Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929)

Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929) Currently, National Government Services has LCD Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929) as well as a Draft [...]

How to Avoid Costly Appeals

How to Avoid Costly Appeals National Government Services has noticed an increase in requests for claim appeals. Upon review, we have found that many of the requests are not appropriate and/or necessary for a claim appeal submission. The [...]

MLN Connects® Special Edition for Thursday, May 6, 2021

MLN Connects® Special Edition for Thursday, May 6, 2021 CMS Increases Medicare Payment for COVID-19 Monoclonal Antibody Infusions New payment policy for at-home administration As part of the ongoing response to address the COVID-19 [...]

MLN Connects® Special Edition for Monday, December 6, 2021

MLN Connects® Special Edition for Monday, December 6, 2021 Provider Requirements Under the No Surprises Act Special ODF — December 8 Wednesday, December 8, 2021 from 2:00-3:00 p.m. eastern time ​​​CMS will host a Special Open Door Forum [...]

Medicare Part A and Part B Billing for the COVID-19 Vaccine and Monoclonal Antibody

Medicare Part A and Part B Billing for the COVID-19 Vaccine and Monoclonal Antibody Medicare Billing for COVID-19 Vaccine Shot Administration How to Bill for COVID-19 Shot Administration You’ll be able to bill on single claims for the [...]

National Government Services Billing VEKLURY™ (remdesivir) Antiviral Medication in Outpatient Settings

National Government Services Billing VEKLURY™ (remdesivir) Antiviral Medication in Outpatient Settings CMS created the new HCPCS code J0248 for VEKLURY™ (remdesivir) antiviral medication. This code is effective for dates of service on or after [...]

Home Health and Hospice December Educational Videos are Now Available On-Demand

Home Health and Hospice December Educational Videos are Now Available On-Demand The National Government Services Home Health and Hospice Provider Outreach & Education team “On-Demand Video Library” offers providers the ability to watch or [...]

Removal of HCPCS Code

Removal of HCPCS Code Prior Authorization Update Effective immediately, for claims with dates of service on or after 1/7/2022, the Centers for Medicare & Medicaid Services is removing current procedural terminology code 67911 (correction [...]

Coronavirus Resources for Home Care and Hospice

Coronavirus Resources for Home Care and Hospice At National Government Services, the health and well-being of our beneficiary and provider communities is our top priority. The Centers for Medicare & Medicaid Services’ COVID-19 web page is [...]

Home Health Bill Type 32A Returning with Reason Code 32114

Home Health Bill Type 32A Returning with Reason Code 32114 The Centers for Medicare & Medicaid Services implemented new home health bill type 32A effective 1/1/2022. An issue with ZIP codes submitted on EMC claims has been identified, [...]

December 2021-January 2022 LCD and Billing and Coding Article Updates

December 2021-January 2022 LCD and Billing and Coding Article Updates Billing and Coding: Autonomic Function Testing (A57024) Due to the annual CPT/HCPCS code updates, effective 1/1/2022, CPT code 95943 has been deleted from the CPT/HCPCS [...]

MLN Connects® Newsletter for Thursday, November 18, 2021

MLN Connects® Newsletter for Thursday, November 18, 2021 COVID-19: Changes to Nursing Home Visitation & Survey Activities   News CMS Repeals MCIT/R&N; Will Consider Other Coverage Pathways to Enhance Access to Innovative [...]

MLN Connects® Newsletter for Thursday, November 4, 2021

MLN Connects® Newsletter for Thursday, November 4, 2021 COVID-19: Changes for Medicare Advantage Plan Claims Starting January 1   News COVID-19 Vaccines for Children COVID-19 Vaccine & Monoclonal Antibody Products: Changes for [...]

MLN Connects® Special Edition for Friday, September 24, 2021

MLN Connects® Special Edition for Friday, September 24, 2021 CMS Will Pay for COVID-19 Booster Shots, Eligible Consumers Can Receive at No Cost Coverage without cost-sharing available for eligible people with Medicare, Medicaid, CHIP, and [...]

MLN Connects® Newsletter for Thursday, September 30, 2021

MLN Connects® Newsletter for Thursday, September 30, 2021 Flu Season is Here: Protect Your Patients, Yourself, & Your Loved Ones View this edition as a: Webpage | PDF News Flu Season is Here: Protect Your Patients, Yourself, [...]

MLN Connects® Special Edition for Monday, September 20, 2021

MLN Connects® Special Edition for Monday, September 20, 2021 Help CMS Improve Your Experience with Provider Resources CMS is conducting a study to help us improve your experience with resources about the Medicare program and correct billing. [...]

MLN Connects® Newsletter for Thursday, August 19, 2021

MLN Connects® Newsletter for Thursday, August 19, 2021 COVID-19: Vaccinate Your Patients View this edition as a: Webpage | PDF News Immunization: Medicare Covers Vaccines Compliance Chiropractic Services: Comply with Medicare [...]

