PC-ACE: How often is the PC-ACE software upgraded?

PC-ACE: Why am I receiving security rights error/issue when installing PC-ACE?

About Us

National Government Services, Inc., a subsidiary of Elevance Health, Inc., has a long history of supporting federal health agencies, including CMS. Throughout the country, NGS has served as a Medicare contractor since the inception of the [...]

LCD NCD: What are the differences between LCDs and NCDs?

PC-ACE: Is there a resource I can use to assist me with Medicare Secondary Payer (MSP) claims when using PC-ACE?

PC-ACE: Where can I find out more about the PC-ACE free billing software?

PC-ACE: How do I correct a web browser error when downloading or making changes to the software?

CAR-T: Will the Part A claim for CAR-T deny if it is submitted with the KX modifier?

CAR-T: Is Risk Evaluation and Mitigation Strategy (REMS) verified by the facility’s site name or address?

CAR-T: Is the KX modifier required for Part A and Part B claims?

CAR-T: What is the effective date for the requirement of the KX modifier for administration of CAR-T?

EDI: Is the 277CA returned for each test submission?

EDI: After I receive a 277CA will I receive anything else?

EDI: How long are Electronic Remittance Advices (ERAs) available in my mailbox?

EDI: How can I tell if I am set up for electronic billing?

EDI: How do I restore a remit file?

Provider Enrollment

Medicare Part B 101 Manual Provider Enrollment Table of Contents National Provider Identifier Required Tips for Successfully Enrolling with the Medicare Part B Contractor When Mailing Paper Applications Tip 1: Submit the correct [...]

CMS Is Using Multi-Factor Authentication Process for Online Provider Enrollment System Applications

CMS Is Using Multi-Factor Authentication Process for Online Provider Enrollment System Applications CMS announced they utilize an MFA process for users of their Provider Enrollment Systems.  MFA is a second layer of security used to [...]

National Government Services Medicare Part B Redetermination Notice Initiative Is Here

National Government Services Medicare Part B Redetermination Notice Initiative Is Here As previously announced, National Government Services is pleased to announce we are discontinuing issuing paper MRNs for requests submitted electronically [...]

Learn About PECOS Web

Learn About PECOS Web Table of Contents CMS Provider Enrollment Systems Advantages of Online Enrollment Get Started Other Resources Get Access Password Requirements Multi-Factor Authentication Get Help [Return to [...]

Credentialing, Enrollment and Revalidation

Credentialing, Enrollment and Revalidation Table of Contents Requirements Facilities that are not qualified Qualifications Application Forms You Will Need Required Application Fee Documentation State Survey, Tie-in Notice [...]

Coverage Criteria and Frequency Limits

Coverage Criteria and Frequency Limits Table of Contents Counseling to Prevent Tobacco Use Diagnosis Coding Cost Sharing Reimbursement Nonparticipating Providers Related Content [Return to Top] Counseling to Prevent Tobacco Use [...]

Counseling to Prevent Tobacco Use and Tobacco Related Diseases Job Aid

April 2025 EDI Front End Quarterly Release

April 2025 EDI Front End Quarterly Release Please be advised that while the Centers for Medicare & Medicaid Services mandated release for April 2025 was installed the weekend of 4/6/2025, the code set updates included with this release [...]

Social Security Income Ratios

Social Security Income Ratios The federal fiscal year 2023 SSI ratios for IPPS hospitals, IRF and LTCH were posted on the CMS website. IPPS IRF LTCH NGS will update the latest published 2023 SSI ratios in the Provider Specific File of [...]

Top J6 Part B Claim Errors are Available

Top J6 Part B Claim Errors are Available We conduct a comprehensive data analysis on a quarterly basis to update and disseminate the latest insights on the most common claim errors. This initiative provides: Claim Error Reason Code [...]

38200

Avoiding/Correcting This Error Always verify the status of a submitted claim before submitting another claim. Verify claim status using the IVR system, FISS/DDE or the NGSConnex online portal. Per CMS mandate, PCC representatives are not [...]

38312

Avoiding/Correcting This Error If appropriate, correct and resubmit a new claim.   To prevent this error on future claims: Ensure you have received all charges from all departments and that no claim has been submitted for the same DOS [...]

38312

Avoiding/Correcting This Error If appropriate, correct and resubmit a new claim.   To prevent this error on future claims: Ensure you have received all charges from all departments and that no claim has been submitted for the same DOS [...]

W7113

Avoiding/Correcting This Error Prevent future similar errors by checking the I/OCE and ICD-10 official guidelines prior to claim submission. Verify the diagnosis codes reported; correct and resubmit. Related Content The I/OCE Quarterly [...]

34963

Avoiding/Correcting This Error Verify billing and, if appropriate correct and return the claim. Online providers should press PF9 to restore the claim. Related Content New Fiscal Intermediary Shared System Consistency Edit to Validate [...]

38031

Avoiding/Correcting This Error If appropriate, correct and resubmit a new claim. To prevent this error on future claims, ensure you have received all charges from all departments and that no claim has been submitted for the same DOS and [...]

W7072

Avoiding/Correcting This Error Verify billing and, if appropriate, correct and resubmit the claim for payment. Related Content Centers for Medicare & Medicaid Services Internet-Only Manual Publication 100-04, Medicare Claims Processing [...]

32078

Avoiding/Correcting This Error Ensure the appropriate revenue code(s) and HCPCS/CPT code(s) are reported on the claim and each claim line contains the correct service date. Verify the information billed and PF9 to resubmit. Related [...]

