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Posting Date: 04/10/2024
Home Health 32G Adjustment Issue for Separation Periods of < 60 Days
A segment of home health claims with 32G type of bills are incorrectly being re-coded to earlier periods during processing, instead of the correct later periods. This error is occurring when the separation between the two periods is 60 days or [...]
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Posting Date: 04/10/2024
Hospice Informational Unsolicited Response Adjustments - Type of Bill 8XG
Due to original informational unsolicited responses (IURs) processing not occurring between the timeframe of 8/1/2017 and 4/1/2021, a significant volume of hospice IUR adjustments have been initiated by the common working file (CWF) to [...]
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Posting Date: 04/10/2024
Optical Character Recognition Misreading Referring Provider Names
OCR software is misreading the referring/ ordering provider name (item 17) on some Part B claims.
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Posting Date: 08/14/2015
Laboratory Tests Billing Alert: Lipid Panel Test (80061) Completed on the Same Date of Service as an LDL Test (83721)
Laboratory Tests Billing Alert: Lipid Panel Test (80061) Completed on the Same Date of Service as an LDL Test (83721) National Government Services, Inc. Medical Review initiated a review of claims containing both a lipid panel test and [...]
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Posting Date: 04/09/2024
G0179FrequencyCalculatorBottom
The home health agency (HHA) certification code can be billed only when the patient has not received Medicare-covered home health services for at least 60 days. The HHA recertification code is used after a patient has received services for [...]
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G0179FrequencyCalculatorTop
G0179 Frequency Calculator Use this calculator to determine the date the next recertification code G0179 may be billed. Enter the date of the last recertification or certification service that met the billing requirements for code G0179 or [...]
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Posting Date: 08/30/2021
Publications for People with Medicare
Publications for People with Medicare Medicare & You Handbook Medicare News Medicare Publications
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Posting Date: 04/09/2024
Get PECOS Access to Maintain Medicare Provider Enrollment Records
Get PECOS Access to Maintain Medicare Provider Enrollment Records Do you need to work on behalf of an individual provider and/or entity to update or submit Medicare enrollment information electronically through PECOS? There are certain [...]
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Posting Date: 04/09/2024
Get PECOS Access to Maintain Medicare Provider Enrollment Records
Get PECOS Access to Maintain Medicare Provider Enrollment Records Do you need to work on behalf of an individual provider and/or entity to update or submit Medicare enrollment information electronically through PECOS? There are certain [...]
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Posting Date: 04/09/2024
What is Medicare Secondary Payer?
Medicare Secondary Payer is the term used for when a Medicare beneficiary has other insurance or coverage that is the primary payer, based on a federal MSP provision, for the beneficiary’s healthcare services. As a result, Medicare is the [...]
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Posting Date: 07/26/2022
Inhalation Treatment CPT 94640 – Billing Errors
Inhalation Treatment CPT 94640 – Billing Errors The National Government Services Appeals Department has identified billing errors relevant to CPT code 94640 for inhalation treatment. When you bill more than one unit per episode of care, the [...]
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Posting Date: 02/08/2017
DME CERT Physician's Corner
DME CERT Physician’s Corner In an effort to reduce the CERT claims error rate, CGS Jurisdiction B DME MAC, has created a Physician’s Corner page which is specifically designed for physicians and practitioners to provide detailed information [...]
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Posting Date: 01/29/2020
Download Medicare Remit Easy Print
Download Medicare Remit Easy Print To download MREP, please select the external link below to navigate to the MREP portion of the CMS Website. Download Medicare Remit Easy Print
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Posting Date: 04/09/2024
Prevent an MSP Rejection on a Medicare Primary Claim
Table of Contents Prevent an MSP Rejection on a Medicare Primary Claim Step 1 Step 2 Step 3 Related Content [Return to Top] Prevent an MSP Rejection on a Medicare Primary Claim If you submit a Medicare primary claim when there is [...]
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Posting Date: 04/09/2024
Populating MSP Insurance Type Code on Electronic Claims
Table of Contents Populating MSP Insurance Type Code on Electronic Claims GHP NGHP Related Content [Return to Top] Populating MSP Insurance Type Code on Electronic Claims When you identify beneficiaries that have Medicare as the [...]
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Posting Date: 03/07/2023
Modifier/Code List
Modifier/Code List CMS established a new modifier, AB, for audiologists to use that describes: audiology service furnished personally by an audiologist without a physician/NPP order for non-acute hearing assessment unrelated to disequilibrium, [...]
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GlobalPeriodCalculator Bottom
Please refer to the Physician Fee Schedule Look up on the CMS Web site to determine whether the procedure in question has a 90 day global period.
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Posting Date: 03/07/2023
General Information
General Information Since 2001, CMS has formally recognized qualified audiologists (specialty 64) to personally furnish diagnostic tests (Section 410.32(b)(2)(ii)) without supervision by a physician or NPP. The statute, at section 1861(ll)(3) [...]
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Posting Date: 04/10/2024
Letter of Authorization for EDI
Letter of Authorization for EDI We’ve extended our Letter of Authorization PIN expiration period based on user feedback. Letter of Authorization PINs are now valid for 30 days and there is no limit on the number of times a PIN can be used. [...]
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Posting Date: 04/11/2024
Hospice Claims Edit Issue RC W7048
National Government Services has noted an increase in hospice claims editing incorrectly for RC W7048 following the July 2023 system release. This is occurring for revenue codes 0250 (non-injectable prescription drugs), 0290 and/or 0294 [...]
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