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Posting Date: 08/27/2021
Alcohol Misuse and Counseling
Preventive Services Guide Alcohol Misuse and Counseling Table of Contents Alcohol Misuse and Counseling Two-Part Benefit Cost Sharing Reimbursement Nonparticipating Providers Common Claim Denial Reasons Related Content [Return [...]
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Posting Date: 10/08/2021
Initial Preventive Physical Examination
Preventive Services Guide Initial Preventive Physical Examination The IPPE is also known as the “Welcome to Medicare Preventive Visit.” The goals of the IPPE are health promotion and disease detection and prevention. Table of Contents [...]
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Posting Date: 02/24/2025
Reminder: New Medicare Part B Redetermination Notice Initiative
Reminder: New Medicare Part B Redetermination Notice Initiative Beginning 3/3/2025, NGS will only issue electronic versions of the MRN when a Medicare Part B Redetermination request is electronically submitted through our portal, NGSConnex. [...]
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Posting Date: 02/25/2025
MLN Connects® Newsletter: February 24, 2025
MLN Connects® Newsletter: February 24, 2025 Compliance Mechanical Ventilation: Bill Correctly for Inpatient Claims Claims, Pricers, & Codes Discarded Drugs & Biologicals: Orphan Drugs with Increased Applicable Percentage for [...]
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Posting Date: 02/03/2025
Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application
Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application Available now is the revised CMS-855A (09/24) paper application that includes a section for SNF to comply with the 2023 Final rule in reporting [...]
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Posting Date: 02/20/2025
Pre-Exposure Prophylaxis Using Antiretroviral Therapy to Prevent HIV Infection
Preventive Services Guide Pre-Exposure Prophylaxis Using Antiretroviral Therapy to Prevent HIV Infection PrEP involves the use of antiretroviral drugs to decrease the risk of acquiring HIV. Under Section 1861(ddd)(1) of the Social Security [...]
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Posting Date: 02/21/2025
Common Working File Host Dark Days for April 2025 Release
Common Working File Host Dark Days for April 2025 Release For Production, CWF will be observing the Gray Day on Thursday, April 3rd, and Dark Days starting Friday, April 4th through Sunday, April 6th to accommodate the anticipated duration of [...]
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Posting Date: 02/24/2025
Important Update for Part B Providers – New NCCI Lookup Tool
Important Update for Part B Providers – New NCCI Lookup Tool The Medicare NCCI promotes accurate coding and prevents improper payments. We have added the NCCI Lookup Tool to our Part B Tools and Calculators page. This tool helps providers [...]
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Posting Date: 06/22/2022
Standard Companion Guides
Standard Companion Guides Standard Companion Guide Trading Partner Information (275) Standard Companion Guide Trading Partner Information (277) Standard Companion Guide Trading Partner Information (278/275) Standard Companion Guide Health [...]
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Posting Date: 12/03/2020
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment Reminder, if a hospital, clinic/group or Independent Diagnostic Treatment Facility has ADI screening equipment, certification from a designated ADI accrediting [...]
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Posting Date: 03/03/2025
MLN Connects® Newsletter: February 28, 2025
MLN Connects® Newsletter: February 28, 2025 CMS Provider Education Message: Hospitals: Actions to Make Healthcare Prices Transparent Update: On February 25, the White House issued an Executive Order to empower patients with clear, accurate, [...]
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Posting Date: 03/03/2025
Clinicians: Are You Ordering Urological Supplies for Your Patients?
Clinicians: Are You Ordering Urological Supplies for Your Patients? Urological supplies are covered as part of the prosthetic device benefit as outlined in the Social Security Act, Section 1861(s)(8). Prosthetic devices (other than dental) [...]
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Posting Date: 03/03/2025
Procedure to Procedure Edits
Procedure to Procedure Edits The purpose of the NCCI PTP edits is to prevent improper payment when incorrect code combinations are reported. The NCCI contains one table of edits for physicians/practitioners and one table of edits for [...]
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Posting Date: 03/03/2025
National Correct Coding Initiative
National Correct Coding Initiative The Medicare NCCI promotes correct coding of Medicare Part B claims. Coding policies are based on coding conventions defined in the AMA’s CPT professional, national and local Medicare policies and edits, [...]
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Posting Date: 03/03/2025
Related Resources
Related Resources MLN® Educational Tool: How to Use the Medicare National Correct Coding Initiative (NCCI) Tools Medicare National Correct Coding Initiative (NCCI) Edits National Correct Coding Initiative Policy Manual Medicare NCCI [...]
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Posting Date: 03/03/2025
Add-on Codes
Add-on Codes Add-on codes are procedure codes that indicate additional work associated with another primary procedure. Add-on codes can be reimbursed when reported with the primary procedure code by the same practitioner. Add-on codes may be [...]
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Posting Date: 02/27/2025
National Correct Coding Initiative
National Correct Coding Initiative We recently introduced the NCCI Lookup Tool on our Part B Tools and Calculators page. This tool is designed to assist providers in identifying codes subject to automated prepayment edits, thereby facilitating [...]
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Posting Date: 10/19/2022
Immunization Roster Billing
Immunization Roster Billing Table of Contents Immunization Roster Billing Claim Submission Options for Roster Billing Electronic Claim Submissions Paper Claim Submissions Vaccine Billing and Coding Resources [Return to Top] [...]
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Posting Date: 10/06/2021
Hepatitis B Virus Vaccine and Administration
Preventive Services Guide Hepatitis B Virus Vaccine and Administration Hepatitis B is a virus that can damage the liver; it is spread through contact with infected blood or body fluids and can be transmitted through sex with an infected [...]
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Posting Date: 03/06/2025
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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