Assistant at Surgery Billing Documentation Reminder

Assistant at Surgery Billing Documentation Reminder Claims for assistant at surgery with a zero (0) indicator in the MPFSDB must have information to support and identify the assistant and also support the medical necessity of his/her [...]

MLN Connects® Newsletter: November 3, 2022

MLN Connects® Newsletter: November 3, 2022   News COVID-19 Vaccine: Novavax Booster Authorized Medicare Part B Immunosuppressive Drug: Get Information on New Benefit Part B Immunosuppressive Drug Benefit: Check Medicare Eligibility [...]

Claims Frequently Asked Question

Claims Frequently Asked Question We have added a new FAQ to our website. View answers to a common question about how to bill for services unrelated to a liability, no fault, or workers compensation claim to ensure you have the information [...]

Announcement About Medicare Participation for Calendar Year 2023

Announcement About Medicare Participation for Calendar Year 2023 The Centers for Medicare & Medicaid Services has posted the Announcement About Medicare Participation for Calendar Year 2023. Posted 11/3/2022

Revalidate Provider Enrollment

This section gives you access and education about revalidating your enrollment.

Electronic Funds Transfer

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Go Electronic

This section gives you access/education about first time Enrollment.

Rebuttal

This section gives you access/education about first time Enrollment.

Appeals

This section gives you access/education about first time Enrollment.

NGSConnex Feedback

NGSConnex Feedback After you log into NGSConnex, each page contains a Feedback button. If you experience issues while using NGSConnex, please use the Feedback to let us know.  Your feedback allows us to begin essential research and [...]

MLN Connects® Newsletter: November 10, 2022

MLN Connects® Newsletter: November 10, 2022     News Teaching Hospitals: Phase 2 Section 131 Reviews — Submission Deadline November 18 Medicare Participation for CY 2023 CMS Innovation Center’s Strategy to Support [...]

Transplant Services

Verify Bank Account Information

Verify Bank Account Information

Verify Bank Account Information

Verify Bank Account Information

The CY 2023 Medicare Physician Fee Schedule Is Now Available

The CY 2023 Medicare Physician Fee Schedule Is Now Available The CY 2023 MPFS is now available. You can view the new fees using the Fee Schedule Lookup tool page on NGSMedicare.com. Posted 11/14/2022

Proper Steps for Notice of Admission Cancel/Resubmission

Proper Steps for Notice of Admission Cancel/Resubmission The purpose of the NOA is to open a new admission period for a home health beneficiary. There are few circumstances when the home health NOA must be canceled and resubmitted to correct [...]

Sequestration Questions and Answers

Sequestration Questions and Answers If a durable medical equipment capped rental period started before 4/1/2013, are the rental payments for months after 4/1/2013, subject to the 2 percent reduction? Answer: Any claims for rental [...]

Billing for Tape Codes (A4450 and A4452) and Modifiers (AU, AV and AW)

Billing for Tape Codes (A4450 and A4452) and Modifiers (AU, AV and AW) Policy specific informational modifiers can be located in the local medical policies. When submitting claims that require policy specific informational modifiers, [...]

Claim Completion Requirements for Facility Location (Item 32)

Claim Completion Requirements for Facility Location (Item 32) When a supplier submits a claim for DMEPOS provided in a location other than the beneficiary’s home (POS 12), the supplier must enter in Item 32, Facility Location, the name and [...]

Coverage and Correct Coding of Blincyto

Coverage and Correct Coding of BlincytoTM Joint DME MAC Publication On 12/3/2014, the FDA gave accelerated approval for Blinatumomab (BlincytoTM) for the treatment of Philadelphia negative relapsed/refractory acute lymphoblastic leukemia. [...]

2015 HCPCS Code Update

2015 HCPCS Code Update The following list identifies changes to level II HCPCS codes for 2015. Added Codes/Added Modifiers: New codes and modifiers are effective for dates of service on or after 1/1/2015. Discontinued Codes/Deleted [...]

Medical Policies/LCDs

What's New in Home Health Education?

