Search Results - NGSMEDICARE

Posting Date: 10/22/2024

37402

Avoiding/Correcting This Error Hospice – This error occurs when a claim is submitted and the previous month's claim has not been found in the system or there is a gap between Through date of the previous claim and From date on this claim. [...]

Posting Date: 10/22/2024

W7113

Avoiding/Correcting This Error Prevent future similar errors by checking the I/OCE and ICD-10 official guidelines prior to claim submission. Verify the diagnosis codes reported; correct and resubmit. Related Content The I/OCE Quarterly [...]

Posting Date: 10/22/2024

U523A

Avoiding/Correcting This Error Hospice – This reason code is a notification to the provider of a VBID patient. For more information, including calendar-year specific downloadable lists of service area plan benefit packages (PBPs) and contact [...]

Posting Date: 10/22/2024

U5181

Avoiding/Correcting This Error Ensure the usage of an appropriate certification or recertification date in accordance with occurrence code 27. Related Content Avoiding Reason Code U5181: Appropriate Use of Occurrence Code 27/Occurrence [...]

Posting Date: 10/22/2024

U5111

Avoiding/Correcting This Error The 8xB (NOTR) transaction should only be submitted when the beneficiary revokes the hospice benefit or is discharged alive and there is no final claim in the system indicating termination of the hospice benefit. [...]

Posting Date: 10/22/2024

U5111

Avoiding/Correcting This Error Hospice – When submitting a hospice Notice of Termination/Revocation (TOB 8XB) or a Cancel Notice of Election (TOB 8XD) ensure that the From date on the transaction matches the Start date posted on CWF for that [...]

Posting Date: 10/22/2024

U5109

Avoiding/Correcting This Error When submitting a transaction to indicate the beneficiary’s election to revoke the hospice benefit, transfer the patient, cancel the election, or a change of ownership, the information on the transactional bill [...]

Posting Date: 10/22/2024

U5065

Avoiding/Correcting This Error Check/verify the beneficiary's entitlement dates in the CWF. A Medicare beneficiary, or their authorized representative, may have requested a new MBI. Verify eligibility and MBI number, correct and return the claim.

Posting Date: 10/22/2024

U5065

Avoiding/Correcting This Error Check/verify the beneficiary's entitlement dates in the CWF. A Medicare beneficiary, or their authorized representative, may have requested a new MBI. Verify eligibility and MBI number, correct and return the claim.

Posting Date: 10/22/2024

N5052

Avoiding/Correcting This Error The beneficiary’s name listed on the claim has to be an exact match to what is posted on CWF. Be sure that any special characters (including apostrophes, dashes, commas) and suffixes (Jr., Sr., III) that are [...]

Posting Date: 10/22/2024

U537F

Avoiding/Correcting This Error Always verify billing before submitting a new NOA for a beneficiary admission. There should not already be an NOA in the system pending processing or finalized prior to submitting a new NOA for a beneficiary. [...]

Posting Date: 10/22/2024

U5233

Avoiding/Correcting This Error Collect all insurance information from the beneficiary when admitted to your HHA. Talk to the beneficiary about insurance changes and check CWF before billing Medicare. Many times a claim will overlap an MAO [...]

Posting Date: 10/22/2024

U5106

Avoiding/Correcting This Error When the hospice NOE was received it fell within a previously established election period. Verify that the NOE is billed with correct dates. If benefit period from the previous hospice is still open, allow [...]

Posting Date: 10/22/2024

U5166

Avoiding/Correcting This Error If a transfer occurred, verify that all claims and notices are submitted in order. The transferring-from hospice agency needs to submit their final claim prior to the transferring-to hospice agency submitting [...]

Posting Date: 10/22/2024

U5065

Avoiding/Correcting This Error HHH may only bill services provided to the patient after the effective date of their Medicare coverage. Verify the effective date(s) for the MBI of the beneficiary prior to billing. If a new MBI has been issued [...]

Posting Date: 10/22/2024

U537F

Avoiding/Correcting This Error Always verify billing before submitting a new NOA for a beneficiary admission. There should not already be an NOA in the system pending processing or finalized prior to submitting a new NOA for a beneficiary. [...]

Posting Date: 10/22/2024

U5194

Avoiding/Correcting This Error In instances where a NOE is not timely-filed, the days of hospice care from the hospice admission date to the date the NOE is submitted to and subsequently processed by the Medicare contractor will not be [...]

Posting Date: 10/22/2024

U5106

Avoiding/Correcting This Error When the hospice NOE was received it fell within a previously established election period. Verify that the NOE is billed with correct dates. If benefit period from the previous hospice is still open, allow [...]

Posting Date: 10/22/2024

7C625

Avoiding/Correcting This Error Hospice – Clarify reason for discharge. Claim is being returned for one of the following reasons: Remarks are not present or do not indicate valid reason for discharge/transfer. Remarks indicate beneficiary [...]

Posting Date: 10/22/2024

38038

Avoiding/Correcting This Error Check OPPS claims for potential overlapping dates of service prior to claim submission and bill accordingly An adjustment bill must be submitted For bill type 34X, only vaccines and their administration, [...]