Answers to Common Fee-For-Time Compensation Arrangements Questions

Save the Dates! National Government Services Fall 2023 Virtual Conference for Medicare Part A Providers

Save the Dates! National Government Services Fall 2023 Virtual Conference for Medicare Part A Providers Ending 2023 on a Strong Medicare Note 11/1/2023-11/2/2023 The National Government Services POE Team will be holding our bi-annual virtual [...]

Join Us for the A/B DME Collaborative Surgical Dressings Webinar

Join Us for the A/B DME Collaborative Surgical Dressings Webinar Representatives from all four DME MAC jurisdictions and the A/B MACs will explain medical record requirements for surgical dressings. We hope you’ll join the MACs for this [...]

October 2023

In This Issue National Government Services Articles for Part A and Part B Providers Dental Services: Billing and Coding Article A59543 is Available EDI Spotlight: Strengthening Security Local Coverage Determination Open Meeting [...]

Don't Miss Out - Register Today! National Government Services: Medicare Part B Care Management Tuesdays

Don't Miss Out - Register Today! National Government Services: Medicare Part B Care Management Tuesdays According to the CDC, six in ten adults in the U.S. have a chronic disease and four in ten adults have two or more. As your Medicare [...]

LCD and Billing and Coding Article Update for October 2023

LCD and Billing and Coding Article Update for October 2023 Billing and Coding: Autonomic Function Testing (A57024) Due to the annual ICD-10 Code updates, ICD-10 code G20 has been deleted and the following ICD-10 codes have been added: G20.A1, [...]

Decrease Burden and Combine Multiple PDFs into One Before Responding to Additional Documentation Requests Using NGSConnex

Decrease Burden and Combine Multiple PDFs into One Before Responding to Additional Documentation Requests Using NGSConnex Recently, National Government Services has seen an increase in providers submitting multiple PDF attachments for the same [...]

MLN Connects® Newsletter: September 28, 2023

MLN Connects® Newsletter: September 28, 2023     News CMS Statement on Current Status of Blood Tests for Organ Transplant Rejection CMS Roundup (Sept 22, 2023) Cardiovascular Disease: Talk with Your Patients about [...]

Medicare Part B CMS-1500 Crosswalk for 5010 Electronic Claims

Collaborative A/B/DME Therapeutic Shoes for Persons with Diabetes Webinar

Collaborative A/B/DME Therapeutic Shoes for Persons with Diabetes Webinar Providers – Do you need assistance in understanding what is needed when ordering diabetic shoes? This collaborative webinar on Therapeutic Shoes for Persons with [...]

Billing for Services Not Included in the FQHC Benefit

Billing for Services Not Included in the FQHC Benefit Table of Contents Billing for Services Not Included in the FQHC Benefit Ambulance Services Body Braces Durable Medical Equipment Laboratory Services Medicare-Excluded [...]

Repetitive Outpatient Services for Providers Submitting Institutional Outpatient Claims

Repetitive Outpatient Services for Providers Submitting Institutional Outpatient Claims Table of Contents Repetitive Outpatient Services for Providers Submitting Institutional Outpatient Claims Repetitive Services Repetitive Services [...]

What All Facilities Need to Know About the Long-Term Care Hospital Three-Day or Less Interrupted Stay Policy

What All Facilities Need to Know About the Long-Term Care Hospital Three-Day or Less Interrupted Stay Policy Table of Contents What All Facilities Need to Know About the Long-Term Care Hospital Three-Day or Less Interrupted Stay Policy [...]

Hospitals Must Correctly Assign Severe Malnutrition Diagnosis Codes to Inpatient Claims

Hospitals Must Correctly Assign Severe Malnutrition Diagnosis Codes to Inpatient Claims Table of Contents Hospitals Must Correctly Assign Severe Malnutrition Diagnosis Codes to Inpatient Claims Hospital Action(s) Related Content [...]

COVID-19 Part A Frequently Asked Questions

COVID-19 Part A Frequently Asked Questions Table of Contents COVID-19 Part A Frequently Asked Questions Section B. Diagnostic Laboratory Services Section LL. Hospital Billing for Remote Services Section MM. Outpatient Therapy Services [...]

Fiscal Intermediary Standard System Direct Data Entry Screen Changes – October 2023

Fiscal Intermediary Standard System Direct Data Entry Screen Changes – October 2023 The October 2023 quarterly system release was implemented on 10/2/2023 and includes the FISS DDE screen changes identified below. CMS issued CR 13138 which [...]

Tip Sheet: Proper Use of Modifier 25

Tip Sheet: Proper Use of Modifier 25 A review of top claim reason codes indicate a steady reoccurrence of claims being returned to provider (RTP) for reason code W7021, when there was a medical visit on same day as a type 'T' or 'S' procedure [...]

Three-Day Qualifying Hospital Stay Required for Medicare-Covered SNF Stay

Three-Day Qualifying Hospital Stay Required for Medicare-Covered SNF Stay Table of Contents Three-Day Qualifying Hospital Stay Required for Medicare-Covered SNF Stay Additional Information Billing Reminders Related Content [Return to [...]

MLN Connects® Newsletter: October 5, 2023

MLN Connects® Newsletter: October 5, 2023     News Administration Moves Forward with Medicare Drug Price Negotiations to Lower Prescription Drug Costs for People with Medicare CMS Requests Public Input on Coverage of [...]

