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Posting Date: 04/07/2022
Provider Action To Be Taken Following the Provider-Based Mid-Build Audit
Provider Action To Be Taken Following the Provider-Based Mid-Build Audit The off-campus PBDs that were “mid-build” prior to 11/2/2015 received mid-build determination letters in January 2021 from the CMS mid-build audit contractor, Cahaba [...]
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Posting Date: 12/03/2021
National Influenza Vaccination Week
National Influenza Vaccination Week National Influenza Vaccination Week is Observed 12/5/2021–12/11/2021 Influenza (flu) is a contagious respiratory illness caused by the influenza virus and causes mild to severe illness. Millions of people [...]
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Posting Date: 07/26/2022
July and August 2022 Billing and Coding Article Updates
July/August 2022 Billing and Coding Article Updates Billing and Coding Articles Billing and Coding: Botulinum Toxins (A52848) Based on comments received, ICD-10-CM codes N39.41 and N39.46 have been added to the Group 4 ICD-10 code list [...]
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Posting Date: 01/23/2020
Change Request 10484, Pub.100-20, Rev2357: Additional Instructions to Hospitals on the Election of a Medicare SSI Component of the DSH Payment Adjustment for Cost Reports FY 2004 and Earlier
Change Request 10484, Pub.100-20, Rev2357: Additional Instructions to Hospitals on the Election of a Medicare SSI Component of the DSH Payment Adjustment for Cost Reports FY 2004 and Earlier Please click on the following link to read the [...]
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Posting Date: 01/21/2020
Appeal Submission Process for Claims with Multiple Line Items
Appeal Submission Process for Claims with Multiple Line Items We have identified instances where providers are submitting several appeals for one claim internal control number. If you need to appeal (redetermination) a claim with multiple [...]
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Posting Date: 01/16/2020
MLN Connects® for Thursday, January 16, 2020
MLN Connects® for Thursday, January 16, 2020 Quality Payment Program: Learn About the MIPS 2020 Performance Period MLN Connects® for Thursday, January 16, 2020 View this edition as a PDF News CMS Reduces Psychiatric Hospital Burden [...]
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Posting Date: 01/09/2020
MLN Connects® for Thursday, January 9, 2020
MLN Connects® for Thursday, January 9, 2020 Read the Latest Quality Payment Program Updates MLN Connects® for Thursday, January 9, 2020 View this edition as a PDF News Quality Payment Program: 2018 Performance Data Quality [...]
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Posting Date: 01/02/2020
Notification to Providers: Preventive and Screening Services
Notification to Providers: Preventive and Screening Services Centralized billing is a process in which a provider, who provides mass immunization services for influenza virus and pneumococcal pneumonia virus (PPV) immunizations, can send all [...]
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Posting Date: 02/27/2020
MLN Connects® for Thursday, February 27, 2020
MLN Connects® for Thursday, February 27, 2020 COVID-19 Coding Guidance MLN Connects® for Thursday, February 27, 2020 View this edition as a PDF News Quality Payment Program: MIPS 2019 Data Submission Period Open through March 31 [...]
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Posting Date: 02/27/2020
Make Today the Day - Sign Up for Medicare Diabetic and Prevention Program Email Updates
Make Today the Day ‒ Sign Up for Medicare Diabetic and Prevention Program Email Updates The MDPP supplier Email Updates are the mechanism by which MDPP suppliers will receive important information and reminders, such as upcoming due [...]
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Posting Date: 02/26/2020
Amending Medical Records
Amending Medical Records Amendments, Corrections and Delayed Entries in Medical Documentation All services provided to beneficiaries are expected to be documented in the medical record at the time they are rendered. [...]
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Posting Date: 02/24/2020
Did You Know that the Medicare Part B Overpayment Form Has Been Retired?
Did You Know that the Medicare Part B Overpayment Form Has Been Retired? Our records indicate some providers are still using the retired Medicare Part B Overpayment Form. The new process for provider-initiated non MSP overpayments is as [...]
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Posting Date: 02/24/2020
Article Revisions: February 2020
Article Revisions: February 2020 The medical policies and related articles can be found in our Medical Policy Center. Billing and Coding: Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy (A57826) The [...]
