Search Results - NGSMEDICARE

Posting Date: 10/22/2024

52NCD

Avoiding/Correcting This Error Ensure all Medicare coverage and medical necessity requirements are met prior to billing. If the provider determines that Medicare will not cover the services, consider submitting the charges as noncovered. [...]

Posting Date: 10/22/2024

52MUE

Avoiding/Correcting This Error You have the right to submit an appeal when you believe the medical records support that the denied services were reasonable and medically necessary. Providers should review the information on the CMS website [...]

Posting Date: 10/22/2024

5ND07

Avoiding/Correcting This Error To prevent this error, ensure all Medicare coverage and medical necessity requirements are met prior to billing. Providers can visit the CMS Coverage Database to review the NCDs and LCDs to determine the [...]

Posting Date: 10/24/2024

Submit an Initial Enrollment Application

Table of Contents Step 1: Determine You are in the Right Place Step 2: Complete the Medicare Application Step 3: Submit the Required Documentation Related Content [Return to Top] Step 1: Determine You are in the Right Place The [...]

Posting Date: 10/24/2024

Submit an Initial Enrollment Application

Table of Contents Step 1: Determine You are in the Right Place Step 2: Complete the Medicare Application Step 3: Submit the Required Documentation Related Content [Return to Top] Step 1: Determine You are in the Right Place The [...]

Posting Date: 10/24/2024

Submit an Initial Enrollment Application

Table of Contents Step 1: Determine You are in the Right Place Step 2: Complete the Medicare Application Step 3: Submit the Required Documentation Related Content [Return to Top] Step 1: Determine You are in the Right Place The [...]

Posting Date: 04/14/2022

View Existing Medicare ID (PTAN) in PECOS and Effective/End Dates for Reassignment

View Existing Medicare ID (PTAN) in PECOS and Effective/End Dates for Reassignment Important: If you recently submitted an application to request a PTAN, please verify the approval letter was received prior to submission of claims. Log [...]

Posting Date: 10/22/2024

34986

Avoiding/Correcting This Error The PN modifier is used on all claim lines for all services, procedures and/or surgeries provided at an excepted off-campus outpatient, PBD of a hospital. The PN modifier applies to a grandfather/excepted PBD for [...]

Posting Date: 10/22/2024

34986

Avoiding/Correcting This Error The PN modifier is used on all claim lines for all services, procedures and/or surgeries provided at an excepted off-campus outpatient, PBD of a hospital. The PN modifier applies to a grandfather/excepted PBD for [...]

Posting Date: 10/22/2024

34985

Avoiding/Correcting This Error The PO modifier is used on all claim lines for all services, procedures and/or surgeries provided at an excepted off-campus provider-based outpatient department (PBD). The PO modifier applies to a [...]

Posting Date: 10/22/2024

34985

Avoiding/Correcting This Error The PO modifier is used on all claim lines for all services, procedures and/or surgeries provided at an excepted off-campus provider-based outpatient department (PBD). The PO modifier applies to a [...]

Posting Date: 10/22/2024

38119

Avoiding/Correcting This Error Verify the admission date and from date on this claim Verify the patient’s MBI to make sure that it has been correctly reported If the MBI is incorrect, this edit will be assigned If admission and from dates [...]

Posting Date: 10/22/2024

38119

SNF inpatient claims have to be processed in sequence. That means that when the beneficiary is going to be in the SNF as an inpatient for several months in a row, claims for the months the beneficiary is in the SNF must be submitted one at a [...]

Posting Date: 10/22/2024

34977

Avoiding/Correcting This Error If you are billing for on-campus services only: Report the billing provider address only in the billing provider loop 2010AA Do not report any service facility location in loop 2310E (or in DDE MAP 171F [...]

Posting Date: 10/22/2024

34977

Avoiding/Correcting This Error If you are billing for on-campus services only: Report the billing provider address only in the billing provider loop 2010AA Do not report any service facility location in loop 2310E (or in DDE MAP 171F [...]

Posting Date: 10/22/2024

32402

Avoiding/Correcting This Error Verify HCPCS code using the FISS DDE Inquiries HCPCS file (option 14) to determine the allowable revenue codes based upon the date of service. Verify billing and, if appropriate, correct the claim using the [...]

Posting Date: 10/22/2024

32402

Avoiding/Correcting This Error Verify HCPCS code using the FISS Inquiries HCPCS file (option 14). Allowable revenue codes will be displayed based on DOS. Use the claims correction option to report the appropriate HCPCS/CPT code and resubmit [...]

Posting Date: 10/22/2024

32404

Verify HCPCS code using the FISS Inquiries HCPCS file (option 14). Allowable HCPCS codes will be displayed based on DOS. Avoiding/Correcting This Error Use the claims correction option to report the appropriate HCPCS/CPT code and resubmit the [...]

Posting Date: 10/22/2024

32266

Avoiding/Correcting This Error Report influenza virus, pneumococcal pneumonia virus, and COVID-19 vaccines (and administration) with your charges on the 77X claim for informational and data collection purposes only. Report revenue code 0771 [...]

Posting Date: 10/22/2024

31191

Avoiding/Correcting This Error: When submitting the NOA, all date fields must match. Since the NOA is the start of the admission period, the "From" date, "Through" date and "Admission" date should all be the same.