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Posting Date: 12/17/2020
Physicians/Practitioners Medical Records Play a Vital Role in Ordering and Providing DMEPOS to Your Patients
Physicians/Practitioners: Medical Records Play a Vital Role in Ordering and Providing DMEPOS to Your Patients For any DMEPOS item to be covered by Medicare, the patient’s medical record must contain sufficient information about the patient’s [...]
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Posting Date: 06/09/2020
Update on Claims for COVID-19 Testing
Update on Claims for COVID-19 Testing As per CMS PHE guidelines, National Government Services is modifying internal claim editing to permit the following COVID-19-related procedure codes to process as potentially payable without ICD-10 [...]
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Posting Date: 12/14/2020
The CY 2021 MPFS Is Now Available
The CY 2021 MPFS Is Now Available The CY 2021 MPFS is now available. You can view the new fees using the Fee Schedule Lookup tool page on our website. Posted 12/14/2020
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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 [...]
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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 [...]
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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 [...]
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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 [...]
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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. [...]
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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 [...]
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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 [...]
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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 [...]
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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
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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 [...]
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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 [...]
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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
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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 [...]
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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 [...]
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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 [...]
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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, [...]
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Posting Date: 08/21/2019
CMS to Begin Using MFA Process for Online Provider Enrollment System Applications
CMS to Begin Using MFA Process for Online Provider Enrollment System Applications CMS recently announced they will begin utilizing a MFA process for users of their Provider Enrollment Systems. MFA is a second layer of security used to [...]
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