Sleep Study Scoring and Testing Physician Letter

Sleep Study Scoring and Testing Physician Letter CGS and Noridian, the DME MAC for J6 and JK respectively, have issued a new Dear Physician letter in regard to sleep study scoring and testing. The letters were issued by these contractors as [...]

External Counterpulsation Billing (G0166)

External Counterpulsation Billing (G0166) National Government Services has discovered providers are billing invalid places of services for G0166 (External Counterpulsation, per treatment session) as per The Centers for Medicare & Medicaid [...]

September is Prostate Cancer Awareness Month

September is Prostate Cancer Awareness Month Prostate cancer is the most common non skin cancer among men in the United States. It is a disease that in which malignant cancer cells form in the tissues of the prostate. Prostate cancer is [...]

Opt Out Affidavits Database

Opt Out Affidavits Database Need to verify if a provider has opted out of Medicare? A resource for a list of opt out providers is located on the Medicare Opt Out Affidavits Database, verify status with effective date range. Instructions for [...]

October 2019 Release Dark Days for the Common Working File Hosts

October 2019 Release Dark Days for the Common Working File Hosts For the upcoming October 2019 Release, CWF will be observing dark days starting Friday, 10/4/2019 through Sunday, 10/6/2019 to accommodate the anticipated duration of this [...]

October 2019 Fiscal Intermediary Standard System Direct Data Entry Screen Changes

October 2019 Fiscal Intermediary Standard System Direct Data Entry Screen Changes The following updates will be made to existing screens and implemented on 10/1/2019. Entry added for new Bone Density HCPCS 0508T eligibility dates to MAP175M. [...]

New Version of PC-ACE: July 2019

New Version of PC-ACE: July 2019 PC-ACE Version 4.3 contains several CMS mandates and product enhancements including but not limited to the items listed below. CR11132 ‒ Update to Mammography Editing CR11192 ‒ April 2019 Integrated [...]

New Version of PC-ACE: October 2019

New Version of PC-ACE: October 2019 PC-ACE Version 4.4 contains several CMS mandates and product enhancements including but not limited to the items listed below. CR11321 - Implement Operating Rules - Phase III Electronic Remittance Advice [...]

New Version of PC Print: July 2019

New Version of PC Print: July 2019 PC Print version 7.1.0 will soon be available on our website. This version contains the following enhancement: Change Request 11204 contains the RARC and CARC published by WPC through March 2019 [...]

New Version of PC Print: October 2019

New Version of PC Print: October 2019 PC Print version 7.1.1 will soon be available on our website. This version contains the following enhancements:   CR11252 contains the RARC and CARC published by WPC through July 2019  [...]

Travel Allowance for Laboratory Services

Travel Allowance for Laboratory Services We have seen an increase in incorrect billing for laboratory service travel allowances. Please see below helpful HCPCS billing information and a link to the CMS IOM on appropriate billing for [...]

Revised Fee for Indium In 111 Capromab Pendetide

Revised Fee for Indium In 111 Capromab Pendetide Effective 1/1/2019, National Government Services is updating the fee for A9507 to $1,5804.00 based on the published price for the kit of this radiopharmaceutical agent.   Posted 6/28/2019

Revised fee for Indium In 111 Capromab Pendetide

Revised fee for Indium In 111 Capromab Pendetide Effective 1/1/2019, National Government Services is updating the fee for A9507 to $1,5804.00 based on the published price for the kit of this radiopharmaceutical agent.   Posted 6/27/2019

Reminder: Use Anesthesia Modifiers Appropriately

Reminder: Use Anesthesia Modifiers Appropriately National Government Services requires placement of pricing modifiers in the first modifier position to process your anesthesia claims correctly. Modifiers for anesthesia pricing must be [...]

Reminder: Important Notice Regarding Handwriting on Claims Submitted to Medicare

Reminder: Important Notice Regarding Handwriting on Claims Submitted to Medicare As a reminder, National Government Services will return to the provider any paper claim submitted with handwriting on the face of the claim that is not a [...]

RAP Overpayment Demand Letters Sent in Error

RAP Overpayment Demand Letters Sent in Error Attention Home Health Agencies As of 10/1/2019, due to the implementation of CR10776, HHAs may have received a demand letter for a RAP overpayment. This letter instructed HHAs to either write [...]

Provider Enrollment Application Fee Amount for CY 2020

Provider Enrollment Application Fee Amount for CY 2020 On November 12, CMS issued a notice: Provider Enrollment Application Fee Amount for Calendar Year 2020 [CMS–6089–N (https://go.usa.gov/xppFM)]. Effective January 1, 2020, the application [...]

Part A East Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration

Part A East Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration C2C Innovative Solutions, Inc., the Part A East QIC, is currently offering providers telephone discussions and reopenings under this [...]

Determine/Pay Application Fee

Blepharoplasty, Eyelid Surgery, Brow Lift and Related Services

General Documentation Requirements for Blepharoplasty, Blepharoptosis Repair, and Brow Ptosis Repair Documented subjective patient complaints which justify functional surgery (vision obstruction, unable to do daily tasks, etc. Documented [...]