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Posting Date: 11/01/2021
Transitional Care Management
Transitional Care Management Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99495: Moderate complexity F2F 7 to 14 days 99496: High complexity F2F 7 days [...]
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Posting Date: 03/10/2025
Medicare Part B Redetermination Notice Initiative Coming Soon
Medicare Part B Redetermination Notice Initiative Coming Soon National Government Services will discontinue issuing paper MRNs for Medicare Part B redetermination requests that are submitted electronically through our portal, NGSConnex. [...]
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Posting Date: 05/08/2023
Home Health Billing When a New MBI is Assigned
Home Health Billing When a New MBI is Assigned A patient’s MBI number is required on all home health billing submitted to Medicare. CMS will issue a new MBI when an original MBI may have been, or has been compromised. There are times a home [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction 6 Part B Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction K Part B Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Paring or Cutting of Benign Hyperkeratotic Lesion 11055, 11056, 11057 A07 – The [...]
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Posting Date: 03/14/2025
MLN Connects® Newsletter: March 13, 2025
MLN Connects® Newsletter: March 13, 2025 News Medicare Shared Savings Program: Application Deadlines for January 1, 2026, Start Date Claims, Pricers & Codes ICD-10 Coordination & Maintenance Committee: Submit Procedure Code [...]
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Posting Date: 09/30/2024
What Should Be Provided if Medical Records Are Requested for Review?
What Should Be Provided if Medical Records Are Requested for Review? The following should be considered if applicable to the service being reviewed. This is not intended to be an all-inclusive list. Progress/visit notes Physician orders [...]
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Posting Date: 01/12/2024
Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate
Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate Table of Contents Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate Background: Standard Payment vs. [...]
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Posting Date: 11/09/2018
Claims for Drugs Without a Product-Specific Code Assigned
Claims for Drugs Without a Product-Specific Code Assigned National Government Services has noticed that when a claim RTPs for additional information to be added to the Remarks field concerning certain drugs, some providers attempt to provide [...]
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Posting Date: 03/13/2025
Denials for HCPCS G2211
NCCI editing for HCPCS G2211 code was updated on 12/05/2024 to require HCPCS G0463 as the primary code for G2211 add-on code. This has resulted in denials of claims for the add-code G2211 when billed with CPTs 99202-99205 and 99211-99215. [...]
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