National Correct Coding Initiative Edits

Beneficiary Eligibility Information Not Offered on the IVR Beginning 11/18/2024

Beneficiary Eligibility Information Not Offered on the IVR Beginning 11/18/2024 To help protect Medicare beneficiaries against fraud, CMS is instructing all MACs to remove beneficiary eligibility information from our IVR systems. Starting [...]

MLN Connects® Newsletter: October 10, 2024

MLN Connects® Newsletter: October 10, 2024 News Resources & Flexibilities to Assist with the Public Health Emergency in Florida CMS Roundup (October 4, 2024) Clinical Laboratory Fee Schedule: Reporting Delayed Until 2026 Respiratory [...]

Jurisdiction 6 Part B Top Claim Errors are Updated

Jurisdiction 6 Part B Top Claim Errors are Updated Using data analysis we update the Top Claim Errors on a quarterly basis and provide: the error reason code; a description of the error; the error type; details that include steps you can [...]

Tobacco Cessation Telehealth Guide

Tobacco Cessation Telehealth Guide Tobacco use is the leading cause of preventable disease, disability, and death in the United States. Each year, nearly half a million Americans die prematurely of smoking or exposure to secondhand smoke. [...]

Tobacco Counseling Documentation

Tobacco Counseling Documentation Many healthcare providers perform tobacco use counseling, but they may not be documenting or reporting it appropriately. Providers must ensure all performed services are claimed and supported by complete [...]

Clinical Guidelines and Recommendations

Clinical Guidelines and Recommendations Treating Tobacco Use and Dependence All health care providers, especially those with direct patient contact, have a unique opportunity to help tobacco users quit. Smokers cite a doctor's advice to quit [...]

Rural Health Clinic

Rural Health Clinic Table of Contents Counseling to Prevent Tobacco Use Diagnosis Coding Billing RHC for Smoking and Tobacco Cessation Services Billing Multiple Visits on the Same Day Related Content [Return to Top] [...]

Tobacco and Health Effects

Tobacco and Health Effects Tobacco use is the leading cause of preventable disease, disability and death in the United States. Tobacco dependence is a chronic, relapsing disorder that, like other chronic diseases, often requires repeated [...]

Benefits of Quitting

Benefits of Quitting Table of Contents Benefits of Quitting Health Benefits of Quitting Smoking Economical Benefits of Quitting Smoking Related Content [Return to Top] Benefits of Quitting Quitting tobacco use in any form is one of [...]

Lung Cancer Screening Counseling and Annual Screening for Lung Cancer with Low-Dose Computed Tomography

Preventive Services Guide Lung Cancer Screening Counseling and Annual Screening for Lung Cancer with Low-Dose Computed Tomography Table of Contents Lung Cancer Screening Counseling and Annual Screening for Lung Cancer with Low-Dose [...]

Federally Qualified Health Center

Federally Qualified Health Center Table of Contents Counseling to Prevent Tobacco Use Diagnosis Coding Billing FQHC for Smoking and Tobacco Cessation Services Related Content [Return to Top] Counseling to Prevent Tobacco [...]

Local Coverage Determination Retirement

Local Coverage Determination Retirement An LCD is a policy decision made by a MAC concerning whether to allow coverage of a particular item or service. The Centers for Medicare & Medicaid Services, Internet-Only Manual Publication 100-08, [...]

Lab National Coverage Determinations (NCDs) Alphabetical Index

Pneumococcal Vaccine and Administration

Preventive Services Guide Pneumococcal Vaccine and Administration Pneumonia affects approximately 450 million people globally (seven percent of the population) and results in about four million deaths per year. Pneumonia was regarded by [...]

Vaccinations

Vaccinations Part B Medicare provides coverage for specific vaccination types: Seasonal Influenza Virus Pneumococcal Hepatitis B COVID-19 Vaccines and Administration [Return to Top] Seasonal Influenza Virus Annual Influenza Vaccine [...]

Assistants at Surgery at Teaching Hospitals

Assistants at Surgery at Teaching Hospitals CMS instructs providers to use specific modifiers on claims representing assistance during a surgical procedure: Modifier 80 denotes service by an assistant surgeon Modifier 82 denotes service by [...]

Bundled Services Missing Appropriate Modifiers at Time of Initial Claim Submission

Bundled Services Missing Appropriate Modifiers at Time of Initial Claim Submission Accurate coding and reporting of services are critical aspects of proper billing. Services denied based on the NCCI code pair edits or MUEs may not be billed to [...]

Clarification for Billing Services on Fingers and Toes Using Modifiers F1-F9, FA, T1-T9 and TA vs. Modifier 50

Clarification for Billing Services on Fingers and Toes Using Modifiers F1-F9, FA, T1-T9 and TA vs. Modifier 50 National Government Services has identified some providers who have been billing for services on the fingers and/or the toes with [...]

Modifier 25

Modifier 25 National Government Services has identified problems common with claims submitted for evaluation and management (E/M) services where modifier 25 was appended. This article is designed to provide education regarding the correct [...]