Update on proposed LCD for Transesophageal Echocardiography

Update on proposed LCD for Transesophageal Echocardiography The LCD for Transesophageal Echocardiography (TEE) was published for comment and presented at an Open Meeting in July 2023. NGS is continuing to assess the provisions in this LCD and [...]

MLN Connects® Newsletter: October 6, 2023

MLN Connects® Newsletter: October 6, 2023     News COVID-19: Updated Novavax COVID-19 Vaccine, Adjuvanted for Patients 12 & Older Posted 10/6/2023

Cognitive Assessment and Care Plan Services CPT Code 99483

Cognitive Assessment and Care Plan Services CPT Code 99483 Effective 1/1/2021, Medicare increased payment for these services to $282 (may be geographically adjusted) when provided in an office setting, added these services to the definition of [...]

Mental Health Crisis Help

Mental Health Crisis Help Anyone experiencing a mental health crisis, including substance use crisis or thoughts of suicide, can get confidential support 24/7 by calling 988 or visiting the 988 Suicide & Crisis Lifeline website. View the [...]

Notification of the 2024 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review

Notification of the 2024 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review The amount that must remain in controversy for ALJ hearing requests filed on or [...]

MLN Connects® Newsletter: October 12, 2023

MLN Connects® Newsletter: October 12, 2023     News CMS Roundup (Oct 6, 2023) Protect Your Patients: Give Them a Flu Shot Publications Direct Data Entry: 10-Digit Screen Expansion Medicare Preventive Services — [...]

Let’s Get Ready for The Great American Smokeout on 11/16/2023!

Let’s Get Ready for The Great American Smokeout on 11/16/2023! For more than 40 years, the American Cancer Society has hosted the Great American Smokeout on the third Thursday of November. This yearly event is a call for action, not just for [...]

Prior Authorization Exemption Process FAQ

Prior Authorization Exemption Process FAQ How many days notice will I receive before I switch from PAR submissions to an exemption cycle? Answer: MACs will provide a 60-day notice prior to any transition period, continuation, or withdrawal [...]

NGSConnex User Guide

Initiate a Claim Status Lookup

Initiate a Claim Status Lookup Click the Claim Status Lookup button from the NGSConnex homepage. In the Select a Provider panel, click the Select button next to the applicable provider account. To search for claims use the filter [...]

Check Status of Prior Authorization Requests

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Tip Sheet #2

National Government Services Office of Congressional Affairs Inquiry: Tip Sheet #2 Tips for a Congressional Inquiry to Move Forward Without Delay Each congressional inquiry includes a ‘Consent for Release’ form of Medicare personal records [...]

Reopening Not Appropriate to Change Diagnosis on Paid Claims

Reopening Not Appropriate to Change Diagnosis on Paid Claims National Government Services periodically receives reopening requests to change the diagnosis on a paid claim.  Submitting a new, or corrected diagnosis on a claim that has [...]

MLN Connects® Newsletter for Thursday, December 2, 2021

MLN Connects® Newsletter for Thursday, December 2, 2021 National Influenza Vaccination Week News National Influenza Vaccination Week Clinical Laboratory Fee Schedule: CY 2022 Final Payment Determinations Skilled Nursing Care & [...]

MLN Connects® Special Edition for Friday, January 7, 2022

MLN Connects® Special Edition for Friday, January 7, 2022 COVID-19: New HCPCS Code for Remdesivir Antiviral Medication Following the recent statement from the National Institutes of Health (NIH) COVID-19 Treatment Guidelines Panel regarding [...]

MLN Connects® Newsletter for Thursday, February 3, 2022

MLN Connects® Newsletter for Thursday, February 3, 2022 Provider Compliance Virtual Focus Group — February 24 News COVID-19: Letter to Health Care Facility Administrators on Health Care Worker Vaccination Rule COVID-19 Vaccine & [...]

MLN Connects® Newsletter for Thursday, February 17, 2022

MLN Connects® Newsletter for Thursday, February 17, 2022 Expanded Coverage: Lung Cancer Screening with Low Dose Computed Tomography News CMS Expands Coverage of Lung Cancer Screening with Low Dose Computed Tomography There’s Still Time [...]

MLN Connects® Special Edition for Friday, February 18, 2022

MLN Connects® Special Edition for Thursday, February 18, 2022 COVID-19 Monoclonal Antibodies: FDA Authorized Bebtelovimab On February 11, the FDA authorized the emergency use of the monoclonal antibody bebtelovimab for the treatment of [...]

MLN Connects® Newsletter for Thursday, February 24, 2022

MLN Connects® Newsletter for Thursday, February 24, 2022 CMS Released Skilled Nursing Facility & ESRD Web Pricers News Podiatry Nail Debridement & Evaluation and Management Services: Comparative Billing Report Skilled Nursing [...]

MLN Connects® Newsletter for Thursday, March 17, 2022

MLN Connects® Newsletter for Thursday, March 17, 2022 Kidney Health: Help Address Disparities News Medicare Shared Savings Program: Application Deadlines for January 1, 2023, Start Date Kidney Health: Help Address Disparities Claims, [...]