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Posting Date: 10/08/2021
Annual Wellness Visit Screening
Preventive Services Guide Annual Wellness Visit Screening Table of Contents Annual Wellness Visit Screening Coverage Criteria Two Types of AWV Elements Elements of Initial AWV Personalized Prevention Plan Services – [...]
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Posting Date: 03/22/2022
Maine, Massachusetts, New Hampshire, Rhode Island and Vermont
Maine, Massachusetts, New Hampshire, Rhode Island, Vermont Member Name Professional Title Association Business Name/Address Email Bedard, Brenda Insurance Compliance & Training Supervisor Maine [...]
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Posting Date: 07/11/2022
Meeting Minutes
Meeting Minutes Jurisdiction 6 Illinois, Minnesota, Wisconsin Jurisdiction K Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Jurisdiction 6 and Jurisdiction K Combined Meeting 12/5/2024 8/8/2024 4/4/2024
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Posting Date: 01/30/2025
Medicare Change of Status Notice
Medicare Change of Status Notice Attention: Hospitals, including CAHs and other providers billing Medicare for inpatient services. The Medicare Change of Status Notice (MCSN) became effective 10/11/2024 and implemented 2/15/2025. Hospitals, [...]
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Posting Date: 08/27/2021
Alcohol Misuse and Counseling
Preventive Services Guide Alcohol Misuse and Counseling Table of Contents Alcohol Misuse and Counseling Two-Part Benefit Cost Sharing Reimbursement Nonparticipating Providers Common Claim Denial Reasons Related Content [Return [...]
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Posting Date: 10/08/2021
Initial Preventive Physical Examination
Preventive Services Guide Initial Preventive Physical Examination The IPPE is also known as the “Welcome to Medicare Preventive Visit.” The goals of the IPPE are health promotion and disease detection and prevention. Table of Contents [...]
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Posting Date: 02/25/2025
MLN Connects® Newsletter: February 24, 2025
MLN Connects® Newsletter: February 24, 2025 Compliance Mechanical Ventilation: Bill Correctly for Inpatient Claims Claims, Pricers, & Codes Discarded Drugs & Biologicals: Orphan Drugs with Increased Applicable Percentage for [...]
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Posting Date: 06/22/2022
Standard Companion Guides
Standard Companion Guides Standard Companion Guide Trading Partner Information (275) Standard Companion Guide Trading Partner Information (277) Standard Companion Guide Trading Partner Information (278/275) Standard Companion Guide Health [...]
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Posting Date: 02/03/2025
Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application
Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application Available now is the revised CMS-855A (09/24) paper application that includes a section for SNF to comply with the 2023 Final rule in reporting [...]
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Posting Date: 12/03/2020
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment Reminder, if a hospital, clinic/group or Independent Diagnostic Treatment Facility has ADI screening equipment, certification from a designated ADI accrediting [...]
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Posting Date: 02/26/2025
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment
Reminder, if a hospital, clinic/group or Independent Diagnostic Treatment Facility has ADI screening equipment, certification from a designated ADI accrediting organization needs to be implemented or updated on the Medicare enrollment. The [...]
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Posting Date: 01/11/2021
Audit and Reimbursement
Audit and Reimbursement Cost Report Filing State/Region Contact Information Jurisdiction 6 J6_cost_report_filing@anthem.com Jurisdiction K JK_cost_report_filing@anthem.com Provider Statistical [...]
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Posting Date: 07/05/2022
Audit and Reimbursement
Audit and Reimbursement Cost Report Filing State/Region Contact Information Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont JK_Cost_Report_Filing@anthem.com FQHC (All), [...]
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Posting Date: 03/03/2025
MLN Connects® Newsletter: February 28, 2025
MLN Connects® Newsletter: February 28, 2025 CMS Provider Education Message: Hospitals: Actions to Make Healthcare Prices Transparent Update: On February 25, the White House issued an Executive Order to empower patients with clear, accurate, [...]
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Posting Date: 03/03/2025
Clinicians: Are You Ordering Urological Supplies for Your Patients?
Clinicians: Are You Ordering Urological Supplies for Your Patients? Urological supplies are covered as part of the prosthetic device benefit as outlined in the Social Security Act, Section 1861(s)(8). Prosthetic devices (other than dental) [...]
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Posting Date: 03/03/2025
Procedure to Procedure Edits
Procedure to Procedure Edits The purpose of the NCCI PTP edits is to prevent improper payment when incorrect code combinations are reported. The NCCI contains one table of edits for physicians/practitioners and one table of edits for [...]
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Posting Date: 03/03/2025
National Correct Coding Initiative
National Correct Coding Initiative The Medicare NCCI promotes correct coding of Medicare Part B claims. Coding policies are based on coding conventions defined in the AMA’s CPT professional, national and local Medicare policies and edits, [...]
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Posting Date: 03/03/2025
Related Resources
Related Resources MLN® Educational Tool: How to Use the Medicare National Correct Coding Initiative (NCCI) Tools Medicare National Correct Coding Initiative (NCCI) Edits National Correct Coding Initiative Policy Manual Medicare NCCI [...]
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Posting Date: 03/03/2025
Add-on Codes
Add-on Codes Add-on codes are procedure codes that indicate additional work associated with another primary procedure. Add-on codes can be reimbursed when reported with the primary procedure code by the same practitioner. Add-on codes may be [...]
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Posting Date: 02/27/2025
National Correct Coding Initiative
National Correct Coding Initiative We recently introduced the NCCI Lookup Tool on our Part B Tools and Calculators page. This tool is designed to assist providers in identifying codes subject to automated prepayment edits, thereby facilitating [...]
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