Medicare FQHC PWK Fax/Mail Cover Sheet

Overpayment Recovery Unit FQHC Voluntary Refund Form

Medical Nutrition Therapy

Diabetes Self-Management Training

Diabetes Screening

JK Medicare Secondary Payer Part B Carrier Voluntary Refund Form

Accessing Eligibility for MDPP in NGSConnex

5010 top page

5010 277CA Reject Code Lookup ToolTo view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code [...]

5010 top page for Durable Medical Equipment

5010 277CA Reject Code Lookup ToolTo view easy-to-understand descriptions associated with the edit code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code information [...]

ASP Drug Form Description

ASP Drug Resources

Note: Codes that have a $0 (zero) fee schedule amount will not display a search result.Locality/Area and County Information for IllinoisLocality/AreaCounties12Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. [...]

Ambulance Form Description

Ambulance Resources

Note: Codes that have a $0 (zero) fee schedule amount will not display a search result.Locality/Area and County Information for IllinoisLocality/AreaCounties12Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. [...]

Ambulatory Form Description

Ambulatory Resources

Note: Codes that have a $0 (zero) fee schedule amount will not display a search result.Locality/Area and County Information for IllinoisLocality/AreaCounties12Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. [...]

Levels of Appeals and Time Limits for Filing

Home Infusion Therapy

Modifiers

National Government Services Part A Medical Review Newsletter June 2021

National Government Services Part A Medical Review Newsletter June 2021The National Government Services MR Department would like to welcome you to our newest service; a regular newsletter. It is our hope that you will find this newsletter [...]

Article Updates for July 2021

Article Updates for July 2021Billing and Coding: Complex Drug Administration Coding (A58620)Under Article Text - Route of Administration Modifier revised the first sentence to read, “The use of the JA and JB modifiers is required for drugs [...]

Financial Contact Information Form

Immediate Recoupment Request Form – Electronic/E-mail

Credit Balance Report Reminders

Credit Balance Report RemindersFor the quarter ending 6/30/2021, CBRs can be submitted starting 7/1/2021 and must be submitted within 30 days to be considered timely.FISS/DDE users who submit the 838 detail page directly over the FISS/DDE [...]

Provider Enrollment: Understand the Process to Opt Out of Medicare

Provider Enrollment: Understand the Process to Opt Out of MedicareProviders that render services to a Medicare beneficiary must enroll with Medicare and submit a claim on behalf of the beneficiary. However, select providers can stay in [...]

July 2021 Release "Dark Days" for the Common Working File Hosts

July 2021 Release "Dark Days" for the Common Working File HostsFor the upcoming July 2021 Release:For Production, CWF will be observing the Gray Day on Thursday, July 1st and Dark Days starting Friday, July 2nd through Sunday, July 4th to [...]

National Government Services Part B Medical Review Newsletter June 2021

National Government Services Part B Medical Review Newsletter June 2021We hope you are enjoying our newest service; a regular newsletter. Our goal is to help you stay up-to-date on the on the MR activities performed here at National Government [...]

National Government Services: Raising Awareness about Care Management

National Government Services: Raising Awareness about Care ManagementAccording to the Center for Disease Control (CDC), an estimated 117 million adults have one or more chronic health conditions, and one in four adults have two or more chronic [...]

Medicare Telehealth versus Telemedicine

Medicare Telehealth versus TelemedicineWe have received many questions that have indicated confusion between telehealth and telemedicine, and which rules apply to which services within these two benefit categories. While there is a perceived [...]

Billing Tip for COVID-19 Vaccine as a Mass Immunizer Roster Biller - Use the Taxonomy Code

Billing Tip for COVID-19 Vaccine as a Mass Immunizer Roster Biller - Use the Taxonomy CodeNational Government Services highly recommends that Part B providers who are credentialed as a Mass Immunizer (specialty 73) and have multiple PTANs [...]

Annual Security Training/Certifying Access

Annual Security Training/Certifying AccessEvery 365 days NGSConnex LSOs and users are required to review the annual Security Awareness Training, including the rules of behavior and acknowledge access still is required. NGSConnex will display [...]

