Search Results - NGSMEDICARE

Posting Date: 12/17/2019

ESRD Facilities: Clarification for Providing Dialysis Services to Patients Acute Kidney Injury

ESRD Facilities: Clarifications for Providing Dialysis Services to Patients Acute Kidney Injury Effective 1/1/2017. ESRD facilities (hospital-based and freestanding) may furnish renal dialysis services to beneficiaries with AKI (both adult and [...]

Posting Date: 09/12/2017

JK: Medicare Paid Hospital Providers Twice for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient IPPS Hospital Stays

Medicare Paid Hospital Providers Twice for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient IPPS Hospital Stays Table of Contents Provider Action Payment Window Policy and Under Arrangement Policy [...]

Posting Date: 12/22/2020

Professional Services During a Patient Hospice Election

Professional Services during a Patient Hospice Election Table of Contents Article Overview Hospice Election Medicare Payment During Hospice Election Determining the Correct Entity to Bill Separately Payable Part B Services Hospice and [...]

Posting Date: 09/18/2023

Direct Data Entry Users May Need to Adjust Screen Size

Direct Data Entry Users May Need to Adjust Screen Size CMS recently issued Change Request 13138 “Implementation to Expand Monetary Amount Fields Related to Billing and Payment to Accommodate 10-Digits in Length ($99,999,999.99) - Phase 1”. [...]

Posting Date: 10/14/2021

Drugs and Biologicals - Coverage and Billing

Drugs and Biologicals – Coverage and Billing Medicare Part B will provide coverage for drugs that are furnished “incident to” a physician’s service. Coverage applies to drugs are not usually self-administered by the patients who take them. In [...]

Posting Date: 02/10/2015

Outpatient Therapy Functional Reporting

Outpatient Therapy Functional Reporting Table of Contents Outpatient Therapy Functional Reporting Reporting Episode - similar to the therapy episode of care Required Functional Reporting Discharge Reporting Unique Functional Reporting [...]

Posting Date: 01/12/2021

Home Health Referrals

Home Health Referrals The certifying physician or allowed nonphysician practitioner, and/or the acute/post-acute care facility referring the patient for home care must ensure that the medical record justifies the referral for Medicare home [...]

Posting Date: 06/02/2020

Modifier CS and COVID-19 Billing

Modifier CS and COVID-19 Billing How should the CS modifier, which removes application of beneficiary cost-sharing (deductible and co-payment), be applied to telehealth services and/or E/M visits? The CS modifier should be applied for certain [...]

Posting Date: 07/20/2023

Submitter Type - Provider

Submitted Type – Provider When Provider is selected as the submitter type the four objectives below are displayed. Select one objective based on the description provided and then click Next. Outlined in the following sections [...]

Posting Date: 07/20/2023

Submitter Type - Billing Service

Submitter Type – Billing Service When Billing Service is selected as your submitter the three objectives below are displayed. Select one objective based on the description provided and then click Next. Outlined in the following [...]

Posting Date: 07/20/2023

Selecting the Contractor Code

Selecting the Contractor Code Select the contract in which the provider of service is enrolled in the Medicare Program in the Contract Code field. Click the drop-down arrow to display the available contractor codes. Select the [...]

Posting Date: 07/25/2023

National Government Services CAC Meeting Notice on KidneyIntelX Test

National Government Services CAC Meeting Notice on KidneyIntelX Test Information has been posted on our website in regards to the National Government Services l Contractor Advisory Committee Meeting regarding KidneyIntelX Test to be [...]

Posting Date: 03/22/2018

Purpose of FISS/DDE Provider Online Guide

Introduction Purpose of FISS/DDE Provider Online Guide This provider online guide was created to assist National Government Services providers in using the FISS/DDE Provider Online System. FISS/DDE is: an application that allows remote [...]

Posting Date: 07/25/2023

Attention All OPPS Providers with Provider-Based Department(s): Permanent Edit Implementation Begins on/after 8/1/2023

Attention All OPPS Providers: Provider-Based Department Edits Being Implemented on/after 8/1/2023 Certain edits are being implemented on/after 8/1/2023 to ensure you are billing your provider-based locations correctly. The edits are FISS [...]

Posting Date: 07/20/2023

Attestation

Attestation At the start of an EDI Guided Enrollment submission, you will need to read and accept the attestation in order to proceed.

Posting Date: 07/20/2023

I Am a Billing Service and “I Want to Use a Provider's PIN From their Letter of Authorization (LOA)”

I Am a Billing Service and “I Want to Use a Provider's PIN From their Letter of Authorization (LOA)” This selection will prompt you to complete the Logon Request with PIN Form. This objective is for a third party who wishes to request, [...]

Posting Date: 07/27/2023

MLN Connects® Newsletter: July 27, 2023

MLN Connects® Newsletter: July 27, 2023 News CMS Continues Work on Behavioral Health Discarded Drugs and Biologicals: Updated FAQs on JW & JZ Modifiers Expanded Home Health Value-Based Purchasing Model: July 2023 Interim Performance [...]

Posting Date: 04/04/2018

Reason Codes

Chapter I: Online System Terminology Reason Codes Purpose Reason codes direct the outcome of an edit or process within FISS—they are the traffic cops of the system. Each reason code, when assigned, sends the claim to a specific [...]

Posting Date: 04/25/2016

View a Report (R2)

Chapter VII: Online Reports View Submenu (04) View a Report (R2) Purpose This option allows the provider to go directly to MAP1661 for report viewing. Task To access the View a Report option from the Fiscal Intermediary (FISS)/Direct [...]

Posting Date: 04/18/2016

FISS UB-04 Data Entry Payer Codes

Resources FISS UB-04 Data Entry Payer Codes The following payer codes may be reported in the CD field on CLAIM PAGE 03 of the online UB-04 claim entry record. Payer Code Description 1 Medicaid 2 Blue [...]