MLN Connects® Newsletter for Thursday, August 26, 2021

MLN Connects® Newsletter for Thursday, August 26, 2021 Health Care Code Sets: ICD-10 — Revised View this edition as a: Webpage | PDF News Impact of the PHE on Telehealth: Comparative Billing Report in August COVID-19 Monoclonal [...]

MLN Connects® Newsletter for Thursday, September 9, 2021

MLN Connects® Newsletter for Thursday, September 9, 2021 SNF: WBT & COVID-19 Reminder View this edition as a: Webpage | PDF    News PEPPERs for Short-term Acute Care Hospitals Outpatient Clinic Visit Services at [...]

MLN Connects® Special Edition for Friday, August 13, 2021

MLN Connects® Special Edition for Friday, August 13, 2021 COVID-19 Vaccine Additional Dose Medicare stands ready to pay for administering an additional dose of COVID-19 vaccine consistent with the FDA EUA. We’ll pay the same amount to [...]

MLN Connects® Newsletter for Thursday, July 15, 2021

MLN Connects® Newsletter for Thursday, July 15, 2021 View this edition as a: Webpage | PDF News Cognitive Assessment: Resources for Providers CMS Opens National Coverage Determination Analysis on Treatment for Alzheimer’s Disease [...]

MLN Connects® Newsletter for Thursday, July 29, 2021

MLN Connects® Newsletter for Thursday, July 29, 2021 Hospital Price Transparency Stakeholder Webinar — August 11 View this edition as a: Webpage | PDF Compliance Ambulance Services & SNF Consolidated Billing Requirements: Avoid [...]

MLN Connects® Special Edition for Tuesday, July 13, 2021

MLN Connects® Special Edition for Tuesday, July 13, 2021 CMS Proposes Physician Payment Rule to Improve Health Equity, Patient Access CMS is proposing changes to address the widening gap in health equity highlighted by the COVID-19 Public [...]

MLN Connects® Special Edition for Monday, July 19, 2021

MLN Connects® Special Edition for Monday, July 19, 2021 CMS Proposes Rule to Increase Price Transparency, Access to Care, Safety & Health Equity CMS is proposing actions to address the health equity gap, ensure consumers have the [...]

Laboratory Date of Service Policy

MLN Connects® Newsletter for Thursday, March 24, 2022

MLN Connects® Newsletter for Thursday, March 24, 2022 ICD-10: Comment on Proposed Procedure and Diagnosis Codes News Additional Residency Positions: Apply by March 31 Long-term Care Hospitals: March Preview Period Ends April 6 [...]

Award of Medicare Administrative Contractor Contract for Jurisdiction K

Award of Medicare Administrative Contractor Contract for Jurisdiction K CMS selected National Government Services to retain the JK MAC contract. As a result, there will be no changes to your service or the support we provide you. NGS looks [...]

April 2022 LCD and Billing and Coding Article Updates

April 2022 LCD and Billing and Coding Article Updates LCDs Effective 4/1/2022 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) (L33559/A56737) The LCD was returned for comment from 6/3/2021 through [...]

MLN Connects® Special Edition for Wednesday, March 30, 2022

MLN Connects® Special Edition for Wednesday, March 30, 2022 Fiscal Year 2023 Hospice Payment Rate Update Proposed Rule - Comment by May 31 On March 30, CMS issued a proposed rule (CMS-1773-P) that would provide routine updates to [...]

New Evaluation and Management Frequently Asked Questions for Prolonged Services

New Evaluation and Management Frequently Asked Questions for Prolonged Services We’ve added new frequently asked questions to the Prolonged Services section of our E/M FAQs to clarify proper billing for CPT codes 99354-99356, 99358-99359, and [...]

MLN Connects® Special Edition for Monday, April 4, 2022

MLN Connects® Special Edition for Monday, April 4, 2022 Biden-Harris Administration Announces a New Way for Medicare Beneficiaries to Get Free Over-the-Counter COVID-19 Tests On April 4, The Biden-Harris Administration announced that more [...]

MLN Connects® Special Edition for Wednesday, April 6, 2022

MLN Connects® Special Edition for Monday, April 6, 2022 Eligible Individuals Can Receive Second COVID-19 Booster Shot at No Cost On April 6, CMS announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna [...]

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport The Repetitive, Scheduled Nonemergent Ambulance Transport Prior Authorization Model establishes a process through which a request for provisional affirmation [...]

Availability and Contact Information

Availability and Contact Information Hours of Availability To optimize your NGSConnex experience, you are encouraged to complete your NGSConnex transactions between the following hours: Monday–Friday: 6:00 a.m.–7:00 p.m. ET Saturday: 7:00 [...]

Related Content

Related Content JK Ambulance Suppliers RSNAT Sample Introductory Letter Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) CMS IOM, Publication 100-02, Medicare Benefit Policy Manual, Chapter 10 CMS IOM, [...]

