Billing and Reimbursement for Noncontact Real-Time Fluorescence Wound Imaging (CPT 0598T and CPT 0599T)

Billing and Reimbursement for Noncontact Real-Time Fluorescence Wound Imaging (CPT 0598T and CPT 0599T) National Government Services has updated its reimbursement policy on CPT codes 0598T and 0599T (Noncontact Real-Time Fluorescence Wound [...]

Billing and Coding Article Updates for January 2023

Billing and Coding Article Updates for January 2023 Billing and Coding: Bevacizumab and biosimilars (A52370) The reference for Bevacizumab-adcd (Vegzelma®) listed under the Ophthalmologic Guidelines section of the article has been removed. [...]

Contractor Advisory Committee Meeting 3/16/2023: Hyaluronans

Contractor Advisory Committee Meeting 3/16/2023: Hyaluronans National Government Services will host a CAC Meeting via teleconference on 3/16/2023, from 1:00–4:00 p.m. ET. Discussions will focus on the treatment of patients with Hyaluronans for [...]

Prior Authorization Outpatient Department Self-Service Inquiry Tools

Prior Authorization Outpatient Department Self-Service Inquiry Tools National Government Services continues to see PARs submitted for non-prior authorization HCPCS codes as well as requests submitted on behalf of providers on exemption.  [...]

View Outstanding Overpayments

View Outstanding Overpayments The View Outstanding Overpayments selection will provide a list of current outstanding overpayments for the provider account selected. In this section you have the opportunity to view/print an overpayment demand [...]

View Provider Earnings to Date

View Provider Earnings to Date Select the Financials button on the home page. In the Select a Provider panel, click the Select button next to the applicable provider account.  Select Provider Earnings to Date from the [...]

Overlap/Dispute Process

Steps for Success in a Targeted Probe and Educate Review

Steps for Success in a Targeted Probe and Educate Review We’ve provided tips and tricks to assist you with succeeding in a TPE review and the post-probe educational process. Content presented includes: Getting started with TPE Updating the [...]

End of Public Health Emergency Brings Change

End of Public Health Emergency Brings Change The end of the PHE is near and you may have questions. CMS and National Government Services want to ensure a seamless transition from the flexibilities enacted as a result of the COVID-19 [...]

Hospice Cap Self-Reporting Reminder for the 2022 Cap Year

Hospice Cap Self-Reporting Reminder for the 2022 Cap Year The hospice cap self-reporting for the 2022 cap year (10/1/2021-9/30/2022) is due no later than 2/28/2023. Hospice providers should submit the pro-forma calculation along with [...]

CMS Updates to Clinical Lab Fee Schedule for 2023 Reminder

CMS Updates to Clinical Lab Fee Schedule for 2023 Reminder National Government Services has received many calls in relation to the CMS updates to the Clinical Laboratory Fee Schedule for 2023. Providers have identified instances of not [...]

MLN Connects® Newsletter: Prescription Drug Inflation Rebate Program Guidance – Feb 9, 2023

MLN Connects® Newsletter: Prescription Drug Inflation Rebate Program Guidance – Feb 9, 2023     News Medicare Part B Drug Inflation Rebates HHS Releases Initial Guidance for Medicare Prescription Drug Inflation Rebate [...]

2023 Evaluation and Management Services – Prolonged Services

2023 Evaluation and Management Services – Prolonged Services Based on recent CMS clarifications for 2023 Evaluation and Management Services, particularly for prolonged services, National Government Services is now revising some previously [...]

Home Health Claims Incorrectly Receiving Reason Code U538E

HH final and adjusted claims with 2022 dates of service are receiving U538E incorrectly, when there is an older period on file. This prevents providers from being able to adjust these claims and update patient status from “06” to any other [...]

MLN Connects® Newsletter: February 16, 2023

MLN Connects® Newsletter: February 16, 2023     News Billing Medicare Part B for Insulin with New Limits on Patient Monthly Coinsurance Unprecedented Efforts to Increase Transparency of Nursing Home Ownership CMS Proposes [...]

New Service Added to the Hospital Outpatient Department Prior Authorization Program

New Service Added to the Hospital Outpatient Department Prior Authorization Program Effective for dates of service rendered on or after 7/1/2023, facet joint interventions are added to the HOPD services requiring prior authorization as a [...]

Bibliography for Hyaluronans CAC Meeting on 3/16/2023

Bibliography for Hyaluronans CAC Meeting on 3/16/2023 George E. Intra-articular hyaluronan treatment for osteoarthritis. Ann Rheum Dis. Nov 1998;57(11):637-40. doi:10.1136/ard.57.11.637. https://ard.bmj.com/content/57/11/637.  [...]

