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Posting Date: 11/12/2021
Revocation
Revocation CMS may revoke a currently enrolled provider or supplier's Medicare billing privileges and any corresponding provider or supplier agreement for the following reasons: Abuse of billing privileges Failure to document or provide [...]
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Posting Date: 02/28/2019
Failure to Report a Critical Change
Failure to Report a Critical Change Providers and suppliers enrolled in Medicare are required to ensure strict compliance with Medicare regulations by submitting updates and changes to enrollment information in accordance with specified [...]
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Posting Date: 04/24/2018
Failure to Complete Revalidation
Failure to Complete Revalidation Avoid claims being rejected or termination of Medicare billing privileges by responding: by the revalidation due date timely to additional information requested Related Content Medicare Revalidation [...]
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Posting Date: 02/10/2025
Global Period Services - HCPCS Code G0559
Global Period Services - HCPCS Code G0559 As of 1/1/2025, CMS has implemented HCPCS Code G0559 to capture work performed by a provider other than the performing surgeon during the global period associated with most surgical procedures. The [...]
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Posting Date: 02/18/2025
Deactivation of Billing Privileges/Suspension of Payment
Reasons for Deactivation of Medicare Billing Privileges/Suspension of Payment (not all inclusive) Inactivity Failure to complete revalidation within required time frame Unreported provider address and/or bank information Inactivity [...]
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Posting Date: 10/08/2021
Annual Wellness Visit Screening
Preventive Services Guide Annual Wellness Visit Screening Table of Contents Annual Wellness Visit Screening Coverage Criteria Two Types of AWV Elements Elements of Initial AWV Personalized Prevention Plan Services – [...]
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Posting Date: 03/22/2022
Maine, Massachusetts, New Hampshire, Rhode Island and Vermont
Maine, Massachusetts, New Hampshire, Rhode Island, Vermont Member Name Professional Title Association Business Name/Address Email Bedard, Brenda Insurance Compliance & Training Supervisor Maine [...]
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Posting Date: 01/30/2025
Medicare Change of Status Notice
Medicare Change of Status Notice Attention: Hospitals, including CAHs and other providers billing Medicare for inpatient services. The Medicare Change of Status Notice (MCSN) became effective 10/11/2024 and implemented 2/15/2025. Hospitals, [...]
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Posting Date: 08/27/2021
Alcohol Misuse and Counseling
Preventive Services Guide Alcohol Misuse and Counseling Table of Contents Alcohol Misuse and Counseling Two-Part Benefit Cost Sharing Reimbursement Nonparticipating Providers Common Claim Denial Reasons Related Content [Return [...]
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Posting Date: 10/08/2021
Initial Preventive Physical Examination
Preventive Services Guide Initial Preventive Physical Examination The IPPE is also known as the “Welcome to Medicare Preventive Visit.” The goals of the IPPE are health promotion and disease detection and prevention. Table of Contents [...]
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Posting Date: 02/25/2025
MLN Connects® Newsletter: February 24, 2025
MLN Connects® Newsletter: February 24, 2025 Compliance Mechanical Ventilation: Bill Correctly for Inpatient Claims Claims, Pricers, & Codes Discarded Drugs & Biologicals: Orphan Drugs with Increased Applicable Percentage for [...]
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Posting Date: 06/22/2022
Standard Companion Guides
Standard Companion Guides Standard Companion Guide Trading Partner Information (275) Standard Companion Guide Trading Partner Information (277) Standard Companion Guide Trading Partner Information (278/275) Standard Companion Guide Health [...]
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Posting Date: 02/03/2025
Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application
Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application Available now is the revised CMS-855A (09/24) paper application that includes a section for SNF to comply with the 2023 Final rule in reporting [...]
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Posting Date: 12/03/2020
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment Reminder, if a hospital, clinic/group or Independent Diagnostic Treatment Facility has ADI screening equipment, certification from a designated ADI accrediting [...]
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Posting Date: 02/26/2025
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment
Reminder, if a hospital, clinic/group or Independent Diagnostic Treatment Facility has ADI screening equipment, certification from a designated ADI accrediting organization needs to be implemented or updated on the Medicare enrollment. The [...]
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Posting Date: 01/11/2021
Audit and Reimbursement
Audit and Reimbursement Cost Report Filing State/Region Contact Information Jurisdiction 6 J6_cost_report_filing@anthem.com Jurisdiction K JK_cost_report_filing@anthem.com Provider Statistical [...]
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Posting Date: 07/05/2022
Audit and Reimbursement
Audit and Reimbursement Cost Report Filing State/Region Contact Information Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont JK_Cost_Report_Filing@anthem.com FQHC (All), [...]
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Posting Date: 03/03/2025
MLN Connects® Newsletter: February 28, 2025
MLN Connects® Newsletter: February 28, 2025 CMS Provider Education Message: Hospitals: Actions to Make Healthcare Prices Transparent Update: On February 25, the White House issued an Executive Order to empower patients with clear, accurate, [...]
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Posting Date: 02/27/2025
National Correct Coding Initiative
National Correct Coding Initiative We recently introduced the NCCI Lookup Tool on our Part B Tools and Calculators page. This tool is designed to assist providers in identifying codes subject to automated prepayment edits, thereby facilitating [...]
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Posting Date: 05/29/2024
Standard Companion Guides
Standard Companion Guides Standard Companion Guide Trading Partner Information (275) Standard Companion Guide Trading Partner Information (277) Standard Companion Guide Trading Partner Information (278/275) Standard Companion Guide Health [...]
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