Use NGSConnex to Submit Quarterly Credit Balance Reports

Use NGSConnex to Submit Quarterly Credit Balance ReportsWe recently posted a news article that explained the process and benefits of using NGSConnex to submit quarterly credit balance reports. Today’s article contains the resolutions for common [...]

Reminder: General Anesthesia and Conscious Sedation is Not Medically Necessary for Facet Joint Interventions

Reminder: General Anesthesia and Conscious Sedation is Not Medically Necessary for Facet Joint InterventionsOn 4/25/2021 National Government Services revised the Local Coverage Determination L35936 “Facet Joint Interventions for Pain [...]

Prior Authorization Exemption: Part B Provider Role

Prior Authorization Exemption: Part B Provider RoleCMS has identified certain Part A HOPDs as having a prior authorization affirmation rate of 90% or greater. As a result, these HOPDs are currently exempt from submitting prior authorization [...]

National Government Services Proposed LCDs for Comment

National Government Services Proposed LCDs for CommentThe proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 6/3/2021 through 7/17/2021.These draft [...]

Why Use NGSConnex?

Why Use NGSConnex?Each day, thousands of claims and eligibility-based inquiries and other Medicare transactions are successfully completed through NGSConnex. As a registered NGSConnex user you will have instant online access to invaluable [...]

Registration is Now Open for the 2021 Home Health and Hospice Medicare Administrative Contractor Collaborative Summit

Registration is Now Open for the 2021 Home Health and Hospice Medicare Administrative Contractor SummitRegistration is now open for the HH+H MAC Collaborative Summit, Operation Collaboration: We are all in this Together. This summit will [...]

Lower Limb Orthosis: A/B and DME Collaborative Presentation

Lower Limb Orthosis: A/B and DME Collaborative PresentationThe A/B and DME MAC’s Lower Limb Orthosis: A/B and DME Collaborative Presentation - YouTube presentation is available. This video presentation provides suppliers information on the [...]

What To Do If You Can’t Log Into NGSConnex

What To Do If You Can’t Log Into NGSConnexIf you attempt to log into NGSConnex and are unsuccessful you must first determine the reason you can’t log in.First Attempt to Log InOn your first attempt if you enter your User ID and/or password [...]

New NGSMedicare.com is Coming Soon

New NGSMedicare.com is Coming SoonWe continue to listen and gain invaluable insight from you on our provider content website, NGSMedicare.com. Coming mid-Summer 2021, you will be able to see your feedback put into action.Watch this video for a [...]

Action Needed: Update Your Browser Now

Action Needed: Update Your Browser NowStarting July 2021, the NGSMedicare.com site will not support the Internet Explorer (IE) browser. For an optimal NGSMedicare.com experience, to access either the secure, self-service provider portal [...]

A/B and DME MAC Collaborative Therapeutic Shoes for Persons with Diabetes

A/B and DME MAC Collaborative Therapeutic Shoes for Persons with DiabetesProviders – Do you need assistance in understanding what is needed when ordering diabetic shoes? This collaborative webinar on therapeutic shoes for persons with diabetes [...]

May 2021 LCD Updates

May 2021 LCDs UpdatesFACET Joint Interventions for Pain Management (L35936)In the Summary of Evidence section, the following corrections have been made:Under the heading – Diagnostic Facet Joint Injections, a reference number has been added to [...]

Revised Fees for Code G0399

Revised Fees for Code G0399National Government Services has reviewed the fees for code G0399 (Home sleep test [HST] with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG; heart rate and 1 [...]

The Provider Contact Center Has a New Option for Diabetic Self-Management Training and Medical Nutrition Therapy Information

The Provider Contact Center Has a New Option for Diabetic Self-Management Training and Medical Nutrition Therapy InformationCalling the PCC to get information on DSMT and MNT just got easier. When you call the PCC and complete authentication, [...]