W7088

Avoiding/Correcting This Error Each FQHC PPS claim must be billed with a qualifying visit code, and associated line-item charges, along with all other FQHC services furnished during the encounter. A qualifying visit code is the code that [...]

W7089

Avoiding/Correcting This Error Payment for a FQHC encounter requires a medically necessary face-to-face visit. Each FQHC specific payment code (G0466-G0470) must have a corresponding service line with a HCPCS code that describes the qualifying [...]

32404

Verify HCPCS code using the FISS Inquiries HCPCS file (option 14). Allowable HCPCS codes will be displayed based on DOS. Avoiding/Correcting This Error Use the claims correction option to report the appropriate HCPCS/CPT code and resubmit the [...]

32266

Avoiding/Correcting This Error Report influenza virus, pneumococcal pneumonia virus, and COVID-19 vaccines (and administration) with your charges on the 77X claim for informational and data collection purposes only. Report revenue code 0771 [...]

W7088

Avoiding/Correcting This Error Each FQHC PPS claim must be billed with a qualifying visit code, and associated line-item charges, along with all other FQHC services furnished during the encounter. A qualifying visit code is the code that [...]

32243

Avoiding/Correcting This Error Review the claim and either update the charges or remove the line containing zero or blank charges. Return the claim for processing. 

N5052

Avoiding/Correcting This Error The beneficiary’s name listed on the claim has to be an exact match to what is posted on CWF. Be sure that any special characters (including apostrophes, dashes, commas) and suffixes (Jr., Sr., III) that are [...]

W7089

Avoiding/Correcting This Error Payment for a FQHC encounter requires a medically necessary face-to-face visit. Each FQHC specific payment code (G0466-G0470) must have a corresponding service line with a HCPCS code that describes the qualifying [...]

37098

Avoiding/Correcting This Error Verify billing and, if appropriate, correct and return the claim. Related Content Billing for FQHC MAO Plan Supplemental Payment (PPS Providers) CMS Internet-Only Manual 100-04, Medicare Claims Processing [...]

32402

Avoiding/Correcting This Error Verify HCPCS code using the FISS DDE Inquiries HCPCS file (option 14) to determine the allowable revenue codes based upon the date of service. Verify billing and, if appropriate, correct the claim using the [...]

55B31

Avoiding/Correcting This Error Review coverage guidelines and patient records to determine if all appropriate documentation was sent for review that may have supported medical necessity.  When you receive an ADR from National Government [...]

59132

Avoiding/Correcting This Error RHCs should not bill codes G0108 or G0109. Related Content CMS Internet-Only Manual, Publication 100-04, Medicare Claims Processing Manual, Chapter 9, Section 70.5 - Diabetes Self-Management Training (DSMT) [...]

U5233

Avoiding/Correcting This Error Verify the admission date, from, and through dates on the claim and compare the dates to the HMO entitlement dates. Verify the admission date, from, and through dates on the claim and compare the dates to the [...]

U5233

Avoiding/Correcting This Error Verify the admission date, from, and through dates on the claim and compare the dates to the HMO entitlement dates. Verify the admission date, from, and through dates on the claim and compare the dates to the [...]

U5220

Avoiding/Correcting This Error Verify the MBI and date(s) of service. If services were provided prior to the date the beneficiary was entitled to Medicare, no further action is necessary. Otherwise, correct and resubmit.

U538Q

Avoiding/Correcting This Error Medicare does not pay for medical items/services furnished to an alien beneficiary who was not lawfully present in the United States on the date of service that the items/services were furnished. Related Content [...]

U5200

Avoiding/Correcting This Error Part of the eligibility verification process should include ensuring the dates of service fall within the Medicare entitlement period. Use the FISS/DDE Provider Online System or NGSConnex to verify [...]

C7010

Avoiding/Correcting This Error If services are unrelated to hospice stay, resubmit with condition code 07 (treatment of nonterminal illness for hospice patient). Verify hospice enrollment prior to claim submission by reviewing the CWF, the [...]

34293

Avoiding/Correcting This Error Review your beneficiary’s enrollment in a Medicare HMO/MAO prior to providing services. A beneficiary may drop MAO coverage; review the CWF, IVR, NGSConnex, or HETS to identify a termination date for the MAO [...]

C7010

Avoiding/Correcting This Error If services are unrelated to hospice stay, resubmit with condition code 07 (treatment of nonterminal illness for hospice patient). Verify hospice enrollment prior to claim submission by reviewing the CWF, the [...]

U5210

Avoiding/Correcting This Error Each beneficiary should be screened for eligibility. Part of the eligibility verification process should include ensuring the dates of service fall within the Medicare entitlement period. Use the FISS Provider [...]

39929

Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Resubmit as appropriate. Line level reason code(s) appear on the right view of claim page two [...]

39934

Avoiding/Correcting This Error Review each line level denial reason code(s). Follow the steps provided in that line level reason code narrative. Line level reason code(s) appear on the right view of claim page two (MAP171D). In order to access [...]

U5210

Avoiding/Correcting This Error Each beneficiary should be screened for eligibility. Part of the eligibility verification process should include ensuring the dates of service fall within the Medicare entitlement period. Use the IVR system, the [...]

39929

Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Resubmit as appropriate. Line level reason code(s) appear on the right view of claim page two [...]

39934

Avoiding/Correcting This Error Review each line level denial reason code(s). Follow the steps provided in that line level reason code narrative. Line level reason code(s) appear on the right view of claim page two (MAP171D). In order to access [...]