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Posting Date: 08/08/2022
Comprehensive Error Rate Testing Redetermination Deadline 9/27/2022
Comprehensive Error Rate Testing Redetermination Deadline 9/27/2022 The CERT RY 2022 is quickly coming to an end. The deadline for redetermination completion is 9/27/2022 to be considered for the CERT RY. National Government Services requests [...]
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Posting Date: 08/08/2022
Comprehensive Error Rate Testing Documentation Deadline 8/22/2022
Comprehensive Error Rate Testing Documentation Deadline 8/22/2022 The CERT RY 2022 is quickly coming to an end. In order to give sufficient time for the CERT RC to complete the review of your claims, all documentation and additional [...]
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Posting Date: 08/10/2022
October 2022 Release "Dark Days" for the Common Working File Hosts
October 2022 Release "Dark Days" for the Common Working File Hosts For the upcoming October 2022 Release: For Production, CWF will be observing the Gray Day on Thursday, September 29th and Dark Days starting Friday, September 30th through [...]
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Posting Date: 08/11/2022
MLN Connects® Newsletter for Thursday, August 11, 2022
MLN Connects® Newsletter for Thursday, August 11, 2022 Monkeypox & Smallpox Vaccines: New Product Codes News Monkeypox & Smallpox Vaccines: New Product Codes Payment Allowance Update for COVID-19 Monoclonal Antibody Therapy [...]
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Posting Date: 08/17/2022
CMS Identifies National System Issue
CMS Identifies National System Issue CMS identified a national system issue, which may have inadvertently adjusted previously processed Part B claims with dates of service (DOS) on or after January 1, 2021. These adjustments processed on July [...]
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Posting Date: 03/21/2022
National Government Services Medicare Spring 2022 Virtual Conference
National Government Services Medicare Spring 2022 Virtual Conference Medicare For You Wednesday, 5/11/2022 – Thursday, 5/12/2022 The NGS Provider Outreach and Education Team is holding our latest bi-annual virtual conference on Wednesday, [...]
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Posting Date: 05/10/2022
Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow!
Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow! Medicare for You offers valuable information that is fundamental for you, as a provider, to submit claims with the needed information so you realize the [...]
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Posting Date: 02/02/2021
Submit an Adjustment to Correct Claims Partially Denied by Automated LCD-NCD Denials
Submit an Adjustment to Correct Claims Partially Denied by Automated LCD-NCD Denials NGS would like to remind providers that using adjustment reason code “LN” to submit adjusted claims (xx7, xxQ), where changes were made to an LCD/NCD denied [...]
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Posting Date: 03/29/2016
Screen Movements
Chapter III: Navigating the Online System Screen Movements Purpose To move within the FISS/DDE Provider Online System, providers will perform several different screen movements. The following chart outlines the various screen [...]
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Posting Date: 08/18/2022
MLN Connects® Newsletter for Thursday, August 18, 2022
MLN Connects® Newsletter for Thursday, August 18, 2022 Discontinuing Use of Certificates of Medical Necessity & Durable Medical Equipment Information Forms News CMS Discontinuing the Use of Certificates of Medical [...]
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Posting Date: 02/16/2015
Accessibility Statement
Accessibility Features of the National Government Services Website The NGSMedicare.com website employs many features to make information more accessible. If you have comments or suggestions, please use our Site Feedback mechanism to let us [...]
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Posting Date: 08/18/2022
MLN Connects® Special Edition for Thursday, August 18, 2022
MLN Connects® Special Edition for Thursday, August 18, 2022 Creating a Roadmap for the End of the COVID-19 Public Health Emergency News Creating a Roadmap for the End of the COVID-19 Public Health Emergency Health Care System Resiliency [...]
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Posting Date: 02/10/2025
Reminder: New Medicare Part B Redetermination Notice Initiative
Reminder: New Medicare Part B Redetermination Notice Initiative As a reminder, beginning 3/3/2025, National Government Services will only issue electronic versions of the MRN when a Medicare Part B Redetermination request is electronically [...]
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Posting Date: 02/03/2025
2025 Gapfill Request
2025 Gapfill Request National Government Services, the MAC for JK and J6 is in receipt of the new laboratory test codes identified by the CMS to be gap-fill priced for 2025. The PAMA regulations instruct the MACs to establish local payment [...]
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Posting Date: 02/03/2025
2025 Gapfill Request Reminder
2025 Gapfill Request Reminder National Government Services, the MAC for JK and J6, is in receipt of the new laboratory test codes identified by CMS to be gap-fill priced for 2025. Please access the complete information on our website: 2025 [...]
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Posting Date: 02/10/2025
Medicare Advantage Information For Part A and Part B Not Offered on the IVR Beginning 3/14/2025
Medicare Advantage Information For Part A and Part B Not Offered on the IVR Beginning 3/14/2025 Effective the evening of 3/14/2025, the Medicare IVR system will no longer provide information regarding the Medicare Advantage: plan [...]
