How to Avoid Duplicate Claims

Duplicate denials continue to be one of the top billing errors. Unnecessary duplicate filing of Medicare claims cost the provider's office valuable time and resources, as well as Medicare's time and money to process them. Please join us [...]

Provider Enrollment: Completing the CMS-855A Paper Application

During this webinar, we’ll provide an understanding of how to complete the CMS-855A provider enrollment paper application.

Medicare Compliance With the Incident To Provision

Do you have nonphysician practitioners that are, or could be, providing services incident to the physicians in the practice? Are you following the Centers for Medicare & Medicaid Services (CMS) regulations for this program? Staying [...]

Provider Enrollment: Completing the CMS-855I Paper Application

During this webinar, we’ll provide an understanding of how to complete the CMS-855I provider enrollment paper application for a group member, sole proprietor or sole owner and we’ll also focus on reassigning Medicare benefits.

Counseling to Prevent Tobacco Use

In an effort to raise awareness and increase utilization of tobacco use counseling, we’ll focus on the effects of nicotine dependence including affected health consequences during this webinar. Medicare coverage, coding, billing and [...]

Counseling to Prevent Tobacco Use

In an effort to raise awareness and increase utilization of tobacco use counseling, we’ll focus on the effects of nicotine dependence including affected health consequences during this webinar. Medicare coverage, coding, billing and [...]

Provider Enrollment: Completing the CMS-855B Paper Application

During this webinar, we'll provide an understanding of how to complete the CMS-855B provider enrollment paper application for a clinic, group or supplier.

Critical Access Hospitals: Preparing and Submitting Compliant Inpatient Claims to Medicare

In this webinar, critical access hospitals (CAHs) will learn how to properly prepare inpatient claims for submission to Medicare. We will review Medicare inpatient hospital benefit days, the Medicare benefit period, the applicable fields of [...]

Medicare Part B Targeted Probe and Educate Process

Are you familiar with targeted probe and educate? Perhaps you've heard of it but are not sure what it entails. Either way, consider attending this webinar as we cover this important topic. We'll discuss everything you need to know so if [...]

EDI Enrollment processing update

EDI Enrollment processing update National Government Services, EDI Enrollment Department will require all information submitted for EDI access to be valid and accurate. Exceptions will no longer be made when validating and processing requests [...]

Provider Transaction Access Number Request Form

Observance of Memorial Day 2025

Observance of Memorial Day 2025 In observance of Memorial Day 2025, our offices will be closed Friday, 5/23/2025 and Monday, 5/26/2025. Note: EDI claim files transmitted after 4:00 p.m. CT/5:00 p.m. ET on 5/22/2025 will have a claim receipt [...]

May 31 is World No Tobacco Day

May 31 is World No Tobacco Day World No Tobacco Day (WNTD) on May 31 is a yearly celebration that informs the public of the dangers of using tobacco, the business practices of tobacco companies, what is being done to fight the tobacco [...]

Maintaining Your Provider Files

During this webinar, we'll share information to aid you in maintaining accurate provider enrollment files for the internet-based CMS systems: Identity & Access Management System (I&A), National Plan & Provider Enumeration System [...]

Medicare Secondary Payer: The Fundamentals Part 2

This is part 2 of a 2-part webinar. In part 2, we continue to introduce our Part A providers to Medicare Secondary Payer (MSP) by providing a high-level overview of your MSP responsibilities per your Medicare provider agreement. You will learn [...]

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments Each year, National Government Services experiences numerous EFT rejections due to inactive or closed bank accounts. To ensure continuous Medicare [...]

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments Each year, National Government Services experiences numerous EFT rejections due to inactive or closed bank accounts. To ensure continuous Medicare [...]

Local Coverage Determination Open Meeting

Local Coverage Determination Open Meeting National Government Services is hosting a Local Coverage Determination Open Meeting on 6/25/2025.  Details are available by accessing the Local Coverage Determination Open Meeting Announcement. [...]

Fraud Prevention and Detection

Please join us to increase your awareness of integrity issues and prevention of potential fraudulent and abusive practices against the Medicare Program. We will also review real life fraud cases. There will be time following the presentation to [...]

Medicare Overpayment Process

Ensure that you are compliant and avoid financial penalties by understanding the Medicare overpayment regulations. This session will focus on identifying overpayments, using the proper forms and procedures, the timelines for repayment and the [...]

Medicare Secondary Payer: The Fundamentals Part 1

This is part 1 of a 2-part webinar. In part 1, we introduce our Part A providers to the fundamentals (basics) of Medicare Secondary Payer (MSP) by providing a high-level overview of the Group Health Plan (GHP) and non-GHP MSP provisions. We [...]