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Posting Date: 02/20/2020
MLN Connects® for Thursday, February 20, 2020
MLN Connects® for Thursday, February 20, 2020 Bill Correctly for Medicare Telehealth Services MLN Connects® for Thursday, February 20, 2020 View this edition as a PDF News CMS Develops New Code for Coronavirus Lab Test [...]
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Posting Date: 02/13/2020
MLN Connects® for Thursday, February 13, 2020
MLN Connects® for Thursday, February 13, 2020 Protect Your Patients from Influenza MLN Connects® for Thursday, February 13, 2020 View this edition as a PDF News DMEPOS Items Subject to Prior Authorization Influenza Activity [...]
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Posting Date: 02/07/2020
Reassignment of Medicare Benefits: Revised CMS-855R Required May 1
Reassignment of Medicare Benefits: Revised CMS-855R Required May 1 Physicians and non-physician practitioners: Use the revised CMS-855R (Reassignment of Benefits) application once it is posted on the CMS Forms List (go.usa.gov/cuu5Y) in early [...]
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Posting Date: 02/06/2020
MLN Connects® for Thursday, February 6, 2020
MLN Connects® for Thursday, February 6, 2020 New Medicare Provider Enrollment Educational Tool MLN Connects® for Thursday, February 6, 2020 View this edition as a PDF News Open Payments Registration Promoting Interoperability [...]
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Posting Date: 01/30/2020
MLN Connects® for Thursday, January 30, 2020
MLN Connects® for Thursday, January 30, 2020 Genetic Testing and Innovative Antibiotics MLN Connects® for Thursday, January 30, 2020 View this edition as a PDF News CMS Expands Coverage of NGS as Diagnostic Tool for Patients with [...]
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Posting Date: 01/30/2020
Calendar Year 2019 1099 Form Information
Calendar Year 2019 1099 Form Information National Government Services will mail all 1099 Forms for CY 2019 by 1/31/2020. Medicare providers and beneficiaries who are serviced by NGS, regardless of their location, will receive a single Part A [...]
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Posting Date: 01/24/2020
LCD and Article Revisions: January–February 2020
LCD and Article Revisions: January–February 2020 The medical policies and related articles can be found in our Medical Policy Center LCD Revisions Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture [...]
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Posting Date: 01/23/2020
MLN Connects® for Thursday, January 23, 2020
MLN Connects® for Thursday, January 23, 2020 Medicare Learning Network Celebrates 20 Years MLN Connects® for Thursday, January 23, 2020 View this edition as a PDF News Medicare Learning Network Celebrates 20 Years CMS Updates [...]
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Posting Date: 03/23/2020
MLN Connects® Special Edition for Monday, March 23, 2020
MLN Connects® Special Edition for Monday, March 23, 2020 COVID-19: Relief for Quality Reporting Programs and Provider Enrollment Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in [...]
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Posting Date: 03/20/2020
Provider Enrollment Hot Line for Matters Related to COVID-19
Provider Enrollment Hot Line for Matters Related to COVID-19 As a result of the effects of 2019 Novel Coronavirus (COVID-19), a national emergency exists nationwide. On 3/13/2020, the Administrator of CMS authorized nationwide waivers under [...]
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Posting Date: 03/20/2020
National Government Services LCD Open Meeting
National Government Services LCD Open Meeting The transcript and recording of the 2/26/2020 LCD Open Meeting are now available on our website at Open Meeting Records. Posted 3/20/2020
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Posting Date: 03/19/2020
Matching Assessments to Home Health Claims
Matching Assessments to Home Health Claims CMS has recently published instructions on validating the OASIS and claim match for home health claims. SE20010 titled “Ensure Required Patient Assessment Information for Home Health Claims” [...]
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Posting Date: 03/19/2020
April 2020 Fiscal Intermediary Standard System Direct Data Entry Screen Changes
April 2020 Fiscal Intermediary Standard System Direct Data Entry Screen Changes The purpose of the new HCPCS screen (1E) is to provide information related to HCPCS pricing and allowable revenue codes related to HCPCS. To access the new HCPCS [...]
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Posting Date: 03/19/2020
Incorrect Provider Types Billing Care Plan Oversight Services for Patients Receiving Care
Incorrect Provider Types Billing Care Plan Oversight Services for Patients Receiving Care CPO is physician supervision of patients under the home health or hospice benefit where the patient requires complex or multi-disciplinary care requiring [...]
