Medicare Part B CMS-1500 Crosswalk for 5010 Electronic Claims

Collaborative A/B/DME Therapeutic Shoes for Persons with Diabetes Webinar

Collaborative A/B/DME Therapeutic Shoes for Persons with Diabetes Webinar Providers – Do you need assistance in understanding what is needed when ordering diabetic shoes? This collaborative webinar on Therapeutic Shoes for Persons with [...]

Billing for Services Not Included in the FQHC Benefit

Billing for Services Not Included in the FQHC Benefit Table of Contents Billing for Services Not Included in the FQHC Benefit Ambulance Services Body Braces Durable Medical Equipment Laboratory Services Medicare-Excluded [...]

Repetitive Outpatient Services for Providers Submitting Institutional Outpatient Claims

Repetitive Outpatient Services for Providers Submitting Institutional Outpatient Claims Table of Contents Repetitive Outpatient Services for Providers Submitting Institutional Outpatient Claims Repetitive Services Repetitive Services [...]

What All Facilities Need to Know About the Long-Term Care Hospital Three-Day or Less Interrupted Stay Policy

What All Facilities Need to Know About the Long-Term Care Hospital Three-Day or Less Interrupted Stay Policy Table of Contents What All Facilities Need to Know About the Long-Term Care Hospital Three-Day or Less Interrupted Stay Policy [...]

Hospitals Must Correctly Assign Severe Malnutrition Diagnosis Codes to Inpatient Claims

Hospitals Must Correctly Assign Severe Malnutrition Diagnosis Codes to Inpatient Claims Table of Contents Hospitals Must Correctly Assign Severe Malnutrition Diagnosis Codes to Inpatient Claims Hospital Action(s) Related Content [...]

COVID-19 Part A Frequently Asked Questions

COVID-19 Part A Frequently Asked Questions Table of Contents COVID-19 Part A Frequently Asked Questions Section B. Diagnostic Laboratory Services Section LL. Hospital Billing for Remote Services Section MM. Outpatient Therapy Services [...]

Fiscal Intermediary Standard System Direct Data Entry Screen Changes – October 2023

Fiscal Intermediary Standard System Direct Data Entry Screen Changes – October 2023 The October 2023 quarterly system release was implemented on 10/2/2023 and includes the FISS DDE screen changes identified below. CMS issued CR 13138 which [...]

Tip Sheet: Proper Use of Modifier 25

Tip Sheet: Proper Use of Modifier 25 A review of top claim reason codes indicate a steady reoccurrence of claims being returned to provider (RTP) for reason code W7021, when there was a medical visit on same day as a type 'T' or 'S' procedure [...]

Three-Day Qualifying Hospital Stay Required for Medicare-Covered SNF Stay

Three-Day Qualifying Hospital Stay Required for Medicare-Covered SNF Stay Table of Contents Three-Day Qualifying Hospital Stay Required for Medicare-Covered SNF Stay Additional Information Billing Reminders Related Content [Return to [...]

MLN Connects® Newsletter: October 5, 2023

MLN Connects® Newsletter: October 5, 2023     News Administration Moves Forward with Medicare Drug Price Negotiations to Lower Prescription Drug Costs for People with Medicare CMS Requests Public Input on Coverage of [...]

Update on proposed LCD for Transesophageal Echocardiography

Update on proposed LCD for Transesophageal Echocardiography The LCD for Transesophageal Echocardiography (TEE) was published for comment and presented at an Open Meeting in July 2023. NGS is continuing to assess the provisions in this LCD and [...]

MLN Connects® Newsletter: October 6, 2023

MLN Connects® Newsletter: October 6, 2023     News COVID-19: Updated Novavax COVID-19 Vaccine, Adjuvanted for Patients 12 & Older Posted 10/6/2023

Cognitive Assessment and Care Plan Services CPT Code 99483

Cognitive Assessment and Care Plan Services CPT Code 99483 Effective 1/1/2021, Medicare increased payment for these services to $282 (may be geographically adjusted) when provided in an office setting, added these services to the definition of [...]

Mental Health Crisis Help

Mental Health Crisis Help Anyone experiencing a mental health crisis, including substance use crisis or thoughts of suicide, can get confidential support 24/7 by calling 988 or visiting the 988 Suicide & Crisis Lifeline website. View the [...]

Notification of the 2024 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review

Notification of the 2024 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review The amount that must remain in controversy for ALJ hearing requests filed on or [...]

MLN Connects® Newsletter: October 12, 2023

MLN Connects® Newsletter: October 12, 2023     News CMS Roundup (Oct 6, 2023) Protect Your Patients: Give Them a Flu Shot Publications Direct Data Entry: 10-Digit Screen Expansion Medicare Preventive Services — [...]

Let’s Get Ready for The Great American Smokeout on 11/16/2023!

Let’s Get Ready for The Great American Smokeout on 11/16/2023! For more than 40 years, the American Cancer Society has hosted the Great American Smokeout on the third Thursday of November. This yearly event is a call for action, not just for [...]

Prior Authorization Exemption Process FAQ

Prior Authorization Exemption Process FAQ How many days notice will I receive before I switch from PAR submissions to an exemption cycle? Answer: MACs will provide a 60-day notice prior to any transition period, continuation, or withdrawal [...]

NGSConnex User Guide