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Posting Date: 08/02/2022
Certified Provider and State Survey Agency
Certified Provider and State Survey Agency Table of Contents Certified Provider and State Survey Agency Certified Providers/Suppliers Certified Providers and Certified Suppliers That Enroll Via the Form CMS-855A Certified Suppliers [...]
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Posting Date: 06/30/2021
Understanding the Approval Recommendation Process for Certified Providers
Understanding the Approval Recommendation Process for Certified Providers The certified provider completes and submits a CMS-855 enrollment application and all supporting documentation to its MAC, including any state require documentation [...]
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Posting Date: 08/21/2018
Certified Provider and State Survey Agency
Certified Provider and State Survey Agency Table of Contents Certified Provider and State Survey Agency Certified Providers/Suppliers Certified Providers and Certified Suppliers That Enroll Via the Form CMS-855A Certified Suppliers That [...]
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Posting Date: 12/12/2024
MLN Connects® Newsletter: December 12, 2024
MLN Connects® Newsletter: December 12, 2024 News FY 2024 Medicare Fee-for-Service Improper Payment Rate Revised Home Health Change of Care Notice Form Effective February 1 Skilled Nursing Facility Value-Based Purchasing Program: December [...]
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Posting Date: 12/12/2024
Your Lunchtime Treat! Listen to the Navigating Medicare: Part A Insights for Providers Podcast
Your Lunchtime Treat! Listen to the Navigating Medicare: Part A Insights for Providers Podcast “Lunch, listen and learn” twice a month with Medicare Part A! We have more than 15 Part A podcasts geared toward our Part A providers and their [...]
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Posting Date: 12/12/2024
Intermittent Issues with NGSMedicare.com on 12/15/2024
Intermittent Issues with NGSMedicare.com on 12/15/2024 We will experience intermittent outages with NGSMedicare.com on Sunday, 12/15/2024 due to maintenance. NGSMedicare.com will be fully operational on Monday, 12/16/2024. We apologize for [...]
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Posting Date: 12/12/2024
Billing and Coding: Omalizumab
Billing and Coding: Omalizumab drug A52448 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52448 J2357
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Posting Date: 12/12/2024
HCPCS 82947 RTPs End-Stage Renal Dialysis Providers
As of 1/1/2024, Medicare has covered HbA1c tests for diabetic screening (HCPCS 82947) when billed with ICD-10 Z13.1. Some of these claims submitted by ESRD providers have been RTP'd in error.
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Posting Date: 12/12/2024
End Stage Renal Disease Claims Returning to Providers with Reason Code 31773
Due to an issue with the October 2024 release, ESRD facility claims, type of bill 72X, are RTPing in error.
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Posting Date: 12/20/2024
Part A Fall 2024 Virtual Conference Playback
Part A Fall 2024 Virtual Conference Playback As part of our efforts to educate our provider community, we have posted all 16 educational sessions from our recent Part A Fall 2024 Virtual Conference: Keeping Compliant with Medicare Starts [...]
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Posting Date: 12/20/2024
Attention FQHCs: Who Is Your MAC?
Attention FQHCs: Who Is Your MAC? National Government Services serves as the CMS Jurisdiction 6 and K MAC for FQHCs in 44 states, Washington D.C. and the five United States Territories of American Samoa, Guam, Northern Mariana Islands, Puerto [...]
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Posting Date: 12/20/2024
What Is Fraud_Part A_B_FQHC_HHH
What Is Fraud? What Is Medicare Fraud? Medicare Fraud is intentionally submitting false information to a government contractor to receive money or a benefit by knowingly and willfully executing a scheme to defraud this health care benefit [...]
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Posting Date: 12/20/2024
What Is Abuse_Part A_B_FQHC_HHH
What Is Abuse? What Is Abuse? Abuse describes incidents or practices that are: not medically necessary as defined by Medicare guidelines; or inconsistent with accepted sound medical, business or fiscal practices. Abuse occurs when individuals [...]
