-
Posting Date: 04/29/2021
MCReF/PS&R Official Supported Browser to Change on 6/21/2021
MCReF / PS&R Official Supported Browser to Change on 6/21/2021Beginning, Monday, 6/21/2021, the supported browser for MCReF system and PS&R system is changing from IE to Google Chrome. With this change, MCReF and PS&R will no longer [...]
Read More -
Posting Date: 04/28/2021
Multi-Jurisdictional CAC Meeting on Amniotic Product Injections for Musculoskeletal Indications, Non-Wound
Multi-Jurisdictional CAC Meeting on Amniotic Product Injections for Musculoskeletal Indications, Non-WoundNoridian Healthcare Solutions along with CGS Administrators, First Coast Services Options, National Government Services, Novitas [...]
Read More -
Posting Date: 04/28/2021
Accelerated and Advanced Payment Nettings/Offsets Across Organization Affiliations
Accelerated and Advanced Payment Nettings/Offsets Across Organization AffiliationsWe are receiving an influx of calls to our Provider Contact Center with regard to recoupment of AAPs with providers questioning recoupments on funds they believe [...]
Read More -
Posting Date: 04/26/2021
Outpatient Prospective Payment System Part B Drug Payment and Status Indicator Change for Healthcare Common Procedure Coding System Q5122
Outpatient Prospective Payment System Part B Drug Payment and Status Indicator Change for Healthcare Common Procedure Coding System Q5122The following instructions have been provided by CMS to National Government Services for HCPCS code Q5122. [...]
Read More -
Posting Date: 04/26/2021
LCD and Article Updates for April and May 2021
LCD and Article Updates for April and May 2021April 2021 Medical Policy Article UpdatesBilling and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography (A52849)This article has been updated due to a provider request to [...]
Read More -
Posting Date: 04/15/2021
Clinicians Ordering Oxygen and Oxygen Equipment – COVID-19 PHE Reference Guide
Clinicians Ordering Oxygen and Oxygen Equipment – COVID-19 PHE Reference GuideAs a result of the COVID-19 PHE, CMS has issued waivers and flexibilities to assist Medicare beneficiaries in obtaining the services they need and allowing [...]
Read More -
Posting Date: 04/14/2021
Responding to an Additional Documentation Request
Responding to an Additional Documentation RequestMost recently, National Government Services has experienced an increasing volume of 56900 denials: medical records not submitted upon receipt of an ADR. In response to the lack of submission of [...]
Read More -
Posting Date: 04/14/2021
CGI Hosting an Upcoming Session on “Easier File Uploads for E-Filing in MCReF”
CGI Hosting an Upcoming Session on “Easier File Uploads for E-Filing in MCReF”Medicare Part A Cost Report: Easier File Uploads for e-Filing in MCReF Webcast:Date: Thursday 4/29/2021Time: 1:00–2:30 p.m. ETRegister today DescriptionMedicare [...]
Read More -
Posting Date: 04/12/2021
Behavioral Health Integration Services: Psychiatric Collaborative Care Model
Behavioral Health Integration Services: Psychiatric Collaborative Care ModelIntegrating behavioral health care with primary care (“behavioral health integration” or “BHI”) is an effective strategy for improving outcomes for the millions of [...]
Read More -
Posting Date: 04/07/2021
Checking the Status of Your Accelerated or Advanced Overpayment
Checking the Status of Your Accelerated or Advanced OverpaymentIf you requested an accelerated or advanced payment (AAP), then the overpayment amount is right at your fingertips. We would like to share some great tips on managing your accounts [...]
Read More -
Posting Date: 04/05/2021
COVID-19 Lump Sum Payments for RHCs and FQHCs
COVID-19 Lump Sum Payments for RHCs and FQHCsRHCs and FQHCs may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS, through your MAC, will pay you up front for COVID-19 vaccines and [...]
Read More -
Posting Date: 04/05/2021
Medicare Diabetes Maintenance Programs
Medicare Diabetes Maintenance ProgramsDiabetes management is an important topic to National Government Services. Patients diagnosed with diabetes may experience challenges with managing their diabetes and are more likely to experience many [...]
Read More -
Posting Date: 04/02/2021
Provider Enrollment: Submitting Claims Before the Effective Date
Provider Enrollment: Submitting Claims Before the Effective DateNational Government Services has noticed an increase of Part B claim submissions from Medicare enrolled group practices for rendering providers prior to receiving their approval [...]
