Search Results - NGSMEDICARE

Posting Date: 11/07/2022

Common Questions for Diabetes Self-Management Program Accreditation

Common Questions for Diabetes Self-Management Program Accreditation Does my organization need to be accredited to bill for DSMT services? Answer: Yes. In order to bill Medicare for DSMT services, your organization’s DSMT program must be [...]

Posting Date: 11/07/2022

Medical Nutrition Therapy Tool for Billing

Medical Nutrition Therapy Tool for Billing CMS considers DSMT and MNT complementary services. This means Medicare will cover both DSMT and MNT without decreasing either benefit as long as the referring physician determines that both are [...]

Posting Date: 06/13/2022

Remote Physiological Monitoring and Cardiovascular Monitoring Service and Billing Information

Remote Physiological Monitoring and Cardiovascular Monitoring Service and Billing Information Table of Contents Remote Physiological Monitoring Services CPT Codes: 99091, 99453, 99454, 99457, 99458 Remote Physiological Monitoring [...]

Posting Date: 09/17/2024

National Government Services Contractor Advisory Committee Meeting

National Government Services Contractor Advisory Committee Meeting There will be a multi-jurisdictional CAC meeting held on Thursday 10/17/2024 at 3:00-5:00 p.m. ET, 2:00-4:00 p.m. CT. Meeting details can be found on the National Government [...]

Posting Date: 09/19/2024

Laboratory and Diagnostic Services: Documentation Responsibilities

Laboratory and Diagnostic Services: Documentation Responsibilities When National Government Services is conducting a pre-pay or post-pay review of claims and services, we may request additional documentation. The billing provider must obtain [...]

Posting Date: 11/01/2021

Global Surgery

Global Surgery Table of Contents Definition of a Global Surgical Package Where can I find the postoperative periods for covered surgical procedures? What services are included in the global surgery payment? What services are not [...]

Posting Date: 08/10/2023

Duplicate Claim Editing Information

Duplicate Claim Editing Information Part B Duplicate Claim Edit National Government Services implemented a Part B duplicate claim edit in our EDI front-end processing system for Part B providers. Providers are notified that a claim is a [...]

Posting Date: 10/15/2021

Physician Dialysis Services

Physician Dialysis Services Table of Contents Physician Dialysis Services Monthly Capitation Payment Coding Claim Submission Tips Billing for a Partial Month Documentation Requirements Related Content [...]

Posting Date: 11/23/2021

Oncology Care Model

Oncology Care Model Note: If you did not register for the CMS OCM during the open application and selection period, then you are not a part of this program. The names of those practices and payers participating in OCM can be found on the OCM [...]

Posting Date: 11/29/2021

Spinraza (nusinersen) Billing

Spinraza (nusinersen) billing Spinraza (nusinersen) is a medication that was approved in December 2016 by the U.S. FDA for the treatment of all forms of SMA. HCPCS code J2326 - Inj, nusinersen, 0.1mg should be used to report Spinraza. [...]

Posting Date: 02/22/2023

Chimeric Antigen Receptor (CAR) T-cell Therapy

Chimeric Antigen Receptor (CAR) T-cell Therapy Table of Contents NCD 110.24: Chimeric Antigen Receptor (CAR) T-cell therapy: Billing Instructions Overview Billing and coding CAR T-cell therapy for inpatient services Clinical [...]

Posting Date: 09/19/2024

MLN Connects® Newsletter: September 19, 2024

MLN Connects® Newsletter: September 19, 2024 News Resources & Flexibilities to Assist with the Public Health Emergency in Louisiana Skilled Nursing Facilities: Report Your Expanded Ownership, Management, & Related Party Data [...]

Posting Date: 09/19/2024

Billing Errors on 2024/2025 Influenza Season Claims

Billing Errors on 2024/2025 Influenza Season Claims The influenza season runs from August 1st of each year until July 31st the following year. Every influenza vaccine is assigned a new NDC each season. This season, some codes no longer have a [...]

Posting Date: 01/19/2022

Learn About MDPP

Learn About MDPP The MDPP expanded model includes an evidence-based set of services aimed to help prevent the onset of type 2 diabetes among Medicare beneficiaries with an indication of prediabetes. MDPP services is available to eligible [...]

Posting Date: 01/19/2022

Framework for Prevention and Goals

Framework for Prevention and Goals CMS along with the CDC provides a framework for diabetes prevention efforts. It brings together partners from the public and private sectors to prevent or delay type 2 diabetes. The MDPP is structured [...]

Posting Date: 01/19/2022

Delivering a Lifestyle Change for Medicare Beneficiaries

Delivering a Lifestyle Change for Medicare Beneficiaries Providers play a vital role in beneficiary referrals. Although a referral is not required, a provider’s assessment during the AWV or the IPPE is strongly recommended by NGS. Providers [...]

Posting Date: 01/19/2022

Receiving CDC Recognition and Medicare Enrollment

Receiving CDC Recognition and Medicare Enrollment Organizations who wish to furnish MDPP services to beneficiaries and bill Medicare for those services must enroll in Medicare as an MDPP supplier. To become a Medicare-enrolled MDPP supplier, [...]

Posting Date: 01/19/2022

MDPP Codes and Payment Amounts 2023

MDPP Codes and Payment Amounts 2023 HCPCS G-codes are used when submitting claims to bill Medicare for payment. MDPP HCPCS G-codes may be used only one time per eligible beneficiary (except for G9890 and G9891). The initial session (G9873) [...]