Reminder: Billing for Facet Joint Interventions for Pain Management and Anesthesia

Reminder: Billing for Facet Joint Interventions for Pain Management and AnesthesiaAs of 4/25/2021, per LCD L35936, general anesthesia is considered not reasonable and necessary for facet joint interventions. Neither conscious sedation nor [...]

Submitting Refunds to National Government Services

Submitting Refunds to National Government ServicesNational Government Services is receiving an influx of unsolicited voluntary refunds without proper documentation.To facilitate prompt and accurate posting of unsolicited monies or voluntary [...]

Children’s Hospitals Verification of Age for Eligibility

Billing and Coding: Complex Drug Administration Coding for Subcutaneous and Intramuscular Routes (A58620) Reminder

Billing and Coding: Complex Drug Administration Coding for Subcutaneous and Intramuscular Routes (A58620) Reminder National Government Services identified claim billing errors for complex drug administration coding for subcutaneous and [...]

COBA Medigap Claim-Based IDs

Prolonged Services: Non-Face-to-Face

Prolonged Services: Non-Face-to-Face Code Definition Provider Guidance As of 1/1/2017, CMS authorized non face-to-face prolonged services (CPT codes 99358‒99359) as payable services. In conjunction with this approval, CMS [...]

Span Date Billing Guide

Span Date Billing Guide Certain DMEPOS items must be submitted with span dates according to the number of days the item or service is being rendered. When billing with span dates, the “From” date should reflect the date that the item was [...]

Provider Revalidation Interactive Tool_Intro

Provider Revalidation Interactive Tool  This tool is designed to assist Part B applicants who are revalidating enrollment. If the reason for your application is other than revalidation, then please refer to the Enrollment tab on our [...]

Improving Customer Experience in 2021

Improving Customer Experience in 2021We are committed to improving your experience. Each day, we review comments from providers who submit surveys to let us know what is working well and how we can improve. We appreciate your feedback. This is [...]

May is National Mental Health Awareness Month

May is National Mental Health Awareness MonthAlthough May is the month of national focus on mental health awareness, it is a daily focus for many dealing with mental health conditions. Integrating behavioral health care with primary care [...]

Reminder: Medicare Part B Voluntary Refunds

Reminder: Medicare Part B Voluntary RefundsProviders submitting voluntary refunds need to be aware that when completing the Part B Voluntary Overpayment Refund Form, additional claim data is required:Complete the Part B Voluntary Overpayment [...]

Cognitive Assessment and Care Plan Services (CPT 99483)

Cognitive Assessment and Care Plan Services (CPT 99483)Medicare covers a separate visit for a cognitive assessment if your patient shows signs of cognitive impairment at their annual wellness visit or a routine visit. The cognitive assessment [...]

MACs to Host Multi-Jurisdictional CAC Meeting Regarding Facet Joint and Medial Nerve Branch Procedures

MACs to Host Multi-Jurisdictional CAC Meeting Regarding Facet Joint and Medial Nerve Branch ProceduresThe MACs will host a multi-jurisdictional CAC via Teleconference on 5/28/2020 from 1:00 p.m.‒4:00 p.m. CDT, 2:00 p.m.‒5:00 p.m. [...]

MAC Customer Experience Survey

MAC Customer Experience SurveyWe often receive feedback from our website users who get frustrated because our MCE survey displays before they are done visiting our website. We understand that it’s better for you to finish your visit before you [...]

Hospice Cap Self-Reporting Reminder

Hospice Cap Self-Reporting ReminderThe Hospice Cap Self-Reporting for the 2020 Cap Year (10/1/2019-9/30/2020) is due no later than 3/1/2021. Hospice providers should submit the pro-forma calculation along with supporting documentation and a [...]

New PC-ACE Version Will Soon Be Available

New PC-ACE Version Will Soon Be AvailableA new version PC-ACE Version 4.6.0.100 will be available 6/2/2020 for download from our website. This new PC-ACE version has been updated to include new HCPCS and ICD-10 diagnosis codes for COVID-19. [...]