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Posting Date: 03/03/2022
MLN Connects® Newsletter for Thursday, March 3, 2022
MLN Connects® Newsletter for Thursday, March 3, 2022 2022 Payment, Quality & Policy Changes News Ambulance Prior Authorization Model Expands April 1 Nutrition-related Health Conditions: Recommend Medicare Preventive Services [...]
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Posting Date: 03/16/2022
Place of Service 10 for Telehealth Services Not for Medicare Billing
Place of Service 10 for Telehealth Services Not for Medicare Billing National Government Services is receiving calls from providers to our call center in regard to the usage of the new Place of Service 10 code. POS 10 was established [...]
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Posting Date: 03/04/2022
2022 CMS Evaluation and Management Regulation Modifications
2022 CMS Evaluation and Management Regulation Modifications On 2/23 and 2/24/2022, National Government Services presented webinars titled “2022 CMS Evaluation and Management Regulation Modifications”. Subsequent to those sessions, we sought [...]
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Posting Date: 12/07/2021
Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2022
Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2022 This announcement provides information that may be helpful to clinicians in determining whether to become a Medicare participating provider, or to continue [...]
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Posting Date: 03/02/2022
April 2022 Release "Dark Days" for the Common Working File Hosts
April 2022 Release "Dark Days" for the Common Working File Hosts For the upcoming April 2022 Release: For Production, CWF will be observing the Gray Day on Thursday, 3/31/2022 and Dark Days starting Friday, 4/1/2022 through Sunday, 4/3/2022 [...]
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Posting Date: 03/02/2022
Chronic Care Management with Transitional Care Management Clarification
Chronic Care Management with Transitional Care Management Clarification TCM policy indicates that it is billable in the same month that CCM services are performed. MLN® Booklet Transitional Care Management Services includes a listing of the [...]
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Posting Date: 03/02/2022
Social Security Income Ratios
Social Security Income Ratios The federal fiscal year 2020 SSI ratios for IPPS hospitals, IRFs and LTCHs were posted on the CMS website. IPPS IRF LTCH We will update the latest published 2020 SSI ratios in the Provider Specific File of [...]
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Posting Date: 03/01/2022
Medicare Advantage Plan Beneficiaries Receiving the COVID-19 Vaccine and Monoclonal Antibody
Medicare Advantage Plan Beneficiaries Receiving the COVID-19 Vaccine and Monoclonal Antibody Effective 1/1/2022, claims for COVID-19 vaccinations or monoclonal antibody treatment provided to patients enrolled in MA plans on or after 1/1/ 2022, [...]
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Posting Date: 02/24/2022
February and March 2022 Billing and Coding Article Updates
February and March 2022 Billing and Coding Article Updates Billing and Coding: Peripheral Nerve Blocks (A57452) This article has been updated due to a provider request to add diagnosis code G58.0 to Group 1 in the "ICD-10 codes that support [...]
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Posting Date: 02/04/2022
Provider Compliance Virtual Focus Group - February 24, 2022
Provider Compliance Virtual Focus Group - February 24, 2022 Thursday, 2/24/2022 from 1:00–4:00 p.m. ET Register by Friday, 2/18/2022 - Registration Closed How can CMS improve its processes and eliminate unnecessary requirements for [...]
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Posting Date: 02/14/2022
Prior Authorization Requests Submitted by Exempt Providers Alert
Prior Authorization Requests Submitted by Exempt Providers Alert The National Government Services PA Department has observed an increase in submission of PAR for exempt providers. These submissions are from the HOPD and/or physician offices on [...]
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Posting Date: 02/08/2022
2022 Gap-Fill Request for Information
2022 Gap-Fill Request for Information 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 2022. The PAMA regulations instruct the MACs to establish [...]
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Posting Date: 12/06/2021
January 2022 EDI Front End Quarterly Release
January 2022 EDI Front End Quarterly Release Please be advised that while the Centers for Medicare & Medicaid Services mandated release for January 2022 will be installed the weekend of 1/2/2022, the code set updates included with this [...]
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Posting Date: 01/28/2022
Home Health Bill Type 32A Returning With Reason Code U537I
Home Health Bill Type 32A Returning With Reason Code U537I CMS implemented HH TOB 32A for the NOA effective for period of care claims on or after 1/1/2022. The NOA is required for all HH period of care claim billing, including demand billing [...]
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Posting Date: 01/26/2022
Skilled Nursing Facility Consolidated Billing Services Reminder
Skilled Nursing Facility Consolidated Billing Services Reminder For Medicare beneficiaries in a covered Part A stay, these separately payable, or excluded, services include select items or services in the following categories: physician’s [...]
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Posting Date: 01/25/2022
January and February 2022 LCD and Billing and Coding Article Updates
January and February 2022 LCD and Billing and Coding Article Updates Colon Capsule Endoscopy (CCE) (L38571) LCD revised effective 2/15/2022: coverage criteria expanded to include blood-based biomarker colorectal cancer screening test, [...]
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Posting Date: 01/24/2022
2021 Calendar Year 1099 Form Information
2021 Calendar Year 1099 Form Information Medicare providers and beneficiaries, who are serviced by National Government Services, regardless of their location, will receive a single Part A and Part B combined Form 1099 from NGS for calendar [...]
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Posting Date: 01/21/2022
Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929)
Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929) Currently, National Government Services has LCD Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929) as well as a Draft [...]
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Posting Date: 01/21/2022
How to Avoid Costly Appeals
How to Avoid Costly Appeals National Government Services has noticed an increase in requests for claim appeals. Upon review, we have found that many of the requests are not appropriate and/or necessary for a claim appeal submission. The [...]
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Posting Date: 05/07/2021
MLN Connects® Special Edition for Thursday, May 6, 2021
MLN Connects® Special Edition for Thursday, May 6, 2021 CMS Increases Medicare Payment for COVID-19 Monoclonal Antibody Infusions New payment policy for at-home administration As part of the ongoing response to address the COVID-19 [...]
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