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Posting Date: 12/20/2024
Fraud and Abuse_Part A_B_FQHC_HHH
Fraud & Abuse Fraud & Abuse Medicare fraud can cost the United States government hundreds of millions of dollars each year and the dollars lost increase the strain on the Medicare Trust Fund. CMS works with other government contractors and law [...]
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Posting Date: 12/20/2024
How Do I Report Suspected Fraud_Part A_B_FQHC_HHH
How Do I Report Suspected Fraud? How Do I Report Suspected Fraud? Table of Contents How Do I Report Suspected Fraud? Department of Health and Human Services OIG CMS Fraud Prevention Tools Instructions for Accessing the Medscape Modules [Return [...]
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Posting Date: 06/02/2023
Billing Original Fee-for-Service Medicare? You Can Help STOP Assignment Violations!
Billing Original Fee-for-Service Medicare? You Can Help STOP Assignment Violations! Table of Contents Billing Original Fee-for-Service Medicare? You can Help STOP Assignment Violations! What is the Definition of Medicare Assignment? [...]
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Posting Date: 02/23/2017
What is NGSConnex?
What is NGSConnex? NGSConnex is a free, secure, web-based application developed by National Government Services just for you! NGSConnex provides access to a wide array of self-service functions that save you time and money, such as: Obtain [...]
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Posting Date: 01/02/2025
The Medicare Appeals Process: What You Need to Know
This informative session will help you navigate Medicare’s appeals process by providing information on what an appeal is, how to determine if a claim can be appealed, who may file an appeal, the appeal levels, timeframes and documentation [...]
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Posting Date: 01/02/2025
Who is My LSO?
Who is My LSO? Select the Manage Account button on the NGSConnex home page. Select User Profile and scroll down to the ‘System Access’ section. Select the Checkbox next to the provider record you want to determine the LSO for. [...]
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Posting Date: 01/02/2025
Magnetic Resonance Angiography (MRA)
Magnetic Resonance Angiography (MRA) gadolinium, contrast, imaging L33633 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33633 A56747 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56747 70544, [...]
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Posting Date: 01/02/2025
LCD/Billing and Coding Article Updates – December 2024–January 2025
LCD/Billing and Coding Article Updates – December 2024–January 2025 Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG) (L39189) – Effective 12/15/2024 Under the Indications of Coverage, added the following language: "The use of [...]
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Posting Date: 01/02/2025
Proper Part B Claim Submissions
This webinar is intended to educate providers and office staff members on how to complete a clean claim to avoid claim rejections, developments or denials. We will guide you through the CMS-1500 claim form and the electronic equivalent loops [...]
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Posting Date: 01/02/2025
Reducing Unprocessable Claims
When claims are submitted with invalid, incomplete or incorrect information, our claims processing system will detect these errors and will reject claims as unprocessable. Our goal is to assist our providers in submitting claims correctly the [...]
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Posting Date: 01/02/2025
Steps to Claim Corrections
This webinar includes the top continuous errors we find at National Government Services with claim submissions. Join us to learn how to correct your claims. We will also include an interactive segment on the different claim scenarios that cause [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction 6 Part A Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Nail Debridement 11719-11721 55B23– The service provided is not covered Medicare benefit. [...]
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Posting Date: 01/02/2025
Provider Enrollment Revalidation Overview
During this webinar, learn about important changes in the revalidation process, how to determine Medicare enrollment revalidation due date and information to avoid disruption in Medicare billing.
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Posting Date: 01/02/2025
PECOS: View and Manage Reassignments through Group Enrollment
During this webinar, we’ll provide an understanding of how to view and manage reassignments through the group enrollment in Provider Enrollment, Chain and Ownership System (PECOS), including to add or terminate reassignments. Individual [...]
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Posting Date: 01/02/2025
Counseling to Prevent Tobacco Use
In an effort to raise awareness and increase utilization of tobacco use counseling, we’ll focus on the effects of nicotine dependence including affected health consequences during this webinar. Medicare coverage, coding, billing and [...]