Posting Date: 02/06/2024

MDPP Codes and Payment Amounts 2024

MDPP Codes and Payment Amounts 2024 Medicare pays up to 22 visits billed with codes G9886 and G9887, combined, in a 12-month period: Months 1–6: one in-person/distance learning visit every week (up to 16) Months 7–12: one [...]

Posting Date: 01/19/2022

MDPP Billing Information

MDPP Billing Information In addition to the usual information that needs to be completed to file a claim for a Medicare Part B service to your MAC, you will need to complete the following items of the CMS-1500 form or electronic equivalent [...]

Posting Date: 01/19/2022

Contact Information and Resources

Contact Information and Resources Inquiry Type Examples Help Desk Contact Information Process of MDPP CDC Recognition Credential via CDC, check status of application for CDC recognition or submitting [...]

Posting Date: 11/15/2021

Prevent Revalidation Processing Delays

Prevent Revalidation Processing Delays When National Government Services receives a revalidation application, we often determine additional information is needed to process the application. In those cases, a request for additional information [...]

Posting Date: 08/01/2024

Medicare University

Medicare University National Government Services offers a variety of teleconferences, webinars and face-to-face educational sessions on Medicare-related topics including rules and regulations throughout the year. Medicare University (MU), our [...]

Posting Date: 09/10/2024

Expected Timeframes for Therapy Services

Expected Timeframes for Therapy Services CMS and CPT guidelines for provider time spent and documented on therapy services may vary, depending on the definition of the service and the context in which it is performed. Therapy services [...]

Posting Date: 01/29/2020

EDI and How it Works

EDI and How it Works EDI is an electronic communication method that enables fast, accurate and reliable exchange of data between the computer systems of organizations that do business together by using the same standardized message formatting, [...]

Posting Date: 09/23/2024

Benefits of EDI and Real Time Claim Status

Table of Contents Benefits of EDI and Real Time Claim Status Real Time Claim Status and Response - A Faster Better Option [Return to Top] Benefits of EDI and Real Time Claim Status There are a number of advantages to enrolling and [...]

Posting Date: 01/29/2020

Benefits of Electronic Attachments

Benefits of Electronic Attachments The X12 275 Attachment transaction supports sending additional documentation electronically. Clinical documentation includes but not limited to; operative notes, consult notes, procedure notes, care plan, and [...]

Posting Date: 08/13/2020

How to Get Started - Five Easy Steps

How To Get Started – Five Easy Steps Contact your vendor, clearinghouse or billing service to ensure they support the electronic attachment program which includes the following: 6020 version of the 275 transaction; HL7 CDA R2 [...]

Posting Date: 07/09/2020

Participating Clearinghouses and Vendors

Participating Clearinghouses and Vendors The following entities support electronic attachments with NGS. Any of these entities can assist you with implementing electronic attachments and participating in the NGS Attachment Program. [...]

Posting Date: 08/10/2023

Duplicate Claim Editing Information

Duplicate Claim Editing Information National Government Services implemented a Part A duplicate claim edit in our EDI front-end processing system. Providers are notified that a claim is a duplicate upon receipt of the 277 Claims [...]

Posting Date: 03/01/2022

Benefits of Electronic Remittance Advice

Benefits of Electronic Remittance Advice Table of Contents Benefits of Electronic Remittance Advice There Are Several Benefits to Choosing ERA Versus SPR Help Interpreting the ERA Is Available [Return to Top] Benefits of Electronic [...]

Posting Date: 02/17/2022

How to Get Started

How to Get Started Making the change is easy. If you use a clearinghouse to submit claims, contact your clearinghouse to ask how to enroll for the electronic remittance service. If you currently have a claim submission software program, [...]

Posting Date: 01/29/2020

Benefits of the 277 RFI

Benefits of the 277 RFI The X12 277 RFI transaction replaces the paper Additional Development Request letters. The 277RFI transaction is available for JK/J6 Part A and Part B providers. The benefits of the 277RFI transaction include: [...]

Posting Date: 04/20/2020

Participating Clearinghouses and Vendors

Participating Clearinghouses and Vendors The following entities support electronic attachments with NGS. Any of these entities can assist you with implementing electronic attachments and participating in the NGS Attachment Program. [...]

Posting Date: 06/22/2022

Standard Companion Guide Trading Partner Information

Standard Companion Guide Trading Partner Information Instructions Related to the X12 277 Health Care Claim Request for Additional Information Version 6020 Companion Guide Version Number: 6.0 Revised: October 2019 Preface Companion Guides [...]

Posting Date: 04/20/2022

Standard Companion Guide Trading Partner Information

Standard Companion Guide Trading Partner Information Instructions Related to the X12 278 and 275 Prior Authorization Transactions Companion Guide Version Number: 1.0 Created: April, 2022 Preface Companion Guides (CG) may contain two types of [...]

Posting Date: 03/08/2021

EDI Gateway Self-Service Password Portal Overview

EDI Gateway Self-Service Password Portal Overview Table of Contents EDI Gateway Self-Service Password Portal Overview Changing versus Resetting Your Password Changing Your Password Resetting Your Password EDI Gateway Self-Service [...]

Posting Date: 09/19/2022

Changing Your EDI Password

Changing Your EDI Password EDI passwords have to be regularly changed or reset to maintain data security. You should note that passwords expire every 60 days and can be changed or reset prior to expiration. Follow these steps to change your [...]

Posting Date: 09/19/2022

Resetting Your EDI Password

Resetting Your EDI Password EDI passwords have to be regularly changed or reset to maintain data security. You should note that passwords expire every 60 days and can be changed or reset prior to expiration. Follow these steps to reset your [...]