850 [...]
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Posting Date: 01/03/2025
Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) ionizing, stereotactic guidance, robotic L35076 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=35076 A56874 [...]
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Posting Date: 01/06/2025
Time Requirements to Notify Medicare of Changes
Report Changes to Your Enrollment Records You must report changes of information in your Medicare enrollment records within 30 days for: Change(s) in ownership or control, including changes in authorized officials(s) All other changes to [...]
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Posting Date: 01/02/2025
Proper Submission of Reopening Requests
Proper Submission of Reopening Requests National Government Services has identified an issue where providers are submitting reopening requests to change or add diagnosis codes on paid claims. These reopening requests do not impact the outcome [...]
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Posting Date: 01/08/2025
Fourth Quarter Top Ten EDI Institutional Edits
Fourth Quarter Top Ten EDI Institutional Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the 2024 fourth quarter. Visit Quarterly Top Ten EDI Institutional Edits to view the edits, their description and learn what you can [...]
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Posting Date: 01/07/2025
Using Nicotine Replacement Therapy for Smoking Cessation
Using Nicotine Replacement Therapy for Smoking Cessation Healthcare providers may choose to offer quit smoking medications to help reduce withdrawal symptoms and cigarette cravings, effectively doubling the chances of quitting successfully. [...]
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Posting Date: 05/06/2016
Inpatient Admission Prior to Medicare Entitlement Job Aid
Inpatient Admission Prior to Medicare Entitlement Job Aid Pre-Entitlement Quick Steps Pre-entitlement is when a beneficiary is admitted as an inpatient to an acute care hospital prior to the beneficiary's Medicare entitlement effective date [...]
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Posting Date: 01/07/2025
Fiscal Intermediary Standard System Direct Data Entry Screen Changes – January 2025
Fiscal Intermediary Standard System Direct Data Entry Screen Changes – January 2025 The January 2025 quarterly system release was implemented on 1/6/2025 with the following changes to the Claims Correction Submenu (03) DDE screen: MAP1704 [...]
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Posting Date: 01/13/2025
Obtaining Beneficiary Eligibility Information Through NGSConnex
Obtaining Beneficiary Eligibility Information Through NGSConnex As a reminder, our Customer Service Representatives aren’t permitted to share eligibility information because it’s available through NGSConnex. We encourage new and [...]
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Posting Date: 01/08/2021
Corporate Holiday Schedule
Corporate Holiday Schedule The National Government Services Provider Contact Centers will be closed in 2025 to observe the following corporate holidays: Date Corporate Holiday Observed Wednesday, January 1, 2025 [...]
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Posting Date: 01/10/2025
Quarterly Credit Balance Reports No Longer Required
Quarterly Credit Balance Reports No Longer Required As of 12/1/2024, providers are not required to submit the Medicare Credit Balance Report (CMS-838) on a quarterly basis. However, to ensure that monies owed to Medicare are repaid in a timely [...]
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Posting Date: 03/14/2022
Submitting a Prior Authorization Request
Submitting a Prior Authorization Request Table of Contents Submitting a Prior Authorization Request Documentation Requirements Documentation Checklist for Medical Professionals Supporting the Physician Certification Statement [Return [...]
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Posting Date: 01/09/2025
National Government Services - Telehealth Extension 2025
National Government Services - Telehealth Extension 2025 Section 3207 of the American Relief Act, 2025 modified Section 1834(m) of the Social Security Act to extend the waiver of the geographic, site of service, and practitioner type [...]
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