Important Steps When Responding to Additional Development Response Letters

Important Steps When Responding to Additional Development Response Letters When National Government Services requests documentation, you must send us only what has been requested. We are receiving numerous unnecessary documents from providers [...]

View 1099s

View 1099s The Internal Revenue Service 1099 form is a collection of tax forms documenting different types of payments made by an individual or a business that typically isn't your employer. The 1099 portal forms are a courtesy copy and are [...]

MLN Connects® Newsletter: Public Health Emergency 1135 Waivers: Updated Guidance for Providers - February 23, 2023

MLN Connects®Newsletter: Public Health Emergency 1135 Waivers: Updated Guidance for Providers -  February 23, 2023     News Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers Posted 2/23/2023

Chimeric Antigen Receptor (CAR) T-cell Therapy Billing Instructions

Chimeric Antigen Receptor (CAR) T-cell Therapy Billing Instructions Effective for dates of service on or after 8/7/2019, Medicare will pay claims from approved providers for administration of autologous T-cells expressing at least one CAR for [...]

LCD, Billing and Coding Article Updates for March 2023

LCD, Billing and Coding Article Updates for March 2023 Billing and Coding: Billing and Coding: Implantable Automatic Defibrillators (A56326) Based on Transmittal 11832 (CR13070) ICD-10-CM and Other Coding Revisions to NCDs - July 2023 Update, [...]

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

April 2023 Release "Dark Days" for the Common Working File Hosts For the upcoming April 2023 Release: For Production, CWF will be observing the Gray Day on Thursday, 3/30/2023 and Dark Days starting Friday, 3/31/2023 through Sunday, 4/2/2023 [...]

Credit Balance Report Reminder for Jurisdiction 6 Part A Providers

Credit Balance Report Reminder for Jurisdiction 6 Part A Providers For the quarter ending 12/31/2022, CBR must be submitted and received by the ORU by 3/1/2023 to be considered timely. Failure to submit the CBR will result in the provider [...]

MLN Connects® Newsletter: COVID-19 Public Health Emergency (PHE) New Overview Fact Sheet — Feb 27, 2023

MLN Connects® Newsletter: COVID-19 Public Health Emergency (PHE) New Overview Fact Sheet — Feb 27, 2023     News COVID-19 Public Health Emergency (PHE) New Overview Fact Sheet​​​​​​​ Posted 2/28/2023

MLN Connects® Newsletter: March 2, 2023

MLN Connects® Newsletter: March 2, 2023 News The Future of Medicare Enrollment: Save Time with PECOS's Consolidated Application Voluntary Prior Authorization Process for Certain Power Mobility Device Accessory Items Expanded Home [...]

LCD Archived Open Meeting Records

Open Meeting Records Jurisdiction 6 Open Meeting Records Meeting Date Audio Transcript 10/15/2020 ‒  J6/JK Open Meeting Recording Transcript 6/24/2020 ‒  J6/JK Open Meeting [...]

Audiology Services

Audiology Services CMS finalized an exception to the physician order requirement for certain diagnostic testing services to broaden patient access to services furnished by audiologists in the CY 2023 Physician Fee Schedule Final Rule. Visit [...]

Audiology

Resolving PECOS Common Errors and Warnings

Medicare Provider/Supplier Specialty Codes

Medicare Provider/Supplier Provider Type Codes

MLN Connects® Newsletter: March 9, 2023

MLN Connects® Newsletter: March 9, 2023 News Nutrition-Related Health Conditions: Recommend Medicare Preventive Services Compliance Advance Care Planning: Bill Correctly for Services Claims, Pricers and Codes Medicare [...]

2023 Evaluation and Management Services – New Frequently Asked Questions

2023 Evaluation and Management Services – New Frequently Asked Questions Based on recent CMS clarifications for 2023 evaluation and management services, we’ve added new frequently asked questions for the following evaluation and management [...]

Tip Sheet #3

Tip Sheet #3 Below are the most common issues handled by the SSA. These Medicare-related issues should be handled by your local SSA office: Change of address requests Medicare beneficiary eligibility status for Medicare Effective dates of [...]

Sacroiliac Joint Injections and Procedures

Sacroiliac Joint Injections and Procedures

Sacroiliac Joint Injections and Procedures Frequently Asked Questions

Sacroiliac Joint Injections and Procedures Frequently Asked Questions  We’ve added frequently asked questions related to New Local Coverage Determination for Sacroiliac Joint Injections and Procedures. We encourage our providers to view [...]

MLN Connects® Newsletter: March 15, 2023

MLN Connects® Newsletter: March 15, 2023     News Inflation Reduction Act Tamps Down on Prescription Drug Price Increases Above Inflation Posted 3/15/2023

Frequently Asked Questions