A/B Rebilling Facts

A/B Rebilling Facts The following information applies to inpatient hospital admissions on/after 10/1/2013 per final rule CMS-1599-F. Background When a Medicare Part A payment cannot be made because an inpatient admission is found to not be [...]

Condition Code G0 Reminder

Condition Code G0 Reminder National Government Services has noticed an increase in the number of claims reporting CC G0 (zero) inappropriately. Please review the following information so that your claims are not rejected or denied due to [...]

Federally Qualified Health Centers Behavioral Health Claims Job Aid

Federally Qualified Health Centers Behavioral Health Claims Job Aid Historically, FQHCs reported behavioral health with codes 90805, 90807 and 90809 with revenue code 0900. However, those codes terminated effective 12/31/2012. Effective [...]

Federally Qualified Health Centers Contracting with Medicare Advantage Plans

Federally Qualified Health Centers Contracting with Medicare Advantage Plans Requirements to Receive Wrap-Around Payments from Medicare The FQHC must have a written contract with the Medicare Advantage (MA) plan that contain the terms [...]

MLN Connects® Newsletter for Thursday, May 5, 2022

MLN Connects® Newsletter for Thursday, May 5, 2022 COVID-19 Patients Can Get Free Over-the-Counter Tests from Participating Providers News COVID-19: Patients Can Get Free Over-the-Counter Tests from Participating Providers [...]

J6 Medicare Secondary Payer Part B Carrier Voluntary Refund Form

MLN Connects® Newsletter for Thursday, July 7, 2022

MLN Connects® Newsletter for Thursday, July 7, 2022 Expanding Access to Emergency Care Services in Rural Communities News Taking Action to Expand Access to Emergency Care Services in Rural Communities People with Disabilities: Help [...]

MLN Connects® Special Edition for Tuesday, June 21, 2022

MLN Connects® Special Edition for Tuesday, June 21, 2022 Home Health & ESRD Proposed CY 2023 Payment Rules Home Health Agencies: Calendar Year 2023 Proposed Rule — Submit Comments by August 16 ESRD Facilities: Calendar Year 2023 [...]

Reminder: 340B-Acquired Drug Claim Appeal Requests

Reminder: 340B-Acquired Drug Claim Appeal Requests Beginning 1/1/2018, separately payable Part B drugs (assigned status indicator “K”), other than vaccines (assigned status indicator “L” or “M”) and drugs on pass-through payment status [...]

Billing Not Otherwise Classified Codes

Billing Not Otherwise Classified Codes When billing NOC codes, if you give a comparable code for the service performed, please include the actual name of the surgical or medical procedure. In some cases, this will eliminate the need to develop [...]

MLN Connects® Special Edition for Thursday, July 7, 2022

MLN Connects® Special Edition for Thursday, July 7, 2022 CMS Proposes Physician Payment Rule to Expand Access to High-Quality Care On July 7, CMS issued the Calendar Year 2023 Physician Fee Schedule (PFS) proposed rule, which would [...]

MLN Connects® Special Edition for Friday, July 15, 2022

MLN Connects® Special Edition for Friday, July 15, 2022 CMS Proposes Rule to Advance Health Equity, Improve Access to Care & Promote Competition and Transparency CMS is proposing actions to advance health equity and improve access to care [...]

MLN Connects® Special Edition for Thursday, April 7, 2022

MLN Connects® Special Edition for Thursday, April 7, 2022 Returning to Certain Pre-COVID-19 Policies & Coverage of Monoclonal Antibodies for Alzheimer's Disease Stakeholder Call CMS Returning to Certain Pre-COVID-19 Policies in [...]

Your Feedback In Action – Medical Policies

Your Feedback In Action – Medical Policies We frequently receive comments through our customer experience surveys that providers cannot find an associated LCD or billing and coding article for a specific procedure within our Medical Policies [...]

You Asked – We Listened: Locating our Contact Information

You Asked – We Listened: Locating our Contact Information We often receive comments through our customer experience surveys that providers are not able to find our contact information. NGS contact information is located in the Resources [...]

Changing or Resetting Your EDI Gateway Password

Changing or Resetting Your EDI Gateway Password The EDI Gateway Self-Service Password Portal is a simple/secure, web-based process for changing or resetting passwords for EDI Trading Partners. There are differences in the steps for these [...]

MLN Connects® Newsletter for Thursday, July 21, 2022

MLN Connects® Newsletter for Thursday, July 21, 2022 988 Suicide & Crisis Lifeline Available Nationwide News 988 Suicide & Crisis Lifeline Available Nationwide COVID-19: Novavax Vaccine, Adjuvanted — New Codes Allergy & [...]

MLN Connects® Newsletter for Thursday, July 14, 2022

MLN Connects® Newsletter for Thursday, July 14, 2022 COVID-19: FDA Authorizes Pharmacists to Prescribe PAXLOVID with Certain Limits News COVID-19: FDA Authorizes Pharmacists to Prescribe PAXLOVID with Certain Limits COVID-19: Moderna [...]

MLN Connects® Newsletter for Thursday, September 23, 2021

MLN Connects® Newsletter for Thursday, September 23, 2021 COVID-19: Compare Nursing Homes by Vaccination Rate View this edition as a: Webpage | PDF News CMS Launches New Medicare.gov Feature to Compare Nursing Homes by [...]

MLN Connects® Newsletter for Thursday, October 14, 2021

MLN Connects® Newsletter for Thursday, October 14, 2021 Pneumococcal Conjugate Vaccine, 20 Valent View this edition as a: Webpage | PDF News Pneumococcal Conjugate Vaccine, 20 Valent DATA 2000 Waiver Training Payments Still [...]