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Posting Date: 11/07/2022
Medicare Diabetes Prevention Program
Medicare Diabetes Prevention Program Table of Contents Background What is the Medicare Diabetes Prevention Program? Overview of MDPP What is Covered Through the Model? What Does this Mean for Beneficiaries? What Does this Mean [...]
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Posting Date: 10/14/2021
Membership Rosters
Membership Rosters Jurisdiction 6 and Jurisdiction K Home Health POE Advisory Group Roster Member Provider/Institution State Abreau-Costa, Maria Mozaic Senior Life Connecticut Adam, Sherie [...]
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Posting Date: 11/07/2022
Diabetes Self-Management Training
Preventive Services Guide Diabetes Self-Management Training According to the Centers for Disease Control and Prevention, approximately 38.4 million Americans have diabetes and 27.2 million people aged 65 years or older (48.8%) have been [...]
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Posting Date: 11/07/2022
Common Questions for Diabetes Self-Management Training and Medical Nutrition Therapy
Common Questions for Diabetes Self-Management Training and Medical Nutrition Therapy Table of Contents Diabetes Programs Billing for Services DSMT and MNT Telehealth Services Related Content [Return to Top] Diabetes Programs [...]
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Posting Date: 12/15/2021
Meeting Schedules
Meeting Schedule Part A POE AG Meetings for Jurisdiction 6 and Jurisdiction K J6: Illinois, Minnesota, Wisconsin and Federally-Qualified Health Centers in all states JK: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island [...]
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Posting Date: 02/11/2025
The National Correct Coding Initiative
The National Correct Coding Initiative The purpose of the NCCI PTP edits is to prevent improper payment when incorrect code combinations are reported. The NCCI contains one table of edits for physicians/practitioners and one table of edits for [...]
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Posting Date: 07/14/2024
Expanded Home Health Value-Based Purchasing Model
Expanded Home Health Value-Based Purchasing Model Overview The HHVBP Model is an initiative by CMS aimed at improving the quality of care provided by home health agencies while also fostering greater efficiency. It builds on the original [...]
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Posting Date: 02/13/2025
Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating
Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating Did you know that tobacco cessation counseling is a covered Medicare service? Brief tobacco counseling provides substantial health benefits while producing cost savings. [...]
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Posting Date: 02/12/2025
HCPCS 90658 Claim Hold
Claim hold for CPT 90658 (influenza vaccine)
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Posting Date: 02/12/2025
FQHC Claim Hold Effective DOS 1/1/2025
CMS has issued claim hold instructions to all MACs, due to release and testing of a new FQHC pricer.
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Posting Date: 02/13/2025
[RESOLVED] Medicare Claim Process System Experiencing Outages
[RESOLVED] Medicare Claim Process System Experiencing Outages We were experiencing outages with our IVR and NGSConnex claim status functionality. Technical support was engaged and the issue is now resolved. The IVR and NGSConnex claim status [...]
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Posting Date: 08/13/2020
How To Get Started - Five Easy Steps
How To Get Started – Five Easy Steps Contact your vendor, clearinghouse or billing service to ensure they support the electronic attachment program which includes the following: 6020 version of the 277RFI transaction; HL7 CDA R2 [...]
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Posting Date: 02/14/2025
MLN Connects® Newsletter: February 14, 2025
MLN Connects® Newsletter: February 14, 2025 News Complex Non-Chemotherapeutic Drug Administration: Determining Payment for Services Claims, Pricers, & Codes Ambulance Fee Schedule: CY 2025 Inflation Factor Integrated Outpatient [...]
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Posting Date: 08/25/2022
PA Exemption Tool Top
Prior Authorization Exemption Status Inquiry Tool This is a self-service tool to allow both hospital or physician office staff responsible for submitting PARs, to check the exempt status of the HOPD. This tool will only recognize the [...]
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Posting Date: 02/17/2025
Reminder: New Medicare Part B Redetermination Notice Initiative
Reminder: New Medicare Part B Redetermination Notice Initiative As we’ve communicated, National Government Services is transitioning to electronic notifications for Part B Medicare Redetermination decisions when a Medicare Part B [...]
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Posting Date: 02/17/2025
Collaborative Urological Supplies Webinar Coming 3/27/2025
Collaborative Urological Supplies Webinar Coming 3/27/2025 This is your opportunity to hear directly from the Medicare contractors regarding Medicare’s criteria necessary for the coverage of urological supplies. Representatives from all four [...]
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Posting Date: 11/12/2021
Requirements of Medicare Opt-Out Affidavit Agreement
Requirements of Medicare Opt-Out Affidavit Agreement Amendment 4507 of the Balanced Budget Act of 1997 permits a physician or practitioner to “opt out” of Medicare and enter into private contracts with Medicare beneficiaries if specific [...]
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Posting Date: 02/17/2025
Prepare and Submit an MSP Conditional Claim
Table of Contents Background Step 1: Determine if You Can Submit a Conditional Claim Step 2: Prepare a Conditional Claim Conditional Billing Code Table Step 3: Check for a Matching MSP Record for the Beneficiary in the Common [...]
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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: 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: 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: 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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