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Posting Date: 01/02/2025
Preventive Services: Flu and PPV Vaccines
During this webinar, we will review the coverage, coding and billing guidelines under Medicare Part B for Influenza and Pneumococcal Pneumonia Virus vaccinations.
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Posting Date: 01/03/2025
Self-Administered Drug Exclusion List - Medical Policy Article (Jurisdiction K Only)
Self-Administered Drug Exclusion List - Medical Policy Article (Jurisdiction K Only) SAD A53021 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53021 C9399, J0129, J0139, J0270, J0364, J0593, J0599, J0630, J0801, [...]
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Posting Date: 01/03/2025
Self-Administered Drug Exclusion List - Medical Policy Article (Jurisdiction 6 Only)
Self-Administered Drug Exclusion List - Medical Policy Article (Jurisdiction 6 Only) SAD A53022 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53022 C9399, J0129, J0139, J0270, J0364, J0593, J0599, J0630, J0801, [...]
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Posting Date: 01/03/2025
Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) ionizing, stereotactic guidance, robotic L35076 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=35076 A56874 [...]
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Posting Date: 01/03/2025
Psychiatric Partial Hospitalization Programs
Psychiatric Partial Hospitalization Programs mental illness, family counseling, vocational training L33626 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33626 A56850 [...]
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Posting Date: 01/03/2025
Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane)
Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™) drug A52450 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52450 J9264, J9267
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Posting Date: 01/03/2025
Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor
Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor N/A L37421 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37421 A57435 https://www.cms.gov/medicare-coverage-database/view/article.aspx?art[...]
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Posting Date: 01/03/2025
Off-Label Use of Intravenous Immune Globulin (IVIG)
Off-Label Use of Intravenous Immune Globulin (IVIG) L39314 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39314 A59105 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59105 A59251 [...]
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Posting Date: 01/03/2025
Noninvasive Vascular Studies
Noninvasive Vascular Studies NonInvasive, leg, clot, plethysmography, duplex scan, Doppler, cerebrovascular, arterial, venous, hemodialysis L33627 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33627 A56758 [...]
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Posting Date: 01/03/2025
Molecular Pathology Procedures
Molecular Pathology Procedures genetic testing, genetic counseling, gene, Tier 1, Tier 2 L35000 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=35000 A56199 https://www.cms.gov/medicare-coverage-database/view/article.aspx?arti[...]
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Posting Date: 01/03/2025
Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms
Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms N/A L37810 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37810 A56867 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=5686[...]
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Posting Date: 01/03/2025
Implantable Continuous Glucose Monitors (I-CGM)
Implantable Continuous Glucose Monitors (I-CGM) N/A L38623 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38623 A58116 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58116 A58342 [...]
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Posting Date: 01/03/2025
Facet Joint Interventions for Pain Management
Facet Joint Interventions for Pain Management Radiofrequency, Neurotomy, pain, cervical, lumbar, thoracic L35936 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35936 A57826 [...]
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Posting Date: 01/03/2025
Billing and Coding: Eculizumab
Billing and Coding: Eculizumab drug, hemolysis A54548 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54548 J1300, Q5139
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Posting Date: 01/03/2025
Billing and Coding: Bevacizumab and Biosimilars
Billing and Coding: Bevacizumab and Biosimilars drug, retinal A52370 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52370 C9257, J3590, J9035, Q5107, Q5118, Q5126, Q5129, 67028
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Posting Date: 01/03/2025
Cardiac Catheterization and Coronary Angiography
Cardiac Catheterization and Coronary Angiography heart, circulatory L33557 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33557 A52850 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52850 36140, [...]
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Posting Date: 07/15/2022
LSO Responsibilities
LSO Responsibilities The LSO is responsible for managing and monitoring access for other NGSConnex users within the organization. LSOs are responsible for approving access to users requesting data access to a specific provider account [...]
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Posting Date: 01/02/2025
Improving Customer Experience
Improving Customer Experience We are committed to improving your experience. Please watch this two-minute video that explains how each day we review comments from providers who submit surveys to let us know what is working well and how we can [...]