Read More -
Posting Date: 03/25/2021
LCD and Article Updates for April 2021
LCD and Article Updates for April 2021New LCDs/ArticlesColon Capsule Endoscopy (CCE) (L38571)CCE is a noninvasive procedure that does not require air inflation or sedation and allows for minimally invasive and painless colonic evaluation. It is [...]
Read More -
Posting Date: 03/22/2021
About Appeals
About AppealsProviders and beneficiaries have the right to appeal claim determinations made by National Government Services. The purpose of the appeals process is to ensure the correct adjudication of claims. Appeals activities conducted by NGS [...]
Read More -
Posting Date: 03/23/2021
New Documentation Requirements for Filing Medicare Cost Reports
New Documentation Requirements for Filing Medicare Cost ReportsAttention: The FY 2019 Medicare IPPS final rule changed the required supporting documentation that must be submitted with the Medicare cost report. CMS also published MLN Matters [...]
Read More -
Posting Date: 03/18/2021
Provider Enrollment: Change in Practice Location
Provider Enrollment: Change in Practice LocationThe fastest way to update a provider enrollment record is through PECOS for the individual (NPI Type 1) or entity/group (NPI Type 2). PECOS allows you to edit, add and delete information according [...]
Read More -
Posting Date: 10/09/2020
COVID-19 Accelerated/Advance Payment Revised Repayment Terms
COVID-19 Accelerated/Advance Payment Revised Repayment TermsThe recently enacted Continuing Appropriations Act, 2021 and Other Extensions Act amended the repayment terms for the COVID-19 accelerated/advance payments. The changes to the [...]
Read More -
Posting Date: 03/29/2021
COVID-19: RHC and FQHC Lump Sum Payments
COVID-19: RHC and FQHC Lump Sum PaymentsRural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS will pay you for [...]
Read More -
Posting Date: 03/30/2021
Responding to a Hospice ADR
Responding to a Hospice ADRNational Government Services performs medical review audits of services billed to Medicare to validate that the documentation supports coverage and level of services billed.When you receive an ADR, it is important to [...]
Read More -
Posting Date: 03/29/2021
Updated Billing Requirements for Home Infusion Therapy (HIT) Services on or After 1/1/2021
Updated Billing Requirements for Home Infusion Therapy (HIT) Services on or After 1/1/2021CR12108Posted 3/29/2021
Read More -
Posting Date: 03/29/2021
Update to Rural Health Clinic (RHC) Payment Limits
Update to Rural Health Clinic (RHC) Payment LimitsCR12185Posted 3/29/2021
Read More -
Posting Date: 03/26/2021
Local Coverage Determination L33626: Psychiatric Partial Hospitalization Programs
Local Coverage Determination L33626: Psychiatric Partial Hospitalization ProgramsA psychiatric partial hospitalization is a distinct and organized intensive psychiatric outpatient treatment of less than 24 hours of daily care, designed to [...]
Read More -
Posting Date: 03/15/2021
Outpatient Prospective Payment System Payment Rate for HCPCS Code A9591
Outpatient Prospective Payment System Payment Rate for HCPCS Code A9591CMS identified an error with the January 2021 OPPS Pricer file where the OPPS payment rate for HCPCS A9591 was incorrect.The correct OPPS payment rate for A9591 [...]
Read More -
Posting Date: 03/09/2021
National Government Services Part A Medical Review Newsletter March 2021
National Government Services Part A Medical Review Newsletter March 2021The National Government Services Medical Review department would like to welcome you to our newest service; a regular newsletter. It is our hope that you will find [...]
Read More -
Posting Date: 03/08/2021
PTB Prescription Drug Management
Prescription Drug ManagementWe have received many questions as to what prescription drug management consists of in the new 2021 E/M Medical Decision Making table. The quick answer is that the concept of prescription drug management has not [...]
Read More -
Posting Date: 03/01/2021
2021 Medicare Participating Physicians Directory
2021 Medicare Participating Physicians DirectoryThe Medicare Participating Physicians Directory (MEDPARD) listing includes all providers in Part B Jurisdiction 6 and Jurisdiction K who have agreed to accept assignment on all Medicare-covered [...]
