EDI: What Entity Name should I enter on the EDI Enrollment Agreement form?

EDI: What information do I need to have available when calling for Electronic Data Interchange (EDI) assistance?

EDI: Will you reject claims where the group number and policy number are the same values?

EDI: Where in the 277 CA file can we find the rejection message that provides the detailed rejection reason description?

EDI: What is an Approved Entity?

EDI: What provider address should I include on the EDI enrollment forms?

EDI: When is a provider authorization form required?

LCD NCD: How do I search for an LCD if I do not know the LCD number?

EDI: Will you reject claims with a P.O. Box in the billing provider address?

LCD NCD: How do I find LCDs?

LCD NCD: Does NGS offer any other LCD resources?

LCD NCD: How do I find out if an LCD or medical coverage policy has changed in my jurisdiction?

LCD NCD: How can I view and comment on proposed LCDs?

LCD NCD: What are Medical Policy Articles?

LCD NCD: Can I request a change be made to a current LCD?

Medical Review: Targeted Probe and Educate Review Topics

Jurisdiction K Part A Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Debridement, subcutaneous tissue (includes epidermis and dermis, if performed) 11042, 11045 [...]

Radiopharmaceutical Reimbursement

Radiopharmaceutical Reimbursement National Government Services has reviewed the radiopharmaceutical pricing methodology set forth in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Section 303(h) which states that [...]

Hospital-Based Ambulance Basic Billing Guidelines

Hospital-Based Ambulance Basic Billing Guidelines For hospital-based ambulance billing under Medicare, services should be billed on the UB-04 form using the ambulance service-specific NPI, not the acute hospital NPI, and claims for inpatient [...]

About Appeals

About Appeals Table of Contents About Appeals Reopening vs. Redetermination Reopening Redetermination [Return to Top] About Appeals Providers and beneficiaries have the right to appeal claim determinations made by National [...]

REMITTANCE: What do the two-letter codes on my remittance advice mean?