Search Results - NGSMEDICARE

Posting Date: 04/02/2025

ASCA: Must an Administrative Simplification Compliance Act waiver be mailed or can it be faxed?

Posting Date: 04/02/2025

ASCA: If my Administrative Simplification Compliance Act Waiver Request is denied, what will happen to my paper claims?

Posting Date: 04/02/2025

ASCA: How will the Administrative Simplification Compliance Act enforcement review affect me as a “small provider/supplier?” Will I be required to submit claims electronically?

Posting Date: 04/02/2025

ASCA: How will I know the outcome of my Administrative Simplification Compliance Act waiver request form?

Posting Date: 04/02/2025

ASCA: I was under Administrative Simplification Compliance Act review once and received an approved waiver request to send paper claims, why am I under review again?

Posting Date: 04/02/2025

DDE: My name changed and I need to change the name associated to my log on ID. How do I do that?

Posting Date: 04/02/2025

DDE: Is there some place on FISS/DDE that shows how many physical therapy (PT) or occupational therapy (OT) visits the beneficiary has had?

Posting Date: 04/02/2025

DDE: I tried to access my claim through the FISS/DDE system and it will not let me pull it up. What is the problem?

Posting Date: 04/02/2025

DDE: How do I get my log on ID password reset?

Posting Date: 04/02/2025

DDE: Can a provider view additional development requests (ADRs) via the FISS/DDE?

Posting Date: 04/02/2025

DDE: I have a claim which was fully denied and I am attempting to use the automated denial adjustment process, but the FISS/DDE system is not allowing me to adjust my claim. Why am I not able to bring up my claim and submit the adjustment?

Posting Date: 04/02/2025

CLAIMS: Why would my postoperative claims deny?

Posting Date: 04/02/2025

CLAIMS: Where are comments entered on the 837P electronic claim form?

Posting Date: 04/02/2025

CLAIMS: When submitting an ambulance claim, do the base and mileage codes need to have the same ZIP code for the same trip?

Posting Date: 04/02/2025

CLAIMS: What is the correct way to submit a beneficiary name on a claim?

Posting Date: 04/02/2025

CLAIMS: On a screening Pap smear test claim, which pointer does my diagnosis code need to be in?

Posting Date: 04/02/2025

CLAIMS: Medicare is the beneficiary's secondary payer and I am receiving denials when submitting using the CMS-1500 form. How can I resolve this?

Posting Date: 04/02/2025

CLAIMS: I file all my Medicare claims electronically except for Medicare Secondary Payer (MSP) claims because I thought I had to attach the primary Explanation of Benefits (EOB). Is this the correct process?

Posting Date: 04/02/2025

CLAIMS: I received a denial stating that the documentation submitted did not support the medical necessity of laboratory services. Can you tell me what I can submit to support these services?

Posting Date: 04/02/2025

CLAIMS: How do I submit documentation for an additional development request (ADR)?

Posting Date: 04/02/2025

CLAIMS: I am receiving inconsistent payments on claims billed for the same drug. How can I prevent this?

Posting Date: 04/02/2025

CLAIMS: How do I prevent monthly End Stage Renal Disease claims from denying?

Posting Date: 04/02/2025

CLAIMS: How do I know if a HCPCS/CPT code is subject to MUE (medically unlikely edit)?

Posting Date: 04/02/2025

CLAIMS: How do I indicate on a Medicare claim that the services are NOT related to a liability, no fault (including medical payment) or Workers’ Compensation accident, injury or illness MSP record in the CWF?

Posting Date: 04/02/2025

CLAIMS: During the patient check in process, may we have the patient check a box on a form at each visit stating they agree to allow us to bill Medicare and have that serve as the patient’s acceptance for our filing a claim?

Posting Date: 04/02/2025

When billing for waste on a single use vial would you round units up or down for a half unit?

Posting Date: 04/02/2025

When billing an unclassified drug code such as J3490, are the units of service on the claim always equal to one?

Posting Date: 04/02/2025

What is the proper way to submit professional physician claim with multiple NDC numbers for the same drug code?

Posting Date: 04/02/2025

J3357, Ustekinumab (Stelara) is listed on the Self-Administered Drug Exclusion List: Medical Policy Article A53021, and it says “acceptable”. Does this mean it is excluded or not?

Posting Date: 04/02/2025

What is the correct way to bill an unlisted drug or biological?

Posting Date: 04/02/2025

Is the shingles vaccine covered by Medicare?

Posting Date: 04/02/2025

Is the GY modifier required on the drug code and the administration code for noncovered self-administered drugs?

Posting Date: 04/02/2025

Have the payable diagnoses for IVIG and Rituximab changed? I don’t see all of the previously payable diagnoses in the applicable drug local coverage determinations (LCDs) and articles.

Posting Date: 04/02/2025

How do I bill a bilateral joint injection and HCPCS J1040 for two units?

Posting Date: 04/02/2025

Do all established drug HCPCS codes require the dosage amount in its description on the claim?

Posting Date: 04/02/2025

Does the waste with the JW modifier appended always go on the second line regardless of the billed amount? For example, the billed amount for the waste is higher than the administered amount.

Posting Date: 04/02/2025

Are unclassified drug codes included in average sales price (ASP) files?

Posting Date: 04/02/2025

Can chemotherapy be split into two doses on two different dates of service if the patient was unable to complete a full dose in one day? For example, the patient's port was not functioning properly.

Posting Date: 04/02/2025

Does Medicare Part B make payment for the unused portion of a multi-dose vial of a drug/biological?

Posting Date: 04/02/2025

Can Medicare Part B providers who bill on the professional CMS-1500 claim form, and electronic equivalent, bill unclassified drug code C9399?