Increased Volume of Appeal Status Inquiries

Increased Volume of Appeal Status Inquiries National Government Services has seen an increase in pending reopenings and redetermination levels, resulting in cases being completed beyond the 60 calendar-day timeframe. We are sharing some [...]

PC-ACE Medicare Secondary Payer Reference Guide for Part B

PC-ACE Medicare Secondary Payer Reference Guide for Part B Payers (Insurance) Setup Payer Information Screen Patient Selection and Setup Setting up the Patient’s Insurance Information MSP Claim Entry (Line Level) MSP Claim Entry (Claim [...]

MLN Connects® Special Edition for Monday, April 18, 2022

MLN Connects® Special Edition for Monday, April 18, 2022 CMS Proposes Policies to Advance Health Equity & Maternal Health, Support Hospitals On April 18, CMS issued a proposed rule for inpatient and long-term hospitals that builds on the [...]

Part B Issue for Coinsurance Payments on Drug Code Claims

Due to an issue with a recent system update, 20% coinsurance for drug codes has been incorrectly calculated during the period of 10/27/2021-11/1/2021.

Anesthesia Conversion Factor Pricing Incorrect for 2022

The incorrect conversion file was loaded to production for dates of service starting 1/1/2022 which caused incorrect payments.

April and May 2022 Billing and Coding Article Updates

April/May 2022 Billing and Coding Article Updates Billing and Coding Articles Billing and Coding: Complex Drug Administration Coding (A58620) J0248 remdesivir (Veklury®) was added under Infusions Non-Chemotherapy Generic/Trade Names table [...]

Home Health PPS PC Pricer

MLN Connects® Special Edition for Thursday, July 29, 2021

MLN Connects® Special Edition for Thursday, July 29, 2021 4 Final FY 2022 Payment Rules Hospice Payment Rate Update: FY 2022 Final Rule IRF Prospective Payment System: FY 2022 Final Rule IPF Prospective Payment System: FY 2022 Final Rule [...]

Tips for Success

Tips for Success Speak naturally and clearly in a quiet environment. Use mute when you are not speaking. Avoid the use of cellular phones or speaker phones. Have all of the information available and organized before you call. Use [...]

Tips for Success

Tips for Success Speak naturally and clearly in a quiet environment. Use mute when you are not speaking. Avoid the use of cellular phones or speaker phones. Have all of the information available and organized before you call. Use [...]

Determine/Pay Application Fee

Determine/Pay Application Fee

Determine/Pay Application Fee

Cervical Fusion with Disc Removal

Cervical Fusion with Disc Removal National Government Services will begin accepting PARs for Cervical Fusion with Disc Removal on 6/17/2021 for services provided beginning on or after 7/1/2021. Checklist of PAR information to include: [...]

Low and No Medicare Utilization Cost Report

Low and No Medicare Utilization Cost Report No Utilization Cost Reports To comply with program cost reporting requirements, a provider that has not furnished any covered Medicare services during a cost reporting period must only complete the [...]

MLN Connects® Special Edition for Thursday, March 31, 2022

MLN Connects® Special Edition for Thursday, March 31, 2022 IPF & IRF Proposed FY 2023 Payment Rules Inpatient Psychiatric Facilities: Fiscal Year 2023 Proposed Rule — Submit Comments by May 31 Inpatient Rehabilitation Facilities: [...]

New Evaluation and Management Frequently Asked Question for Emergency Department

New Evaluation and Management Frequently Asked Question for Emergency Department We’ve added a new frequently asked question to the Emergency Department section of our E/M FAQs to further define how time can be used as a factor in billing [...]

New Evaluation and Management Frequently Asked Question for Time-Based Services

New Evaluation and Management Frequently Asked Question for Time-Based Services We’ve added a new FAQ for E/M time-based services. Please define rules for using time to level-set a service in the inpatient setting. ​​​​​​​Answer: In [...]

Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice"

Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice" The 2022 HH+H MAC Collaborative Summit: One Program, One Voice is now available for early bird registration. This huge [...]