What's New in Home Health Education? Updates are currently being made to home health YouTube tutorials and job aids to ensure that all federal regulation changes are captured. Most recently, we have updated the following educational materials [...]

Proper Billing for LEQVIO®

Proper Billing for LEQVIO® National Government Services has noticed improper billing of units and diagnosis related to HCPCS code J1306. We’ve published Proper Billing for LEQVIO® HCPCS Code J1306 to assist our provider community with billing [...]

Multijurisdictional CAC meeting Notice on Micro-Invasive Glaucoma Surgery

Multijurisdictional CAC meeting Notice on Micro-Invasive Glaucoma Surgery Information has been posted on our website about a multijurisdictional Contractor Advisory Committee Meeting Regarding Micro-invasive Glaucoma Surgery to be held on [...]

Proper Billing for TEZSPIRE™

Proper Billing for TEZSPIRE™ National Government Services has noticed improper billing of units related to HCPCS code J2356. We’ve published Proper Billing for TEZSPIRE™ HCPCS Code J2356 to assist our provider community with billing for this [...]

Ambulance

MLN Connects® Newsletter: November 17, 2022

MLN Connects® Newsletter: November 17, 2022     News Hospital Price Transparency: Download Machine-Readable File Sample Formats & Data Dictionaries Medical Review After the COVID-19 Public Health Emergency: New FAQ [...]

2022 Home Health and Hospice Medicare Administrative Contractors Collaborative Summit

Early Bird Registration is Now Open for the 2022 Home Health and Hospice Medicare Administrative Contractors Collaborative Summit The 2022 HH+H MACs Collaborative Summit: One Program, One Voice is now open for early bird registration. This [...]

Credit Balance Status Lookup

About This Tool This tool can be used to check on the status of your mailed or faxed Credit Balance Report. Any reports submitted through Connex will not appear in this tool. How to Search To perform a search, enter a valid PTAN into the [...]

Anesthesia CPT 00537 Being Underpaid for 2022

The 2022 Anesthesia Base Unit for 00537 was not updated for dates of service starting 1/1/2022 which has caused services being underpaid.

Part A FISS Cancel Adjustment Issue

FISS Maintainer will be creating a file to identify the cancel claim records that posted to the CWF as original claims (those with a CD value of “3” instead of “4”) and will be providing those files to CWF. The CWF Maintainer will run those [...]

Part A Invalid MBI Cross-Reference Issue

National Government Services is informing Part A providers of a claim processing issue causing invalid MBI cross-referencing. This is resulting in multiple, inactivated HICN being associated with the impacted claims.

Setting Your Security Questions

Setting Your Security Questions Setting up Security Questions is part of the required process for establishing an EDI Gateway Self-Service Portal account. Follow these steps to set up your account Security Questions. Access the Trading [...]

Cardiac, Intensive Cardiac and Pulmonary Rehabilitation Services

Cardiac, Intensive Cardiac and Pulmonary Rehabilitation Services We’ve added Cardiac, Intensive Cardiac and Pulmonary Rehabilitation information to the Cardiac Specialty section of our website. These resources provide detailed coverage and [...]

LCD, Billing and Coding Article Updates for November-December 2022

LCD, Billing and Coding Article Updates for November-December 2022 New LCDs and Articles (Effective 11/1/2022) Off-Label Use of Intravenous Immune Globulin (IVIG) – (L39314) This LCD addresses off-label uses for IVIG. We define off-label as [...]

January 2023 Release "Dark Days" for the Common Working File Hosts

January 2023 Release "Dark Days" for the Common Working File Hosts For the upcoming January 2023 Release: For Production, CWF will be observing the Gray Day on Thursday, 12/29/2022 and Dark Days starting Friday, 12/30/2022 through Sunday, [...]

MLN Connects® Newsletter: December 8, 2022

MLN Connects® Newsletter: December 8, 2022     News CMS Proposes Rule to Expand Access to Health Information and Improve the Prior Authorization Process Rural Emergency Hospitals: New Institutional Provider Type Starting [...]