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Posting Date: 01/01/1970
Targeted Probe and Educate
Targeted Probe and Educate Targeted Probe and Educate Table of Contents Targeted Probe and Educate Key Elements of TPE Provider Tips Related Content [Return to Top] National Government Services restarted targeted probe and educate reviews on [...]
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Posting Date: 02/04/2022
Medical Review: Targeted Probe and Educate Review Topics
Medical Review: Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to [...]
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Posting Date: 01/01/1970
B_How to Proactively Address Denials
How to Proactively Address Denials How to Proactively Address Denials Want to improve the Payment Error Rate for the next round of review? Be sure to learn about and understand claim denials before the end of round education with the Case [...]
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Posting Date: 06/04/2025
Some Claims Editing for Reason Code U537I, HH Claim Falls Outside of an HH Admission Period for the Same Provider
Note: This issue was originally reported and resolved in April 2025. The issue has returned so we have reopened the alert. The CWF can only hold the 36 most recent periods of care for any beneficiary. CWF also contains the indicator of when [...]
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Posting Date: 06/04/2025
Observance of Juneteenth Holiday
Observance of Juneteenth Holiday In observance of Juneteenth, the National Government Services offices will be closed on Thursday, 6/19/2025. This includes the following departments: EDI Help Desk* Provider Contact Center Provider [...]
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Posting Date: 06/05/2025
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 [...]
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Posting Date: 08/15/2023
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 [...]
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Posting Date: 09/04/2024
Psychotherapy Services
Psychotherapy Services Medicare Regulations Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-02, Medicare Benefit Policy Manual, Chapter 6, Section 70.1 Local Coverage Determination (LCD): [...]
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