Proper Billing for LEQVIO® HCPCS Code J1306

Proper Billing for LEQVIO® HCPCS Code J1306 Table of Contents Proper Billing for LEQVIO® HCPCS Code J1306 Claim Completion Requirements Drug Wastage Related Content [Return to Top] Proper Billing for LEQVIO® HCPCS Code J1306 [...]

Erythropoiesis Stimulating Agents: Clinical Indications and Coverage Criteria Overview

Erythropoiesis Stimulating Agents: Clinical Indications and Coverage Criteria Overview Table of Contents Erythropoiesis Stimulating Agents: Clinical Indications and Coverage Criteria Overview Drugs and Dosage Conditions Requiring Prior [...]

Account Suspensions

Account Suspensions Table of Contents Account Suspensions Unsuspend Your Account Invalid Login Attempts [Return to Top] Account Suspensions NGSConnex accounts may be suspended for one of the following reasons.  If an [...]

Proper Billing Units for HCPCS Code J7320

Proper Billing Units for HCPCS Code J7320 National Government Services has noticed improper billing units used for HCPCS code J7320, Hyaluronan or derivative, GenVisc 850, for intra-articular injection, 1 mg. GenVisc 850 is indicated for the [...]

Proper Billing for TEZSPIRE™ HCPCS Code J2356

Proper Billing for TEZSPIRE™ HCPCS Code J2356 Table of Contents Proper Billing for TEZSPIRE™ HCPCS Code J2356 Claim Completion Requirements Drug Wastage Appropriate Administration Coding Related Content [Return to Top] Proper [...]

MLN Connects® Newsletter: March 21, 2024

MLN Connects® Newsletter: March 21, 2024 News New Initiative to Increase Investments in Person-Centered Primary Care Marriage and Family Therapists & Mental Health Counselors: Get Information about Billing Medicare Electronic Funds [...]

View Claim Details

View Claim Details Select the Claim Number hyperlink to view additional claim details. If the claim was denied, you can view the reason for denial. You can view the following claim details from the Left-Side navigation. Claim Header [...]

Related Content

Related Content CMS-1500 Claim Form Instructions CMS IOM Publication 100-02, Medicare Benefit Policy Manual CMS IOM Publication 100-04, Medicare Claims Processing Manual Chapter 1 - General Billing Requirements Chapter 12 - [...]

Mental Health Services

Mental Health Services Table of Contents Psychiatric Diagnostic Procedures: 90791‒90792 Interactive Complexity: 90785 Psychotherapy: 90832‒90838 Psychotherapy for Crisis: 90839‒90840 Mobile Psychotherapy for Crisis Services: G0017-G0018 [...]

General Information

General Information Medicare Part B provides benefits for psychiatric services, which are medically necessary for the diagnosis or treatment of diagnostic and/or behavioral health treatment. Medicare recognizes the following Part B providers [...]

Incident-to Services

Incident-to Services A physician, CP, CNS, NP, PA, or CNM may have outpatient psychiatric services and supplies furnished incident to his or her professional service. To be covered under the Incident to provision, the following requirements [...]

CMS Issues Change Request 13294 – Impacts Cost Reports with Disproportionate Share Hospital Reimbursement

CMS Issues Change Request 13294 – Impacts Cost Reports with Disproportionate Share Hospital Reimbursement CMS issued CR 13294,“Change Request (CR) to Implement the Medicare Program Final Action: Treatment of Medicare Part C Days in the [...]

Credit Balance Reminder: Submissions For Quarter Ending 3/31/2024 Start Soon!

Credit Balance Reminder: Submissions For Quarter Ending 3/31/2024 Start Soon! CBR submissions can be submitted starting on 4/1/2024 and are due within 30 days to be considered timely. Remember, even if no monies are owed to Medicare for this [...]

[REVISED] Submitting Paper Claim Forms to National Government Services Due to the Change Healthcare Security Incident

[REVISED] Submitting Paper Claim Forms to National Government Services Due to the Change Healthcare Security Incident As a follow up to our 2/28/2024 article, Change Healthcare Security Incident, providers have asked if they can submit their [...]

Ambulance Physician Certification Statement Guidelines

Ambulance Physician Certification Statement Guidelines Certification Type Certification Required? Yes/No Who May Sign the Certification Timeframe Other Information /Resources Nonemergency, scheduled, [...]

Provider Revalidation Fact Sheet for Congressional Field Offices

Provider Revalidation Fact Sheet for Congressional Field Offices The Affordable Care Act, Section 6401 (a), requires enrolled providers to revalidate their Medicare enrollment every five years, and enrolled durable medical equipment suppliers [...]

Opioid Use Disorder Screening and Treatment: G0402, G0438, G0439, G2011, G0396, G0397

Opioid Use Disorder Screening and Treatment: G0402, G0438, G0439, G2011, G0396, G0397 Medicare coverage includes OUD screening when performed by physicians and NPPs. OUD screening must be performed as part of a Medicare beneficiary’s IPPE and [...]

Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated and Advance Payments for Part A Providers and Part B Suppliers

Provider Qualifications

Provider Qualifications Table of Contents Physicians - Psychiatrists Clinical Psychologist Independently Practicing Psychologist (IPP) Clinical Social Worker Marriage and Family Therapist (MFT) Mental Health Counselor (MHC) Physician [...]

View a General Inquiry

View a General Inquiry Table of Contents View a General Inquiry Attachments [Return to Top] View a General Inquiry National Government Services, Inc. will respond to your inquiry via NGSConnex within 45-business days of the date your [...]