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Posting Date: 03/19/2020
MLN Connects® for Thursday, March 19, 2020
MLN Connects® for Thursday, March 19, 2020 Interoperability and Patient Access MLN Connects® for Thursday, March 19, 2020 View this edition as a PDF News Quality Payment Program: 2020 Facility-Based Status Lower Extremity Joint [...]
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Posting Date: 03/17/2020
MLN Connects® Special Edition for Tuesday, March 17, 2020
MLN Connects® Special Edition for Tuesday, March 17, 2020 President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak CMS Outlines New Flexibilities Available to People with Medicare The Trump [...]
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Posting Date: 03/16/2020
MLN Connects® Special Edition for Friday, March 13, 2020
MLN Connects® Special Edition for Friday, March 13, 2020 COVID-19: Test Pricing, Diagnostic Lab Tests, Pricing & Codes, and EHB Coverage COVID-19: Test Pricing; Diagnostic Lab Tests, Pricing & Codes; and EHB Coverage Quarterly [...]
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Posting Date: 03/16/2020
MLN Connects® Special Edition for Monday, March 16, 2020
MLN Connects® Special Edition for Monday, March 16, 2020 COVID-19: FFS Response and Nursing Home Visitor Guidance Medicare FFS Response to COVID-19 The HHS Secretary declared a public health emergency, which allows for CMS programmatic [...]
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Posting Date: 03/12/2020
MLN Connects® for Thursday, March 12, 2020
MLN Connects® for Thursday, March 12, 2020 2019 Novel Coronavirus Guidance MLN Connects® for Thursday, March 12, 2020 View this edition as a PDF News CMS Sends More Detailed Guidance to Providers about COVID-19 HHS Finalizes [...]
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Posting Date: 03/09/2020
MLN Connects® Special Edition for Friday, March 6, 2020
MLN Connects® Special Edition for Friday, March 6, 2020 CMS Develops Additional Code for Coronavirus Lab Tests Agency Issues Fact Sheets Detailing Coverage under Programs On March 6, CMS took additional actions to ensure America’s patients, [...]
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Posting Date: 03/09/2020
MLN Connects® Special Edition for Monday, March 9, 2020
MLN Connects® Special Edition for Monday, March 9, 2020 COVID-19 Response: CMS Issues FAQs to Assist Medicare Providers On March 6, CMS issued frequently asked questions and answers (FAQs) for health care providers regarding Medicare payment [...]
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Posting Date: 03/05/2020
MLN Connects® for Thursday, March 5, 2020
MLN Connects® for Thursday, March 5, 2020 Ambulance Fee Schedule, Transports & Data Collection MLN Connects® for Thursday, March 5, 2020 View this edition as a PDF News DMEPOS Suppliers: HCPCS Codes Affected by Further [...]
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Posting Date: 03/05/2020
MLN Connects® Special Edition for Wednesday, March 4, 2020
MLN Connects® Special Edition for Wednesday, March 4, 2020 CMS Announces Actions to Address Spread of Coronavirus CMS calls on all health care providers to activate infection control practices and issues guidance to inspectors as they inspect [...]
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Posting Date: 04/07/2020
MLN Connects® Special Edition for Tuesday, April 7, 2020
MLN Connects® Special Edition for Tuesday, April 7, 2020 COVID-19: Telehealth Video, Coinsurance and Deductible Waived, ASC Attestations, Ambulance Modifiers, Lessons From Front Lines, MLN Call Today New Video Available on Medicare Coverage [...]
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Posting Date: 04/06/2020
Pricing of HCPCS G2066 - Update
Pricing of HCPCS G2066 — Update On 3/12/2020 NGS posted an article on our website regarding a fee adjustment for HCPCS G2066 (Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, [...]
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Posting Date: 04/03/2020
MLN Connects® Special Edition for Friday, April 3, 2020
MLN Connects® Special Edition for Friday, April 3, 2020 COVID-19: Telehealth Billing Correction, Nursing Home Recommendations, Billing for Multi-Function Ventilators, New ICD-10-CM Diagnosis Code Billing for Professional Telehealth [...]
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Posting Date: 04/02/2020
MLN Connects® for Thursday, April 2, 2020
MLN Connects® for Thursday, April 2, 2020 Interoperability and Patient Access Final Rule Call — April 7 MLN Connects® for Thursday, April 2, 2020 View this edition as a PDF News IRF Provider Preview Reports: Review Your Data by [...]
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