Search Results - NGSMEDICARE

Posting Date: 05/08/2025

MLN Connects® Newsletter: May 8, 2025

MLN Connects® Newsletter: May 8, 2025 News Direct Graduate Medical Education: Get Annual Update Factors Compliance Walkers: Prevent Claim Denials Events HCPCS Public Meeting — June 2–3 Medicare Advisory Panel on Clinical [...]

Posting Date: 05/08/2025

CO-109

Avoiding/Correcting This Error This denial is received when your Medicare patient is enrolled in a MA plan, instead of “traditional fee-for-service” Medicare. MA plans are health plans offered by private companies approved by Medicare that [...]

Posting Date: 05/08/2025

CO-109

Avoiding/Correcting This Error Palmetto GBA is the Medicare Administrative Contractor for processing claims of railroad retirees, regardless of their location. Providers and suppliers must verify patients' Medicare entitlement before [...]

Posting Date: 05/08/2025

CO-16

Avoiding/Correcting This Error This denial message is specific to chiropractic claims with CPT/HCPCS codes that are not billable by Medicare enrolled chiropractors. Medicare Part B coverage for chiropractic care is limited to spinal [...]

Posting Date: 05/08/2025

CO-16

Avoiding/Correcting This Error The billing provider's information on the claim is missing or invalid. To avoid this error, ensure the following details are accurate and included: the billing provider's NPI, name, address, ZIP code, and phone [...]

Posting Date: 05/08/2025

CO-16

Avoiding/Correcting This Error Certain services require the name and NPI of the ordering or referring physician, depending on the service type. Definitions: Referring physician: Requests an item or service for a Medicare beneficiary. [...]

Posting Date: 05/08/2025

CO-16

Avoiding/Correcting This Error The MBI is necessary for all claims submitted to MAC. Claims without a correct MBI are rejected, requiring providers to verify and resubmit them. To avoid this, use the Eligibility Lookup in NGSConnex before [...]

Posting Date: 05/08/2025

CO-16

Avoiding/Correcting This Error This rejection is the result of submitting a CPT/HCPCS code without a required modifier. You are required to research the proper modifier to report with the CPT/HCPCS code then submit a new claim. Please use [...]