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Posting Date: 09/16/2024
Care Management: Principal Care Management Services
As part of a continued series, National Government Services (NGS) is raising awareness on the benefits of care management. During this webinar, we’ll discuss principal care management services for patients with a single chronic condition and [...]
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Posting Date: 01/18/2022
Quarterly Top Ten EDI Institutional EDI Edits
Quarterly Top Ten EDI Institutional EDI Edits National Government Services EDI has identified the following top ten CEM edits that were received during the third quarter on the 277CA (Claims Acknowledgement) report for 837I 5010A1 formatted [...]
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Posting Date: 01/18/2022
Quarterly Top Ten EDI Part B EDI Edits
Quarterly Top Ten EDI Part B EDI Edits National Government Services EDI has identified the following Top Ten Claim Edit Module (CEM) edits that were received during the third quarter on the 277CA (Claims Acknowledgement) report for 837P 5010A1 [...]
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Posting Date: 09/16/2024
Third Quarter Top Ten EDI Part B Edits
Third Quarter Top Ten EDI Part B Edits Using data analysis we’ve updated the Top Ten EDI Edits for the third quarter. Visit Quarterly Top Ten EDI Part B Edits to view the edits and their description, and learn how you can quickly identify the [...]
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Posting Date: 09/16/2024
Third Quarter Top Ten EDI Institutional Edits
Third Quarter Top Ten EDI Institutional Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the third quarter. Visit Quarterly Top Ten EDI Institutional Edits to view the edits and their description, and learn how you can [...]
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Posting Date: 07/11/2022
Meeting Minutes
Meeting Minutes Jurisdiction 6 Illinois, Minnesota, Wisconsin Jurisdiction K Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Jurisdiction 6 and Jurisdiction K Combined Meeting 8/8/2024 4/4/2024 12/7/2023
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Posting Date: 07/05/2022
Audit and Reimbursement
Audit and Reimbursement Cost Report Filing State/Region Contact Information Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Bobbi Jo Luciano Office: South Portland, ME [...]
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Posting Date: 09/16/2024
Podiatry Services - Routine Foot Care and Debridement of Nails
While the Medicare Program generally excludes routine foot care services from coverage, there are specific indications or exceptions under which there are program benefits. Medicare payment may be made for routine foot care when the patient has [...]
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Posting Date: 01/02/2024
Medicare Part B Final Rule 2024
Medicare Part B Final Rule 2024 CMS announced finalized policy changes for Medicare payments under the PFS, and other Medicare Part B topics, effective on or after 1/1/2024. The CY 2024 PFS final rule is one of several final rules that [...]
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Posting Date: 11/07/2022
Who Can Bill for Diabetes Self-Management and Medical Nutrition Therapy?
Who Can Bill for Diabetes Self-Management and Medical Nutrition Therapy? Table of Contents Who Can Bill for Diabetes Self-Management and Medical Nutrition Therapy? Who Can Bill for DSMT Billable Codes for Diabetes Self-Management Training [...]
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Posting Date: 11/07/2022
Common Questions for Diabetes Self-Management Training and Medical Nutrition Therapy
Common Questions for Diabetes Self-Management Training and Medical Nutrition Therapy Table of Contents Diabetes Programs Billing for Services DSMT and MNT Telehealth Services Related Content [Return to Top] Diabetes Programs [...]
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Posting Date: 11/07/2022
Common Questions for Diabetes Self-Management Program Accreditation
Common Questions for Diabetes Self-Management Program Accreditation Does my organization need to be accredited to bill for DSMT services? Answer: Yes. In order to bill Medicare for DSMT services, your organization’s DSMT program must be [...]
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Posting Date: 11/07/2022
Medical Nutrition Therapy Tool for Billing
Medical Nutrition Therapy Tool for Billing CMS considers DSMT and MNT complementary services. This means Medicare will cover both DSMT and MNT without decreasing either benefit as long as the referring physician determines that both are [...]
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Posting Date: 11/07/2022
Medicare Diabetes Prevention Program
Medicare Diabetes Prevention Program Table of Contents Background What is the Medicare Diabetes Prevention Program? Overview of MDPP What is Covered Through the Model? How Does the Model Pay for MDPP Services? What Does this [...]
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Posting Date: 06/13/2022
Remote Physiological Monitoring and Cardiovascular Monitoring Service and Billing Information
Remote Physiological Monitoring and Cardiovascular Monitoring Service and Billing Information Table of Contents Remote Physiological Monitoring Services CPT Codes: 99091, 99453, 99454, 99457, 99458 Remote Physiological Monitoring [...]
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Posting Date: 09/17/2024
National Government Services Contractor Advisory Committee Meeting
National Government Services Contractor Advisory Committee Meeting There will be a multi-jurisdictional CAC meeting held on Thursday 10/17/2024 at 3:00-5:00 p.m. ET, 2:00-4:00 p.m. CT. Meeting details can be found on the National Government [...]
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Posting Date: 09/19/2024
Laboratory and Diagnostic Services: Documentation Responsibilities
Laboratory and Diagnostic Services: Documentation Responsibilities When National Government Services is conducting a pre-pay or post-pay review of claims and services, we may request additional documentation. The billing provider must obtain [...]
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Posting Date: 11/01/2021
Global Surgery
Global Surgery Table of Contents Definition of a Global Surgical Package Where can I find the postoperative periods for covered surgical procedures? What services are included in the global surgery payment? What services are not [...]
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Posting Date: 08/10/2023
Duplicate Claim Editing Information
Duplicate Claim Editing Information Part B Duplicate Claim Edit National Government Services implemented a Part B duplicate claim edit in our EDI front-end processing system for Part B providers. Providers are notified that a claim is a [...]
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Posting Date: 09/19/2024
Part A Incorrect Dialysis Payments
We have recently become aware of an issue which began on 7/15/2024 where ESRD claims with demo code 94P were finalizing with incorrect payment amounts (overpayments as well as underpayments). The incorrect payment amount is a result of FISS [...]
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