Read More -
Posting Date: 03/02/2021
Save the Date: National Government Services Spring 2021 Virtual Conference
Save the Date: National Government Services Spring 2021 Virtual ConferenceMedicare 2021: A Journey to a Healthier Future and PartnershipThe National Government Services Provider Outreach and Education Team will be holding our latest bi-annual [...]
Read More -
Posting Date: 03/01/2021
New Consolidated Home Page Coming Soon
New Consolidated Home Page Coming SoonComing soon, NGSConnex and NGSMedicare are uniting to become your new consolidated home page - NGSMedicare.com.You will have one single point of entry on NGSMedicare.com to access both NGSConnex, the secure [...]
Read More -
Posting Date: 02/26/2021
New Home Health Video Tutorials
New Home Health Video TutorialsGreat news for our HH providers! The NGSMedicare.com YouTube video portal is now fully loaded with eight short, educational HH eligibility videos. Be the first to take a look by heading out to our YouTube channel [...]
Read More -
Posting Date: 02/24/2021
National Government Services Part B Medical Review Newsletter March 2021
National Government Services Part B Medical Review Newsletter March 2021The National Government Services Medical Review department would like to welcome you to our newest service; a regular newsletter. It is our hope that you will find this [...]
Read More -
Posting Date: 02/25/2021
Article Updates for February and March 2021
Article Updates for February and March 2021Billing and Coding: IUD (Hormone-Eluting) for Endometrial Hyperplasia - CPT 58999 (A58649)This article contains coding and other guidelines that reflect proper billing for insertion of an IUD [...]
Read More -
Posting Date: 02/24/2021
COVID-19 Vaccine and/or Monoclonal Antibodies in Rural Health Clinics and Federally Qualified Health Centers
COVID-19 Vaccine and/or Monoclonal Antibodies in Rural Health Clinics and Federally Qualified Health CentersAdministration of the COVID-19 vaccine and/or monoclonal antibodies does not qualify as a stand-alone visit. Independent and [...]
Read More -
Posting Date: 01/12/2021
COVID-19 Vaccine and Monoclonal Antibody
COVID-19 Vaccine and Monoclonal AntibodyThe National Government Services COVID-19 Vaccine and Monoclonal Antibody web page is now available. In addition to important resources, the Medicare Part A and Part B Billing for the COVID-19 Vaccine and [...]
Read More -
Posting Date: 02/17/2021
Reminders on the Prior Authorization Program for Certain Hospital Outpatient Department Services
Reminders on the Prior Authorization Program for Certain Hospital Outpatient Department ServicesEffective for dates of service on or after 7/1/2020, a PAR is required for certain OPD services.Hospital Responsibility: Submission of [...]
Read More -
Posting Date: 02/16/2021
Nuclear Medicine Billing Reminder
Nuclear Medicine Billing ReminderNational Government Services has identified an issue with billing for nuclear medicine services under CPT codes 78429-78434.We are receiving claims without the service facility location on the electronic claim. [...]
Read More -
Posting Date: 02/12/2021
National Government Services Gap-fill Pricing Requests 2021
National Government Services Gap-fill Pricing Requests 2021NGS, the MAC for Jurisdictions 6 and K has received the new laboratory test codes identified by CMS that require gap-fill pricing for 2021.The Protecting Access to Medicare Act (PAMA) [...]
Read More -
Posting Date: 02/10/2021
Medicare Diabetes Programs
Medicare Diabetes ProgramsDiabetes is an important topic to National Government Services.Patients diagnosed with diabetes may experience challenges with managing their diabetes and are more likely to experience many complications from the [...]
Read More -
Posting Date: 02/08/2021
Psychotherapy Coverage Criteria: Approved Providers of Service
Psychotherapy Coverage Criteria: Approved Providers of ServiceApproved providers of service include physicians (MD/DO), clinical psychologists, clinical social workers, nurse practitioners, clinical nurse specialists and physician’s [...]
Read More -
Posting Date: 02/08/2021
Psychotherapy Coverage Criteria: Treatment Plans
Psychotherapy Coverage Criteria: Treatment PlansIndividualized Treatment Plan: (A plan is not required if only a few brief services will be furnished)The plan must include:Date plan was established (can be no older than one year prior to the [...]
Read More