Health Benefits of Quitting Smoking

Health Benefits of Quitting Smoking Help your Patients Kick the Habit! Smoking leads to multiple diseases and potentially death, but this is preventable – anyone at any age can benefit from quitting smoking. Medicare covers tobacco cessation [...]

Change to Roster Claims Information Entry in the Fiscal Intermediary Standard System Direct Data Entry

Change to Roster Claims Information Entry in the FISS DDE Effective 1/28/2013, the FISS maintainer has made a change to the way roster claims are entered. After entering the required information into the FISS DDE, providers will have to hit [...]

Common Working File (CWF) Host Dark Days for April 2024 Release

Common Working File (CWF) Host Dark Days for April 2024 Release For the upcoming April 2024 Release: For Production, CWF will be observing the Gray Day on Thursday, 3/28/2024 and Dark Days starting Friday, 3/29/2024 through Sunday, 3/31/2024 [...]

Proper Billing for Patient Supplied Drugs

Proper Billing for Patient Supplied Drugs Drugs, including biologicals, must represent an expense to the physician or legal entity billing for the services or supplies. In some instances, the patient purchases the drug or, the physician [...]

Evaluation and Management Frequently Asked Questions

Evaluation and Management Frequently Asked Questions We’ve expanded our E/M FAQs for the Complex and Chronic Care – HCPCS code G2211 category to include answers to common questions we’ve received about this add-on code. Visit this page for the [...]

MLN Connects® Newsletter: February 22, 2024

MLN Connects® Newsletter: February 22, 2024 News CMS Issues Additional Guidance on Program to Allow People with Medicare to Pay Out-of-Pocket Prescription Drug Costs in Monthly Payments Compliance Medical Services Authorized by the [...]

Correct or Reopen a Claim Due to an MSP-Related Issue

Table of Contents Correct or Reopen a Claim Due to an MSP-Related Issue Identify the Finalized Status of the Claim and Take the Appropriate Action Depending on the Type of Denial/Correction That Needs to be Made Step 1 Claim Denied as [...]

Prolonged Services Timeline 2024

Prolonged Services Timeline 2024 We’ve updated the Prolonged Services Timetable with 2024 HCPCS and CPT codes, time requirements and date spans. We encourage providers to view this information to ensure you’re billing claims for prolonged [...]

Medicare Part B Overpayments

Medicare Part B Overpayments We developed the Medicare Part B Overpayments Tip Sheet to provide instructions for reporting various overpayment situations. Topics include responding to a demand letter, viewing outstanding overpayments, [...]

Overpayments Right Hand

Resources Medicare Part B Overpayments Tip Sheet Form(s) you'll need: Financial Contact Submissions All Forms

Overpayments Right Hand

Resources Medicare Part B Overpayments Tip Sheet Form(s) you'll need: Financial Contact Submissions All Forms

Ambulance Duplicate Claim Denials

Sample TPE Notification Letter

Sample TPE Notification Letter Mail Date Provider Name Provider Address City, State, Zip Casefolder ID: Casefolder ID Provider Number PTAN: PTAN (Provider Transaction Access Number) Provider Number NPI: NPI (National Provider Identifier) [...]

Sample TPE Notification Letter

Sample TPE Notification Letter Mail Date Provider Name Provider Address City, State, Zip Casefolder ID: Casefolder ID Provider Number PTAN: PTAN (Provider Transaction Access Number) Provider Number NPI: NPI (National [...]

Medicare Preventive Services

Medicare Preventive Services Medicare covers many preventive services to help keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain [...]

LCD and Billing and Coding Article Updates for February/March 2024

LCD and Billing and Coding Article Updates for February/March 2024 Local Coverage Determinations Biomarker Testing for Prostate Cancer Diagnosis (L37733) This LCD has been retired and will no longer be in effect for services performed after [...]

Date of Service on CMS-1500 Billing

Date of Service on CMS-1500 Billing Overview Radiology Services Surgical and Anatomical Pathology Chronic Care Management Care Plan Oversight Home Health Certification and Recertification Physician End-Stage Renal Disease Services [...]

[REVISED] 2024 Gapfill Request

[REVISED] 2024 Gapfill Request National Government Services, the MAC for JK and J6 is in receipt of the new laboratory test codes identified by the CMS to be gap-fill priced for 2024. The PAMA regulations instruct the MACs to establish local [...]