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Posting Date: 05/11/2018
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. [...]
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Posting Date: 10/28/2021
Medical Review Targeted Probe and Educate ADRs
Medical Review Targeted Probe and Educate Additional Development Requests Medical Review NGS Medical Review Department will be performing service specific post-payment reviews for a random selection of claims billed to Medicare Part A and B. [...]
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Posting Date: 09/26/2024
Provider Enrollment Revalidation Overview
During this webinar, learn about important changes in the revalidation process, how to determine Medicare enrollment revalidation due date and information to avoid disruption in Medicare billing.
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Posting Date: 09/26/2024
Physical/Occupational Therapy Billing
Join us as we review billing guidelines for physical and occupational therapy. We'll review when to apply the KX modifier and the importance of appropriate medical documentation. National Government Services has a Local Coverage Determination [...]
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Posting Date: 02/24/2021
General Information
General Information In certain circumstances, National Government Services or other contractors working under the CMS may need to request additional information with regard to claims submitted to the Medicare Program. The requests for [...]
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Posting Date: 10/28/2021
Ways to Respond to ADRs
Ways to Respond to ADRs Table of Contents Ways to Respond to ADRs Utilizing Paperwork Segment and esMD Electronic Submission of Medical Documentation NGSConnex Portal Fax U.S. Mail, FedEx, UPS [Return to Top] Ways to Respond to ADRs [...]
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Posting Date: 10/28/2021
Claim ADRs
Claim Additional Development Requests National Government Services will not be able to process your claim without additional documentation. The following are the most common situations when NGS would require additional documentation to process [...]
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Posting Date: 10/28/2021
Other Audit Contractor ADRs
Other Audit Contractor Additional Development Requests An ADR may be requested from one of the contractors listed below. If you receive correspondence from any one of these contractors, please follow the instructions within their letter. [...]
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Posting Date: 10/28/2021
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 [...]
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