Medicare Part B - Submitting Medical Documentation Electronically

During this webinar, we'll cover the enrollment, registration and methods available for submitting medical documentation to National Government Services. There will be time for your questions following the presentation.

Medicare Global Surgery

Global surgery policy was introduced into Medicare over thirty years ago and still today some of the concepts can be confusing. During this webinar, we'll go through the global surgery policy as it stands today, and cover when the global [...]

Submitting Revalidation via PECOS

During this webinar, we’ll provide an understanding of how to utilize the Centers for Medicare & Medicaid Services (CMS) Internet-based Provider Enrollment Chain & Ownership System (PECOS) to be comfortable in navigating the system to [...]

[RESOLVED] NGSConnex and Interactive Voice Response System Experiencing Intermittent Issues

[RESOLVED] NGSConnex and Interactive Voice Response System Experiencing Intermittent Issues We were experiencing intermittent outages with NGSConnex and the IVR. In some cases, the IVR was not playing back information when claim status was [...]

How to Become a Medicare-Enrolled OTP Supplier

How to Become a Medicare-Enrolled OTP Supplier OTPs with current, valid and full certification by the Substance Abuse and Mental Health Services Administration (SAMHSA) and accredited by a SAMHSA-approved accrediting body; including the DEA [...]

Learn Over Lunch – NGSConnex Inquiries

Effective 5/27/2025, National Government Services will no longer accept inquiries submitted through the postal service to any of our P.O. Boxes or faxed to any of our fax lines. Are you prepared? Join this session to learn how to efficiently [...]

Depression Screening: Promoting Good Health Through Disease Prevention and Detection

Medicare covers many preventive services to keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain diseases. Register today for an [...]

The National Correct Coding Initiative and Medically Unlikely Edits for Part B Providers

This webinar will assist Part B providers with navigating tables for the National Correct Coding Initiative and the medically unlikely edits. We will also review proper modifiers to use to avoid denials. There will be time following the [...]

Overpayments Due to Contractor Audit Reviews

Overpayments Due to Contractor Audit Reviews If you do not agree with any CMS contractor audits determination and you are a provider practicing in JK (CT, MA, ME, NH, NY, RI, VT) or J6 (IL, MN, WI), you may use the Medicare appeals process [...]

CMS Links

Accreditation of Advanced Diagnostic Imaging Suppliers All Fee-For-Service Providers Ambulatory Surgical Centers (ASC) Center Beneficiary Notices Initiative (BNI)  Care Management including: Advanced Care Planning Behavioral [...]

MLN Connects® Newsletter: May 22, 2025

MLN Connects® Newsletter: May 22, 2025 News Discarded Drugs: Get Updated Lists Medicare Provider Payment & Utilization Public Use Files: Annual Update Medicare Fee-for-Service Geographic Variation Public Use Files & Interactive [...]

Medically Unlikely Edits

Claim ADRs

Claim Additional Development Requests Types include: Origins Facts Identification NOC and unlisted codes. Modifiers: AS, 22, 52, 53, 62, 66, 80, 81, 82. PWK initiated and records are not [...]

Medically Unlikely Edits and Related Billing Clarifications

Medically Unlikely Edits and Related Billing Clarifications An MUE is the maximum number of UOS allowable under most circumstances for a single HCPCS/CPT code billed by a provider for a particular date of service for a single beneficiary. [...]

CMS Medically Unlikely Edits

General Information

General Information National Government Services or other CMS contractors may need to request additional information for Medicare claims to assess compliance with Medicare rules. These requests are ADRs. An ADR is a notification/letter [...]

Related Resources

Related Resources MLN® Educational Tool: How to Use the Medicare National Correct Coding Initiative (NCCI) Tools Medicare National Correct Coding Initiative (NCCI) Edits Medicare NCCI Medically Unlikely Edits (MUEs) National Correct [...]

The National Correct Coding Initiative Lookup Tool

The National Correct Coding Initiative Lookup Tool The National Correct Coding Initiative Lookup Tool is designed to help providers identify when certain codes are subject to the automated code pair edits. Search for coding pairs by entering a [...]

Ways to Respond to ADRs

Ways to Respond to ADRs When you are ready to submit, refer to the ADR for the specific submission methods available. NGS offers multiple ways for providers to submit their documentation in response to an ADR. CMS audit contractors notate in [...]

Relocation of the Medically Unlikely Edit Webpage Information

Relocation of the Medically Unlikely Edit Webpage Information National Government Services would like to inform you of an important change regarding the placement of the MUE section on our website. The MUE information has been relocated and is [...]

