October 2019 Fiscal Intermediary Standard System Direct Data Entry Screen Changes

October 2019 Fiscal Intermediary Standard System Direct Data Entry Screen Changes The following updates will be made to existing screens and implemented on 10/1/2019. Entry added for new Bone Density HCPCS 0508T eligibility dates to MAP175M. [...]

New Version of PC-ACE: July 2019

New Version of PC-ACE: July 2019 PC-ACE Version 4.3 contains several CMS mandates and product enhancements including but not limited to the items listed below. CR11132 ‒ Update to Mammography Editing CR11192 ‒ April 2019 Integrated [...]

New Version of PC-ACE: October 2019

New Version of PC-ACE: October 2019 PC-ACE Version 4.4 contains several CMS mandates and product enhancements including but not limited to the items listed below. CR11321 - Implement Operating Rules - Phase III Electronic Remittance Advice [...]

New Version of PC Print: July 2019

New Version of PC Print: July 2019 PC Print version 7.1.0 will soon be available on our website. This version contains the following enhancement: Change Request 11204 contains the RARC and CARC published by WPC through March 2019 [...]

New Version of PC Print: October 2019

New Version of PC Print: October 2019 PC Print version 7.1.1 will soon be available on our website. This version contains the following enhancements:   CR11252 contains the RARC and CARC published by WPC through July 2019  [...]

Travel Allowance for Laboratory Services

Travel Allowance for Laboratory Services We have seen an increase in incorrect billing for laboratory service travel allowances. Please see below helpful HCPCS billing information and a link to the CMS IOM on appropriate billing for [...]

Revised Fee for Indium In 111 Capromab Pendetide

Revised Fee for Indium In 111 Capromab Pendetide Effective 1/1/2019, National Government Services is updating the fee for A9507 to $1,5804.00 based on the published price for the kit of this radiopharmaceutical agent.   Posted 6/28/2019

Revised fee for Indium In 111 Capromab Pendetide

Revised fee for Indium In 111 Capromab Pendetide Effective 1/1/2019, National Government Services is updating the fee for A9507 to $1,5804.00 based on the published price for the kit of this radiopharmaceutical agent.   Posted 6/27/2019

Reminder: Use Anesthesia Modifiers Appropriately

Reminder: Use Anesthesia Modifiers Appropriately National Government Services requires placement of pricing modifiers in the first modifier position to process your anesthesia claims correctly. Modifiers for anesthesia pricing must be [...]

Reminder: Important Notice Regarding Handwriting on Claims Submitted to Medicare

Reminder: Important Notice Regarding Handwriting on Claims Submitted to Medicare As a reminder, National Government Services will return to the provider any paper claim submitted with handwriting on the face of the claim that is not a [...]

RAP Overpayment Demand Letters Sent in Error

RAP Overpayment Demand Letters Sent in Error Attention Home Health Agencies As of 10/1/2019, due to the implementation of CR10776, HHAs may have received a demand letter for a RAP overpayment. This letter instructed HHAs to either write [...]

Provider Enrollment Application Fee Amount for CY 2020

Provider Enrollment Application Fee Amount for CY 2020 On November 12, CMS issued a notice: Provider Enrollment Application Fee Amount for Calendar Year 2020 [CMS–6089–N (https://go.usa.gov/xppFM)]. Effective January 1, 2020, the application [...]

Part A East Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration

Part A East Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration C2C Innovative Solutions, Inc., the Part A East QIC, is currently offering providers telephone discussions and reopenings under this [...]

Determine/Pay Application Fee

Blepharoplasty, Eyelid Surgery, Brow Lift and Related Services

General Documentation Requirements for Blepharoplasty, Blepharoptosis Repair, and Brow Ptosis Repair Documented subjective patient complaints which justify functional surgery (vision obstruction, unable to do daily tasks, etc. Documented [...]

MLN Connects® Newsletter for Thursday, June 16, 2022

MLN Connects® Newsletter for Thursday, June 16, 2022 ICD-10-CM Diagnosis Codes: Fiscal Year 2023 News Comprehensive Error Rate Testing Program Report: Sample Reduced for Reporting Year 2023 Men’s Health: Talk to Your Patients About [...]

MLN Connects® Newsletter for Thursday, June 9, 2022

MLN Connects® Newsletter for Thursday, June 9, 2022 Learn about the CMS National Quality Strategy News CMS National Quality Strategy: A Person-Centered Approach to Improving Quality Strategy to Strengthen Behavioral Health Care [...]

MLN Connects® Newsletter for Thursday, June 2, 2022

MLN Connects® Newsletter for Thursday, June 2, 2022 ICD-10-PCS Procedure Codes: Fiscal Year 2023 News Medicare Shared Savings Program: Application Deadlines for January 1 Start Date Claims, Pricers, & Codes ICD-10-PCS Procedure [...]

MLN Connects® Newsletter for Thursday, May 26, 2022

MLN Connects® Newsletter for Thursday, May 26, 2022 Biosimilars: Interchangeable Products May Increase Patient Access News COVID-19: New Administration Code for Pfizer Pediatric Vaccine Booster Dose Biosimilars: Interchangeable [...]

Physicians/Practitioners Who Order Ambulance Transport: Helping Your Patients With Prior Authorization

Physicians/Practitioners Who Order Ambulance Transport: Helping Your Patients With Prior Authorization The RSNAT Prior Authorization Model is a Medicare Fee-for-Service program that was recently instituted throughout the National Government [...]