Why Use NGSConnex?

Why Use NGSConnex?Each day, thousands of claims and eligibility-based inquiries and other Medicare transactions are successfully completed through NGSConnex. As a registered NGSConnex user you will have instant online access to invaluable [...]

Registration is Now Open for the 2021 Home Health and Hospice Medicare Administrative Contractor Collaborative Summit

Registration is Now Open for the 2021 Home Health and Hospice Medicare Administrative Contractor SummitRegistration is now open for the HH+H MAC Collaborative Summit, Operation Collaboration: We are all in this Together. This summit will [...]

Lower Limb Orthosis: A/B and DME Collaborative Presentation

Lower Limb Orthosis: A/B and DME Collaborative PresentationThe A/B and DME MAC’s Lower Limb Orthosis: A/B and DME Collaborative Presentation - YouTube presentation is available. This video presentation provides suppliers information on the [...]

What To Do If You Can’t Log Into NGSConnex

What To Do If You Can’t Log Into NGSConnexIf you attempt to log into NGSConnex and are unsuccessful you must first determine the reason you can’t log in.First Attempt to Log InOn your first attempt if you enter your User ID and/or password [...]

New NGSMedicare.com is Coming Soon

New NGSMedicare.com is Coming SoonWe continue to listen and gain invaluable insight from you on our provider content website, NGSMedicare.com. Coming mid-Summer 2021, you will be able to see your feedback put into action.Watch this video for a [...]

Action Needed: Update Your Browser Now

Action Needed: Update Your Browser NowStarting July 2021, the NGSMedicare.com site will not support the Internet Explorer (IE) browser. For an optimal NGSMedicare.com experience, to access either the secure, self-service provider portal [...]

A/B and DME MAC Collaborative Therapeutic Shoes for Persons with Diabetes

A/B and DME MAC Collaborative Therapeutic Shoes for Persons with DiabetesProviders – Do you need assistance in understanding what is needed when ordering diabetic shoes? This collaborative webinar on therapeutic shoes for persons with diabetes [...]

May 2021 LCD Updates

May 2021 LCDs UpdatesFACET Joint Interventions for Pain Management (L35936)In the Summary of Evidence section, the following corrections have been made:Under the heading – Diagnostic Facet Joint Injections, a reference number has been added to [...]

Revised Fees for Code G0399

Revised Fees for Code G0399National Government Services has reviewed the fees for code G0399 (Home sleep test [HST] with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG; heart rate and 1 [...]

The Provider Contact Center Has a New Option for Diabetic Self-Management Training and Medical Nutrition Therapy Information

The Provider Contact Center Has a New Option for Diabetic Self-Management Training and Medical Nutrition Therapy InformationCalling the PCC to get information on DSMT and MNT just got easier. When you call the PCC and complete authentication, [...]

Reminder: Billing for Facet Joint Interventions for Pain Management and Anesthesia

Reminder: Billing for Facet Joint Interventions for Pain Management and AnesthesiaAs of 4/25/2021, per LCD L35936, general anesthesia is considered not reasonable and necessary for facet joint interventions. Neither conscious sedation nor [...]

Submitting Refunds to National Government Services

Submitting Refunds to National Government ServicesNational Government Services is receiving an influx of unsolicited voluntary refunds without proper documentation.To facilitate prompt and accurate posting of unsolicited monies or voluntary [...]

Children’s Hospitals Verification of Age for Eligibility

Billing and Coding: Complex Drug Administration Coding for Subcutaneous and Intramuscular Routes (A58620) Reminder

Billing and Coding: Complex Drug Administration Coding for Subcutaneous and Intramuscular Routes (A58620) Reminder National Government Services identified claim billing errors for complex drug administration coding for subcutaneous and [...]

COBA Medigap Claim-Based IDs

Prolonged Services: Non-Face-to-Face

Prolonged Services: Non-Face-to-Face Code Definition Provider Guidance As of 1/1/2017, CMS authorized non face-to-face prolonged services (CPT codes 99358‒99359) as payable services. In conjunction with this approval, CMS [...]