National Correct Coding Initiative and Medically Unlikely Edits

Medical Review Targeted Probe and Educate ADRs

Medical Review Targeted Probe and Educate Additional Development Requests Origins Facts Identification CMS’ TPE program is provider specific education that will focus on improving issues without allowing other [...]

Quarterly Version Update Changes

Quarterly Version Update Changes CMS posts changes to each of its NCCI PTP published edit files on a quarterly basis. This includes additions, deletions and modifier indicator quarterly changes to PTP column one/column two correct coding edits [...]

Add-on Codes

Add-on Codes Add-on codes are specific types of HCPCS/CPT codes intended to describe services that can only be reported in conjunction with a primary procedure. They represent additional work performed during the primary procedure and [...]

Procedure to Procedure Edits

Procedure to Procedure Edits The NCCI contains one table of edits for physicians/practitioners and one table of edits for outpatient hospital services. Hospital PTP edits apply to types of bills subject to the outpatient code editor for the [...]

MLN Connects® Newsletter: May 22, 2025

MLN Connects® Newsletter: May 22, 2025 Departments of Labor, Health and Human Services, Treasury Announce Move to Strengthen Healthcare Price Transparency Trump administration issues request for information, guidance to expand access to real [...]

The 2025 Spring Part B Virtual Conference Begins in One Week!

The 2025 Spring Part B Virtual Conference Begins in One Week! The 2025 Spring Part B Virtual Conference begins in one week! This is your last chance to register and join us on June 3–5, 2025! Don’t miss out on this must-attend event!   [...]

Rural Emergency Hospital Basics

Do you know what a Rural Emergency Hospital (REH) is and what services can be provided? Part A facilities, including Critical Access Hospitals and small rural hospitals, are eligible to enroll as a REH. Join this session to learn more about the [...]

MLN Connects® Newsletter: June 5, 2025

MLN Connects® Newsletter: June 5, 2025 News 2023 Doctors & Clinicians Preview Period Open Until June 25 Hospital Price Transparency: Respond to Accuracy & Completeness RFI by July 21 Medicare & Veteran Affairs: Adjustments for [...]

Part A Summit - Provider Outreach and Education Roundtable

Join us for an interactive and insightful roundtable discussion with the Provider Outreach and Education Manager and team. This session is designed to offer a comprehensive look into the future of POE and explore innovative strategies for [...]

Part A Summit - World of Medicare Contractors

Medicare Administrative Contractors are responsible for processing claims, managing policy and payment, and establishing regional policy guidelines. Centers for Medicare & Medicaid Services also uses several additional contractors to manage [...]

Part A Summit - Exploring the NGS TPE Process

Join us to explore essential strategies for a successful Targeted Probe and Educate review. We'll cover the purpose of TPE and best practices, roles and responsibilities of National Government Service and providers under review. Gain [...]

Part A Summit- Medicare Secondary Payer: Preventing Rejections of Your Medicare Primary Claims

Increase your cash flow by preventing rejections of your Medicare primary claims! In this webinar, we review why claims reject for Medicare Secondary Payer and explain how to prevent these rejections by reporting information on your claims that [...]

Part A Summit - Need Answers? The Options to Consider Before Calling or Writing into Medicare

During this session, we will review top trends on why providers are reaching out to Medicare and the best options to resolve those inquires. Plus, valuable tips and resources to help get the most out of Medicare.

Medicare Part B Coverage and Billing Guidance for Breast Ultrasound

Medicare Part B Coverage and Billing Guidance for Breast Ultrasound Breast ultrasound uses sound waves to produce pictures of the inside of the breast and can show changes that are more difficult to see on a mammogram. Breast ultrasound is not [...]

Part A Summit - NGSConnex: User Pain Points Examples/Solutions

Are you experiencing issues while utilizing NGSConnex? Join this informative session to learn what user pain points are and how to resolve these issues from an NGSConnex Agile Product Owner. This session will encompass issues with [...]

Part A Summit- Navigating Billing and Documentation for Behavioral Health Services in Federally Qualified Health Centers

Unlock the secrets to effective billing and documentation for behavioral health services within Federally Qualified Health Centers. This collaborative webinar will include insights from Medical Review and is designed to help healthcare [...]

Part A Summit- Skilled Nursing Facility: Coverage and Documentation

During this collaborative education session between Case Management and Medical Review, attendees will learn documentation requirements for skilled nursing facility (SNF) coverage, how to properly respond to Additional Documentation Requests [...]

Part A Summit – How to Submit an Appeal Request

Join us for a comprehensive session focused on understanding the appeal submission process within National Government Service. This presentation is designed to guide participants through each step of submitting an appeal, ensuring clarity and [...]