New Version of PC-ACE: January 2021

PC-ACE Version 4.9 contains several CMS mandates and product enhancements including but not limited to the items listed below.

• • 11939 - Quarterly Update to the MPFSDB - October 2020 Update
  • 11988 - Implement Operating Rules - Phase III ERA EFT: CORE 360 Uniform Use of CARC, RARC and CACG Rule - CAQH CORE
  • 10432 - ICD-10 and Other Coding Revisions to NCDs-April 2021
  • 12049 - Implementation of two new NUBC Condition Codes. Condition Code “90”, “Service provided as Part of an EA” and Condition Code “91”, “Service Provided as Part of an EUA”
  • 12071 - Summary of Policies in the CY 2021 MPFS Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List

*Part B Providers please note, that all COVID-19 vaccine codes do not populate any administration codes while generating the claim from Roster Billing Form in PC-ACE Version 4.9. When a COVID-19 vaccination code is selected in the Roster Billing functionality, a single-line claim will be created containing only the vaccine code. Users will need to add the appropriate Administration Code, if necessary, and will be responsible to select the correct code. This allows users the flexibility to bill COVID-19 related items to meet their business and payer needs. Users should verify/recalculate correct claim total and codes within PC-ACE claims list.

To download PC-ACE please access the NGS website, click on Claims & Appeals and then EDI Solutions. Once on the EDI Solutions landing page select EDI Software: PC-ACE and then Download PC-ACE.

Please take time on Wednesday 1/6/2021 to upgrade to the latest version (4.9) of the software.

If you have any questions or need assistance in downloading the PC-ACE upgrade from the EDI Solutions section, please contact the EDI Help Desk:

• • J6: 877-273-4334
  • JK: 888-379-9132

Posted 12/22/2020