Submitting a Prior Authorization Request

Submitting a Prior Authorization Request Ambulance suppliers or beneficiaries should legibly complete the National Government Services Prior Authorization Request for Repetitive, Scheduled Non-Emergent Ambulance Transports. The Cover [...]

Related Content

Related Content J6 Ambulance Suppliers RSNAT Sample Introductory Letter Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) CMS IOM, Publication 100-02, Medicare Benefit Policy Manual, Chapter 10 CMS [...]

Prior Authorization Request for Repetitive, Scheduled Nonemergent Ambulance Transports Medicare Part B Fax/Mail Coversheet

Five Steps to Webinar Success

Increased Volume of Appeal Status Inquiries

Increased Volume of Appeal Status Inquiries National Government Services has seen an increase in pending reopenings and redetermination levels, resulting in cases being completed beyond the 60 calendar-day timeframe. We are sharing some [...]

PC-ACE Medicare Secondary Payer Reference Guide for Part B

PC-ACE Medicare Secondary Payer Reference Guide for Part B Payers (Insurance) Setup Payer Information Screen Patient Selection and Setup Setting up the Patient’s Insurance Information MSP Claim Entry (Line Level) MSP Claim Entry (Claim [...]

MLN Connects® Special Edition for Monday, April 18, 2022

MLN Connects® Special Edition for Monday, April 18, 2022 CMS Proposes Policies to Advance Health Equity & Maternal Health, Support Hospitals On April 18, CMS issued a proposed rule for inpatient and long-term hospitals that builds on the [...]

Part B Issue for Coinsurance Payments on Drug Code Claims

Due to an issue with a recent system update, 20% coinsurance for drug codes has been incorrectly calculated during the period of 10/27/2021-11/1/2021.

Anesthesia Conversion Factor Pricing Incorrect for 2022

The incorrect conversion file was loaded to production for dates of service starting 1/1/2022 which caused incorrect payments.

April and May 2022 Billing and Coding Article Updates

April/May 2022 Billing and Coding Article Updates Billing and Coding Articles Billing and Coding: Complex Drug Administration Coding (A58620) J0248 remdesivir (Veklury®) was added under Infusions Non-Chemotherapy Generic/Trade Names table [...]

Home Health PPS PC Pricer

MLN Connects® Special Edition for Thursday, July 29, 2021

MLN Connects® Special Edition for Thursday, July 29, 2021 4 Final FY 2022 Payment Rules Hospice Payment Rate Update: FY 2022 Final Rule IRF Prospective Payment System: FY 2022 Final Rule IPF Prospective Payment System: FY 2022 Final Rule [...]

Tips for Success

Tips for Success Speak naturally and clearly in a quiet environment. Use mute when you are not speaking. Avoid the use of cellular phones or speaker phones. Have all of the information available and organized before you call. Use [...]

Tips for Success

Tips for Success Speak naturally and clearly in a quiet environment. Use mute when you are not speaking. Avoid the use of cellular phones or speaker phones. Have all of the information available and organized before you call. Use [...]

Determine/Pay Application Fee

Determine/Pay Application Fee

Determine/Pay Application Fee

Cervical Fusion with Disc Removal

Cervical Fusion with Disc Removal National Government Services will begin accepting PARs for Cervical Fusion with Disc Removal on 6/17/2021 for services provided beginning on or after 7/1/2021. Checklist of PAR information to include: [...]

Low and No Medicare Utilization Cost Report

Low and No Medicare Utilization Cost Report No Utilization Cost Reports To comply with program cost reporting requirements, a provider that has not furnished any covered Medicare services during a cost reporting period must only complete the [...]

MLN Connects® Special Edition for Thursday, March 31, 2022

MLN Connects® Special Edition for Thursday, March 31, 2022 IPF & IRF Proposed FY 2023 Payment Rules Inpatient Psychiatric Facilities: Fiscal Year 2023 Proposed Rule — Submit Comments by May 31 Inpatient Rehabilitation Facilities: [...]

New Evaluation and Management Frequently Asked Question for Emergency Department

New Evaluation and Management Frequently Asked Question for Emergency Department We’ve added a new frequently asked question to the Emergency Department section of our E/M FAQs to further define how time can be used as a factor in billing [...]

New Evaluation and Management Frequently Asked Question for Time-Based Services

New Evaluation and Management Frequently Asked Question for Time-Based Services We’ve added a new FAQ for E/M time-based services. Please define rules for using time to level-set a service in the inpatient setting. ​​​​​​​Answer: In [...]

Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice"

Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice" The 2022 HH+H MAC Collaborative Summit: One Program, One Voice is now available for early bird registration. This huge [...]

MLN Connects® Newsletter for Thursday, May 12, 2022

MLN Connects® Newsletter for Thursday, May 12, 2022 Biosimilars Curriculum: Resources for Teaching Your Students News Comprehensive Error Rate Testing Documentation Center Moved on April 13 Physicians, Teaching Hospitals, Physician [...]