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Posting Date: 01/03/2025
Getting Access to PECOS
During this webinar, we’ll discuss how to obtain access to the Internet-based Provider Enrollment Chain & Ownership System (PECOS) and gain connection to provider enrollment record as well as understand other Centers for Mediacre & Medicaid [...]
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Posting Date: 01/03/2025
All LOBs - Customer Xperience
Thank You For Your Feedback! /web/ngs/news-article-details?selectedArticleId=11220579
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Posting Date: 01/03/2025
12/12/2024 Part B POE Advisory Group Meeting
12/12/2024 Part B POE Advisory Group Meeting Meeting Minutes Meeting Time: 10:00 a.m.‒12:00 p.m. ET Member Attendees: Elizabeth Aldrich, Dawson Ballard, Doris Barnes, Sheila Bembeneck, Madelon Berger, Louise Bertrand, Kimberly Bischel, [...]
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Posting Date: 04/14/2022
Meeting Minutes
Meeting Minutes Jurisdiction 6 and Jurisdiction K Combined Meeting 12/12/2024 Meeting 9/18/2024 Meeting 6/12/2024 Meeting 3/13/2024 Meeting
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Posting Date: 01/03/2025
Prepare and Submit a Medicare Secondary Payer Claim
Table of Contents Background Step 1: Determine If You Must Submit an MSP Claim Step 2: Prepare an MSP Claim MSP Billing Code Table Step 3: Check for a Matching MSP Record for the Beneficiary in the Common Working File Step [...]
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Posting Date: 06/14/2023
Meeting Minutes
Meeting Minutes Jurisdiction 6 Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Jersey, New York, Northern Mariana Island, Oregon, Puerto Rico, U.S. Virgin Islands, Washington and Wisconsin [...]
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Posting Date: 11/15/2022
Proper Billing for TEZSPIRE™ HCPCS Code J2356
Proper Billing for TEZSPIRE™ HCPCS Code J2356 Table of Contents Proper Billing for TEZSPIRE™ HCPCS Code J2356 Claim Completion Requirements Drug Wastage Appropriate Administration Coding Related Content [Return to Top] Proper [...]
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Posting Date: 04/15/2022
Jurisdiction K State Licensing and Certification Websites
State Licensing and Certification Websites The following list contains helpful links to websites of some organizations within the JK jurisdictions that can be used to verify your status. Table of Contents Connecticut Maine Massachusetts [...]
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Posting Date: 01/30/2020
DX Proc Codes ICD-10 (1B)
Chapter IV: Inquiries Submenu (01) DX Proc Codes ICD-10 (1B) Purpose The purpose of the DX/PROC CODES ICD-10 option is to provide a reference of ICD-10 code(s) used to identify a specific or various diagnosis codes or inpatient surgical [...]
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Posting Date: 11/16/2021
Jurisdiction 6 State Licensing and Certification Websites
State Licensing and Certification Websites The following list contains helpful links to websites of some organizations within the J6 jurisdictions that can be used to verify your status. Table of Contents Illinois Minnesota Wisconsin [...]
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Posting Date: 07/11/2023
Overcoming Barriers to Tobacco Counseling
Overcoming Barriers to Tobacco Counseling Healthcare providers do face several challenges when implementing tobacco cessation counseling into a clinical practice routine. These various factors influence the healthcare professionals’ [...]
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Posting Date: 10/06/2021
Screening Mammography
Preventive Services Guide Screening Mammography A mammogram is an X-ray of the breast. Screening mammograms are routinely administered to detect breast cancer in women who have no apparent symptoms. Coverage Guidelines and Frequency Limits [...]
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Posting Date: 01/26/2021
Other Medicare Contacts
Other Medicare Contacts Organization Contact Information ALJ BP Tower & Garage 200 Public Square, Suite 1300 Cleveland, OH 44114-2316 American Medical Association Website Phone: [...]
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