-
Posting Date: 05/11/2020
Skin Substitutes and Wound Care Products Billing Reminder
Skin Substitutes and Wound Care Products Billing Reminder CMS provides pricing for some wound care products; however, there are many that do not have established pricing. If a skin substitute/wound care product does not have established [...]
Read More -
Posting Date: 04/15/2020
Request for Anticipated Payment Auto-Cancellation Extension
Request for Anticipated Payment Auto-Cancellation Extension Due to CMS guidelines during the Public Health Emergency, all RAPs processed during the PHE will have an additional 90 days from the date of the processed RAP to submit the claim for [...]
Read More -
Posting Date: 07/27/2020
Repayment of Accelerated and Advance Payments for Part B Providers Begins July 27
Repayment of Accelerated and Advance Payments for Part B Providers Begins July 27 Did you know that repayment period for the relief funds advanced payment begins 120 days after a provider received the payment? For the first 120 days, claims [...]
Read More -
Posting Date: 01/31/2020
Reminder: Hospitals Billing for the Appropriate Use Criteria for Advanced Diagnostic Imaging
Reminder: Hospitals Billing for the Appropriate Use Criteria for Advanced Diagnostic Imaging On 1/9/2020, CMS issued additional instructions in SE20002, Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging- Approval of Using the K3 [...]
Read More -
Posting Date: 05/12/2020
Reminder: 340B Hospital Survey Closes 5/15
Reminder: 340B Hospital Survey Closes 5/15 Reminder: the 340B hospital survey closes on Friday, 5/15/2020. This survey is for hospitals paid under the OPPS, that were enrolled in the 340B program during calendar year Q4 2018 and/or Q1 2019. [...]
Read More -
Posting Date: 09/09/2020
Reminder: Medicare Patient Equal Care Policy is the Law
Reminder: Medicare Patient Equal Care Policy is the Law It has come to our attention that some providers are refusing to offer certain services to Medicare patients that they make available to private-pay patients and patients who have other [...]
Read More -
Posting Date: 09/03/2020
We Can Now Accept Electronic Appeal Requests Using the X12 275 Version 6020 Transaction
We Can Now Accept Electronic Appeal Requests Using the X12 275 Version 6020 Transaction National Government Services will now allow Medicare Part A and Part B providers to submit their claim appeal requests, including medical record [...]
Read More -
Posting Date: 11/20/2020
VBID Hospice Benefit Component Information Now Available
VBID Hospice Benefit Component Information Now Available Beginning on January 1, 2021, CMS is testing the inclusion of the Part A Hospice Benefit within the MA benefits package through the Hospice Benefit Component of the Value-Based Insurance [...]
Read More -
Posting Date: 12/15/2020
Updates to Nursing and Allied Health Education Medicare Advantage Payment Policies
Updates to Nursing and Allied Health Education Medicare Advantage Payment Policies Change Request 11642 Revised 12/15/2020 Revised 12/1/2020 Posted 8/24/2020
Read More -
Posting Date: 09/17/2020
Updated Future Effective LCD and Article
Updated Future Effective LCD and Article Fluid Jet System Treatment for LUTS/BPH (L38367) The Fluid Jet System Treatment for LUTS/BPH is now considered medically reasonable and necessary for 30-150 cc- sized prostates when the Indications of [...]
Read More -
Posting Date: 09/17/2020
Updated Future Effective LCD and Article
Updated Future Effective LCD and Article Fluid Jet System Treatment for LUTS/BPH (L38367) The Fluid Jet System Treatment for LUTS/BPH is now considered medically reasonable and necessary for 30-150 cc- sized prostates when the Indications of [...]
Read More -
Posting Date: 08/21/2019
Ambulance Fee Schedule and Medicare Transports Booklet
Ambulance Fee Schedule and Medicare Transports Booklet A new Ambulance Fee Schedule and Medicare Transports Booklet is available. Learn about coverage, billing and payment for ground and air ambulance transport benefits. Posted 8/21/2019
Read More -
Posting Date: 10/09/2019
Medicare’s 2020 Open Enrollment: October 15–December 7
Medicare’s 2020 Open Enrollment: October 15–December 7 Medicare Patients May Have Questions - A State Health Insurance Assistance Program Can Help What is the State Health Insurance Assistance Program? A SHIP is a free insurance counseling [...]
Read More -
Posting Date: 09/27/2019
Local Coverage Determination and Article Revisions September-October 2019
Local Coverage Determination and Article Revisions September‒October 2019 All medical policies and related articles can be found on the NGS Medical Policy Center. Bevacizumab and Biosimilars - Related to LCD L33394 (A52370) Bevacizumab-awwb [...]
Read More -
Posting Date: 11/01/2019
Local Coverage Determination and Article Revisions October-November 2019
Local Coverage Determination and Article Revisions October‒November 2019 The medical policies and related articles can be found in our Medical Policy Center. Updates Billing and Coding: Molecular Pathology Procedures (A56199) Added [...]
Read More -
Posting Date: 11/25/2019
LCD and Article Revisions: November/December 2019
Local Coverage Determination and Article Revisions November–December 2019 LCDs and Articles Revised in November and December: B-type Natriuretic Peptide (BNP) Testing (L33573) Consistent with Change Request 10901, all coding information, [...]
Read More -
Posting Date: 09/13/2019
276 Claim Status Inquiry Near Real-Time Response
276 Claim Status Inquiry Near Real-Time Response We are excited to announce a process change for our Part A providers that will return a 277 Claim Status Inquiry Response in “near real time.” Beginning in October, 2019, we will return the 277 [...]
Read More -
Posting Date: 08/14/2019
Medicare Beneficiary Identifier Monthly Tip
Medicare Beneficiary Identifier Monthly Tip Are you receiving claim rejections because of an invalid beneficiary identifier? It could be that you are using the wrong characters on the MBI. The new Medicare number will not include the letters [...]
Read More -
Posting Date: 07/25/2019
Changes to National Government Services Local Coverage Determination Process
Changes to National Government Services Local Coverage Determination Process In accordance with Section 4009 of H.R. 34-21st Century Cures Act (Public Law No: 114-255), CMS is updating the “Medicare Program Integrity Manual” with detailed [...]
Read More -
Posting Date: 07/19/2019
Attention PIP Hospitals – Delay in Periodic Interim Payment (PIP) Payments
Attention PIP Hospitals – Delay in Periodic Interim Payment (PIP) Payments We have been informed that the biweekly PIP/Pass-Through payment cycle did not initiate as scheduled last night. Therefore, the biweekly payments will be delayed by one [...]
Read More