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Posting Date: 09/19/2022
Password Reset Requirements Checklist
Password Reset Requirements Checklist The following information will assist you in successfully resetting your password and eliminate any unnecessary disconnects. You should note that passwords expire every 60 days and can be reset prior to [...]
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Posting Date: 09/19/2022
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 [...]
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Posting Date: 01/29/2020
Key Features
Key Features PC-ACE is a comprehensive claims management system. Some of the more prominent features include: Combined Medicare Part A, Institutional All-Payer and Professional claims system Electronic submission of claims in ANSI-837 [...]
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Posting Date: 01/29/2020
Minimum System Requirements and Support
Minimum System Requirements and Support Minimum System Requirements SVGA monitor resolution (800 x 600) Windows 10, Windows 8.1, Windows 7 or Vista operating system Adobe Acrobat Reader Version 4.0 or later (for overlaid claim printing) [...]
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Posting Date: 06/15/2022
Creating a 276 Claim Status Request in PC-ACE
Creating a 276 Claim Status Request in PC-ACE Claim Status Request Files must be prepared and transmitted using communication software. Select INST or PROF from the PC-ACE Claims Processing System main menu. Select List Claims [...]
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Posting Date: 12/19/2016
PC-ACE for Institutional Users: Importing and Reading the 999 and 277CA Files
PC-ACE: Importing and Reading the 999 and 277CA Files In order for PC-ACE to read 999 or 277CA files, they must be saved into the proper sub-folder within the WINPCACE folder. 277CA files go within the Stat1500 (Part B) sub-folder or the [...]
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Posting Date: 03/28/2022
PC-ACE Quick Reference Guide: Medicare Secondary Payer
PC-ACE Quick Reference Guide: Medicare Secondary Payer The following are Medicare A (Institutional) instructions for entering line item and claim information into PC-ACE when Medicare is the secondary payer. Situations where Medicare is the [...]
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Posting Date: 11/19/2018
View and Print ERA in PC-ACE
View and Print ERA in PC-ACE PC-ACE offers the ability to translate an ERA to either view and/or print for both institutional and professional ERAs after they have been downloaded. ERAs viewed/printed in PC-ACE provides the same data that is [...]
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Posting Date: 11/17/2020
Download PC-ACE
Download PC-ACE Download PC-ACE If you intend to administer the COVID-19 vaccines when they become available, or the new monoclonal antibody bamlanivimab, especially if you intend to roster bill these codes, please download and install the [...]
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Posting Date: 01/29/2020
About PC Print
About PC Print The PC Print software is available for providers to view and print HIPAA-compliant ERAs from their own computer. The PC Print software is available to you at no cost. This software is easy to use and will save you both time and [...]
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Posting Date: 01/29/2020
Key Features
Key Features PC Print offers several different report displays and the ability to print the reports as needed. The Single Claim Report includes the activity at the claim and detail line items for a single claim. The All Claims Report [...]
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Posting Date: 01/29/2020
Minimum System Requirements and Support
Minimum System Requirements and Support PC Print is only compatible with officially supported Microsoft Windows Operating Systems. Please note that PC Print v4.2.6 is the only version compatible with Windows XP. PC Print software allows [...]
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Posting Date: 06/03/2022
Network Service Vendors
Network Service Vendors National Government Services requires connectivity to the EDI Gateway for exchange of EDI data through select NSVs. In addition to connectivity to the EDI Gateway for the exchange of HIPPAA transactions, these vendors [...]
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Posting Date: 09/26/2024
MLN Connects® Newsletter: September 26, 2024
MLN Connects® Newsletter: September 26, 2024 News CMS Roundup (September 20, 2024) Cardiovascular Disease: Talk with Your Patients about Screening Claims, Pricers, & Codes Cardiology CPT Code 75580: Issue with Claims Returned to [...]
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Posting Date: 05/11/2018
Medically Unlikely Edits and Related Billing Clarifications
Medically Unlikely Edits and Related Billing Clarifications An MUE is the maximum number of UOS allowable under most circumstances for a single HCPCS/CPT code billed by a provider for a particular date of service for a single beneficiary. [...]
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Posting Date: 10/28/2021
Medical Review Targeted Probe and Educate ADRs
Medical Review Targeted Probe and Educate Additional Development Requests Medical Review NGS Medical Review Department will be performing service specific post-payment reviews for a random selection of claims billed to Medicare Part A and B. [...]
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Posting Date: 02/24/2021
General Information
General Information In certain circumstances, National Government Services or other contractors working under the CMS may need to request additional information with regard to claims submitted to the Medicare Program. The requests for [...]
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Posting Date: 10/28/2021
Ways to Respond to ADRs
Ways to Respond to ADRs Table of Contents Ways to Respond to ADRs Utilizing Paperwork Segment and esMD Electronic Submission of Medical Documentation NGSConnex Portal Fax U.S. Mail, FedEx, UPS [Return to Top] Ways to Respond to ADRs [...]
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Posting Date: 10/28/2021
Claim ADRs
Claim Additional Development Requests National Government Services will not be able to process your claim without additional documentation. The following are the most common situations when NGS would require additional documentation to process [...]
