Search Results - NGSMEDICARE

Posting Date: 05/03/2022

Botulinum Toxin Injections

General Documentation Requirements for Botulinum Toxin Injections Prior authorization is only required when one of the required Botulinum Toxin codes (J0585, J0586, J0587, or J0588) is used in conjunction with one of the required CPT injection [...]

Posting Date: 11/09/2023

Processing Issue Botulinum Toxin Claims Returned to Provider with 5PRIA

Part A claims that have been submitted with Botulinum J codes (J0585, J0586, J0587, J0588) have incorrectly RTP with reason code 5PRIA.

Posting Date: 08/04/2022

Medicare Part B Coverage and Billing Guidance for Breast Ultrasound

Medicare Part B Coverage and Billing Guidance for Breast Ultrasound Breast ultrasound uses sound waves to produce pictures of the inside of the breast and can show changes that are more difficult to see on a mammogram. Breast ultrasound is not [...]

Posting Date: 04/27/2023

KX Modifier on Outpatient Physical Therapy, Occupational Therapy or Speech Language Pathology Claims

KX Modifier on Outpatient Physical Therapy, Occupational Therapy or Speech Language Pathology Claims Reminders Providers report KX modifier on a claim line(s) to confirm the medical records contain specific required documentation that meets [...]