Seasonal Influenza Vaccines Pricing

Seasonal Influenza Vaccines Pricing For Medicare billing purposes, the flu season runs from August to July of the following year. Medicare Part B covers one flu shot per flu season, if medically necessary, more than one per season may be [...]

Billing for Qutenza Administration (REVISED)

Billing for Qutenza Administration (REVISED) Qutenza is topical high concentration (8%) capsaicin which is administered by a physician. The FDA approved this treatment for neuropathic pain associated with PHN in 2009 and for neuropathic pain [...]

Prior Authorization Exemption Status Inquiry Tool

MLN Connects® Special Edition for Monday, September 12, 2022

MLN Connects® Special Edition for Monday, September 12, 2022 News Updated COVID-19 Vaccines Providing Protection Against Omicron Variant Available at No Cost Posted 9/12/2022

MLN Connects® Newsletter for Thursday, September 15, 2022

MLN Connects® Newsletter for Thursday, September 15, 2022 Make Your Voice Heard News Make Your Voice Heard Request for Information Seeks Public Comment to Promote Efficiency, Reduce Burden, & Advance Equity within CMS Programs [...]

Password Reset Requirements Checklist

Password Reset Requirements Checklist The following information will assist you in successfully resetting your password and eliminate any unnecessary disconnects. You should note that passwords expire every 60 days and can be reset prior to [...]

Changing Your EDI Password

Changing Your EDI Password EDI passwords have to be regularly changed or reset to maintain data security. You should note that passwords expire every 60 days and can be changed or reset prior to expiration. Follow these steps to change your [...]

EDI Self-Service Gateway Password Portal

EDI Self-Service Gateway Password Portal 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 password [...]

MLN Connects® Newsletter for Thursday, September 22, 2022

MLN Connects® Newsletter for Thursday, September 22, 2022 Encourage Preferred Flu Vaccines for Patients 65+ News Flu Shot: Encourage Preferred Vaccines for Patients 65+ Cataract Surgery: Comparative Billing Report Do You Only Order or [...]

Notice Regarding Targeted Probe and Educate Topic: Breast Ultrasound

Notice Regarding Targeted Probe and Educate Topic: Breast Ultrasound National Government Services has received approval from CMS to deny related claims (modifier 26 and/or TC) in accordance to the CMS IOM Publication 100-08, Medicare Program [...]

Billing and Coding and Medical Policy Article Updates September/October 2022

Billing and Coding and Medical Policy Article Updates September/October 2022 Billing and Coding: Bevacizumab and biosimilars (A52370) Based on Transmittal 11594, (CR 12885) October 2022 Update of the Hospital OPPS, HCPCS code C9142 has been [...]

Reminder: Documenting Physical Therapy Services

Reminder: Documenting Physical Therapy Services Insufficient documentation causes most improper payments. Visit our CERT Alerts webpage for Topic specific articles that provide instructions and resources for submitting appropriate [...]

Removal of HCPCS Code

Removal of HCPCS Code Prior Authorization Update Effective immediately, for claims with dates of service on or after 1/7/2022, the Centers for Medicare & Medicaid Services is removing current procedural terminology code 67911 (correction [...]

Appropriate Use Criteria

MLN Connects® Newsletter for Thursday, September 29, 2022

MLN Connects® Newsletter for Thursday, September 29, 2022​​​​​​​ News Resources & Flexibilities to Assist with Public Health Emergency in Puerto Rico Resources & Flexibilities to Assist with Public Health Emergency in Florida [...]

Diabetes Awareness

Drugs and Biologicals

Sleep Studies

Timely Filing