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Posting Date: 10/28/2021
Other Audit Contractor ADRs
Other Audit Contractor Additional Development Requests An ADR may be requested from one of the contractors listed below. If you receive correspondence from any one of these contractors, please follow the instructions within their letter. [...]
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Posting Date: 10/28/2021
Overpayments Due to Contractor Audit Reviews
Overpayments Due to Contractor Audit Reviews If you do not agree with any CMS contractor audits determination and you are a provider practicing in JK (CT, MA, ME, NH, NY, RI, VT) or J6 (IL, MN, WI), you may use the Medicare appeals process [...]
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Posting Date: 10/08/2021
Bone Mass Measurements
Preventive Services Guide Bone Mass Measurements Table of Contents Bone Mass Measurements Risk Factors Coverage Guidelines and Frequency Limits Coverage Criteria HCPCS/CPT Coding HCPCS/CPT Codes ICD-10 Codes Diagnosis [...]
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Posting Date: 09/26/2024
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a “Stay of Enrollment” or claim rejections which may [...]
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Posting Date: 09/26/2024
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a “Stay of Enrollment” or claim rejections which may [...]
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Posting Date: 10/06/2021
Hepatitis B Virus Screening
Preventive Services Guide Hepatitis B Virus Screening Hepatitis B is a virus that can damage the liver, it is spread through contact with infected blood or body fluids and can be transmitted through sex with an infected person or by sharing [...]
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Posting Date: 10/06/2021
Screening for Sexually Transmitted Infections and HIBC to Prevent STIs
Preventive Services Guide Screening for Sexually Transmitted Infections and HIBC to Prevent STIs Table of Contents Screening for Sexually Transmitted Infections Coverage Criteria High/Increased Risk Factors Frequency Limits [...]
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Posting Date: 05/14/2018
Hospice Claim Reporting Requirements for Attending and Certifying Physicians
Hospice Claim Reporting Requirements for Attending and Certifying Physicians Under CMS' current guidelines, the hospice medical director or the hospice physician and the attending physician (if the beneficiary has one), must initially [...]
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Posting Date: 09/27/2024
LCD and Article Updates for September/October 2024
LCD and Article Updates for September/October 2024 A58152 Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP) The following ICD-10-CM diagnosis codes were added to Group 1- ICD-10-CM Codes That Support Medical necessity [...]
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Posting Date: 10/08/2021
Cardiovascular Disease Screening Tests
Preventive Services Guide Cardiovascular Disease Screening Tests Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Table of [...]
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Posting Date: 10/06/2021
Counseling to Prevent Tobacco Use
Preventive Services Guide Counseling to Prevent Tobacco Use Smoking is the leading preventable cause of disease, disability and death in the United States. It harms nearly every organ in the body and causes about one in every five deaths. [...]
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Posting Date: 11/10/2021
Depression Screening
Preventive Services Guide Depression Screening Also Known as Screening for Depression in Adults Coverage Criteria Covered annually At least 11 months must have passed since last depression screening G0444: Annual depression [...]
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Posting Date: 10/06/2021
Glaucoma Screening
Preventive Services Guide Glaucoma Screening Glaucoma is a group of eye diseases in which damage to the optic nerve results in loss of eyesight. Medicare beneficiaries over the age of 60 have an increased risk of developing glaucoma. CMS has [...]
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Posting Date: 10/06/2021
Hepatitis C Virus Screening
Preventive Services Guide Hepatitis C Virus Screening Hepatitis C is a virus that can damage the liver; it is transmitted through infected blood or body fluids. The most common way people get infected is by sharing needles used to inject [...]
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Posting Date: 10/08/2021
Human Immunodeficiency Virus Screening
Preventive Services Guide Human Immunodeficiency Virus Screening HIV attacks cells that help the body fight infection making a person vulnerable to other infections. Nearly 1.2 million Americans are now living with HIV infection and about [...]
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Posting Date: 10/11/2021
Intensive Behavioral Therapy for Cardiovascular Disease
Preventive Services Guide Intensive Behavioral Therapy for Cardiovascular Disease CVD generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain or stroke. CMS has determined [...]
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Posting Date: 10/11/2021
Intensive Behavioral Therapy for Obesity
Preventive Services Guide Intensive Behavioral Therapy for Obesity In 2003, the United States Preventive Services Task Force found good evidence that BMI “is reliable and valid for identifying adults at increased risk for mortality and [...]
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Posting Date: 11/07/2022
Medical Nutrition Therapy
Preventive Services Guide Medical Nutrition Therapy MNT is a dietary intervention that is used to prevent or treat health conditions that are caused by or made worse by unhealthy eating habits. Table of Contents Eligibility Criteria [...]
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Posting Date: 10/14/2021
Prostate Cancer Screening
Preventive Services Guide Prostate Cancer Screening Prostate cancer is the second most common cancer in men in the United States, after skin cancer. Older men, African-American men and men who have a family history of prostate cancer have a [...]
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Posting Date: 03/15/2019
Screening for Cervical Cancer with Human Papillomavirus Tests
Preventive Services Guide Screening for Cervical Cancer with Human Papillomavirus Tests Cervical cancer is commonly caused by the HPV. The USPSTF found that regular screening greatly reduces the rate of cervical cancer and the number of [...]
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