Search Results - NGSMEDICARE

Posting Date: 10/09/2024

CLAIMS: What is the correct way to submit a beneficiary name on a claim?

Posting Date: 10/09/2024

CLAIMS: When submitting an ambulance claim, do the base and mileage codes need to have the same ZIP code for the same trip?

Posting Date: 10/09/2024

CLAIMS: Where are comments entered on the 837P electronic claim form?

Posting Date: 10/09/2024

CLAIMS: Why would my postoperative claims deny?

Posting Date: 10/09/2024

ASCA: Where do we mail our Administrative Simplification Compliance Act (ASCA) waiver request?

Posting Date: 10/09/2024

Are unclassified drug codes included in average sales price (ASP) files?

Posting Date: 10/09/2024

Can Medicare Part B providers who bill on the professional CMS-1500 claim form, and electronic equivalent, bill unclassified drug code C9399?

Posting Date: 10/09/2024

Can chemotherapy be split into two doses on two different dates of service if the patient was unable to complete a full dose in one day? For example, the patient's port was not functioning properly.

Posting Date: 10/09/2024

Do all established drug HCPCS codes require the dosage amount in its description on the claim?

Posting Date: 10/09/2024

Does Medicare Part B make payment for the unused portion of a multi-dose vial of a drug/biological?

Posting Date: 10/09/2024

Does the waste with the JW modifier appended always go on the second line regardless of the billed amount? For example, the billed amount for the waste is higher than the administered amount.

Posting Date: 10/09/2024

Have the payable diagnoses for IVIG and Rituximab changed? I don’t see all of the previously payable diagnoses in the applicable drug LCDs and articles.

Posting Date: 10/09/2024

How do I bill a bilateral joint injection and HCPCS J1040 for two units?

Posting Date: 10/09/2024

Is the GY modifier required on the drug code and the administration code for noncovered self-administered drugs?

Posting Date: 10/09/2024

Is the shingles vaccine covered by Medicare?

Posting Date: 10/09/2024

J3357, Ustekinumab (Stelara) is listed on the Self-Administered Drug Exclusion List: Medical Policy Article A53021, and it says “acceptable”. Does this mean it is excluded or not?

Posting Date: 10/09/2024

What is the correct way to bill an unlisted drug or biological?

Posting Date: 10/09/2024

What is the proper way to submit professional physician claim with multiple NDC numbers for the same drug code?

Posting Date: 10/09/2024

When billing an unclassified drug code such as J3490, are the units of service on the claim always equal to one?

Posting Date: 10/09/2024

When billing for waste on a single use vial would you round units up or down for a half unit?

Posting Date: 10/09/2024

With the end of the PHE, will HIPAA compliant telehealth platforms only be allowed, or can we continue to use any platform?

Posting Date: 10/09/2024

LCD NCD: Can I request a change be made to a current LCD?

Posting Date: 10/09/2024

LCD NCD: Does NGS offer any other LCD resources?

Posting Date: 10/09/2024

LCD NCD: How can I view and comment on proposed LCDs?

Posting Date: 10/09/2024

LCD NCD: How do I find LCDs?

Posting Date: 10/09/2024

LCD NCD: How do I find out if an LCD or medical coverage policy has changed in my jurisdiction?

Posting Date: 10/09/2024

LCD NCD: How do I search for an LCD if I do not know the LCD number?

Posting Date: 10/09/2024

LCD NCD: What are Medical Policy Articles?

Posting Date: 10/09/2024

LCD NCD: What are the differences between LCDs and NCDs?

Posting Date: 10/09/2024

MEDICAL REVIEW: How can I use NGSConnex to respond to Medical Review additional documentation requests?

Posting Date: 10/09/2024

MEDICAL REVIEW: How do I appeal a claim that MR reviewed but went to a T status or R status because of a CWF issue after MR processed?

Posting Date: 10/09/2024

MEDICAL REVIEW: How do I change my address and which address exactly am I changing to ensure receipt of the MR letters and ADRs?

Posting Date: 10/09/2024

MEDICAL REVIEW: How do I request an appeal on a claim reviewed by the Medical Review Department?

Posting Date: 10/09/2024

MEDICAL REVIEW: How do I respond to an ADR Not In List?

Posting Date: 10/09/2024

MEDICAL REVIEW: How do I sign up for the CMS and NGS Listserv messages?

Posting Date: 10/09/2024

MEDICAL REVIEW: I am under TPE review and my claims were denied, who can I speak to about this?

Posting Date: 10/09/2024

MEDICAL REVIEW: I’m appealing my claim but received a letter to recoup funds from the TPE denial. What do I do about these letters?

Posting Date: 10/09/2024

MEDICAL REVIEW: My claim was denied “56900 Documentation not received”; however, I did send in documentation. What now?

Posting Date: 10/09/2024

MEDICAL REVIEW: My claim was reopened or adjusted by Medical Review. Does this impact the appeal window?

Posting Date: 10/09/2024

MEDICAL REVIEW: The Medical Review Department did a post payment review of my Medicare claim and it was denied. How do I pay the money back to NGS Medicare?