Span Date Billing Guide

Span Date Billing Guide Certain DMEPOS items must be submitted with span dates according to the number of days the item or service is being rendered. When billing with span dates, the “From” date should reflect the date that the item was [...]

Provider Revalidation Interactive Tool_Intro

Provider Revalidation Interactive Tool  This tool is designed to assist Part B applicants who are revalidating enrollment. If the reason for your application is other than revalidation, then please refer to the Enrollment tab on our [...]

Outpatient Department Prior Authorization for Implanted Spinal Neurostimulators Alert

Outpatient Department Prior Authorization for Implanted Spinal Neurostimulators AlertImplanted Spinal Neurostimulator Prior AuthorizationNational Government Services Medical Review initiated prior authorization reviews for the outpatient [...]

Refunds Due to Beneficiaries by Providers

Refunds Due to Beneficiaries by Providers In some situations providers are responsible for refunding monies to beneficiaries that have paid for services that providers have determined to be noncovered and nonpayable by Medicare. When an ABN [...]

There’s Still Time to Register – National Government Services Preventive Service Week

There’s Still Time to Register – National Government Services Preventive Service Week National Government Services Provider Outreach and Education Team is holding a Special Virtual Conference on Medicare Preventive Services. Join us on [...]

Testosterone Pellet Dosage

Testosterone Pellet Dosage The dosage approved by the US Food and Drug Administration for testosterone pellet replacement therapy in androgen-deficient males is 150 mg to 450 mg subcutaneously every 3-6 months. Effective for dates of [...]

Register for EDI

DME National Supplier Clearinghouse

DME National Supplier Clearinghouse The primary role of the National Supplier Clearinghouse is to process the Medicare enrollment application from a DME supplier in order to be eligible to receive Medicare payment for covered services [...]

Railroad Retirees Part B Questions

Railroad Retirees Part B Questions Palmetto GBA processes all Railroad Retirement Part B (medical) coverage claims and handles all inquiries for Railroad Retirees on a national basis. Railroad Retirees can call 877-772-5772 for their Part [...]

About Medicare

About Medicare Part A Hospital Services Part A (hospital insurance) provides coverage of inpatient hospital, limited skilled nursing facility, home health & hospice care, and health care center services. National Government Services [...]

Membership Rosters

Membership Rosters Jurisdiction K Connecticut Maine, Massachusetts, New Hampshire, Rhode Island, Vermont New York Jurisdiction 6 Illinois, Minnesota, Wisconsin

Temporary Holding for Some Part B Claims

An issue has been identified resulting in the need to hold a segment of claims until the appropriate system fix can be installed.

06/21 B MMR: Evaluation and Management Coding: Medical Decision Making Moderate Point Scoring for Data Elements

Evaluation and Management Coding: Medical Decision Making Moderate Point Scoring for Data Elements On 1/1/2021, CMS approved and issued modifications to E/M coding guidelines that were originally developed and adopted by the AMA. This change [...]

Review for codes 0207T and 0563T

Review for codes 0207T and 0563T Services for CPT 0207T (Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral), and CPT 0563T (Evacuation of meibomian glands, automated, using heat delivered through [...]

Medicare Learning Network Articles, Medicare Monthly Review

Sample Results Letter

Sample Results Letter MAIL DATE PROVIDER NAME PROVIDER ADDRESS CITY, STATE, ZIP Provider PTAN/NPI Number: XXXXXXXX RE:Notice of Review - Targeted Probe and Education Results (Round X) Case Number: XXXXXX Dear Medicare Provider, Supplier [...]

Botox Chemodenervation Administration Codes

The above-described administration codes are billed on the Part B claim without the corresponding drug J0585, J0586, J0587 or J0588 and the claim rejects with messages CO16 N56 MA130. The article A52848 indicates the drug should be billed on [...]

End-Stage Renal Disease

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Eligibility

ClaimTimelyFilingCalc-footer

Claims for services furnished to Medicare beneficiaries must be filed to the appropriate MAC no later than one calendar year after the date the services were rendered. Revised 10/20/2021

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