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Posting Date: 08/09/2024
Monoclonal Antibodies in Treatment of Alzheimer’s Disease - Medicare Advantage Plan Responsibility
Monoclonal Antibodies in Treatment of Alzheimer’s Disease - Medicare Advantage Plan Responsibility NCD 200.3 was issued by CMS in April,2022 and outlines Medicare coverage policy for monoclonal antibodies that target amyloid (or plaque) for [...]
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Posting Date: 08/10/2024
HETS EDI Enrollment Form User Guide
The HETS EDI Enrollment Form allows providers to attest their relationship with a 3rd party entity to exchange the ANSI X12 270/271 Beneficiary Eligibility transaction on their behalf. Table of Contents Step 1 – Authorization [...]
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Posting Date: 08/10/2024
HETS EDI Enrollment Form
HIPAA Eligibility Transaction System (HETS) allows users to exchange HIPAA compliant ANSI ASC X12 270/271 transactions for the purpose of checking Medicare eligibility. The HETS EDI Enrollment Form allows providers to attest their [...]
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Posting Date: 08/05/2024
Telehealth Place of Service 02 and 10 Clarification
Telehealth Place of Service 02 and 10 Clarification National Government Services has been receiving inquiries from providers in regard to POS 02 and POS 10 for telehealth service reporting. We’ve created this article to provide clarification. [...]
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Posting Date: 07/31/2024
CLIA Number Processing Issue
CLIA Number Processing Issue National Government Services has been made aware of an issue with CLIA lab claims processing. CLIA numbers were not loaded through CWF, resulting in claim denials as CLIA did not match any file. We were informed [...]
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Posting Date: 11/14/2022
The CY 2023 Medicare Physician Fee Schedule Is Now Available
The CY 2023 Medicare Physician Fee Schedule Is Now Available The CY 2023 MPFS is now available. You can view the new fees using the Fee Schedule Lookup tool page on NGSMedicare.com. Posted 11/14/2022
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Posting Date: 11/14/2022
Proper Steps for Notice of Admission Cancel/Resubmission
Proper Steps for Notice of Admission Cancel/Resubmission The purpose of the NOA is to open a new admission period for a home health beneficiary. There are few circumstances when the home health NOA must be canceled and resubmitted to correct [...]
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Posting Date: 03/18/2015
Sequestration Questions and Answers
Sequestration Questions and Answers If a durable medical equipment capped rental period started before 4/1/2013, are the rental payments for months after 4/1/2013, subject to the 2 percent reduction? Answer: Any claims for rental [...]
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Posting Date: 03/24/2015
Billing for Tape Codes (A4450 and A4452) and Modifiers (AU, AV and AW)
Billing for Tape Codes (A4450 and A4452) and Modifiers (AU, AV and AW) Policy specific informational modifiers can be located in the local medical policies. When submitting claims that require policy specific informational modifiers, [...]
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Posting Date: 09/12/2011
Claim Completion Requirements for Facility Location (Item 32)
Claim Completion Requirements for Facility Location (Item 32) When a supplier submits a claim for DMEPOS provided in a location other than the beneficiary’s home (POS 12), the supplier must enter in Item 32, Facility Location, the name and [...]
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Posting Date: 02/19/2015
Coverage and Correct Coding of Blincyto
Coverage and Correct Coding of BlincytoTM Joint DME MAC Publication On 12/3/2014, the FDA gave accelerated approval for Blinatumomab (BlincytoTM) for the treatment of Philadelphia negative relapsed/refractory acute lymphoblastic leukemia. [...]
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Posting Date: 12/29/2014
2015 HCPCS Code Update
2015 HCPCS Code Update The following list identifies changes to level II HCPCS codes for 2015. Added Codes/Added Modifiers: New codes and modifiers are effective for dates of service on or after 1/1/2015. Discontinued Codes/Deleted [...]
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Posting Date: 12/11/2020
What's New in Home Health Education?
What's New in Home Health Education? Updates are currently being made to home health YouTube tutorials and job aids to ensure that all federal regulation changes are captured. Most recently, we have updated the following educational materials [...]
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Posting Date: 11/15/2022
Proper Billing for LEQVIO®
Proper Billing for LEQVIO® National Government Services has noticed improper billing of units and diagnosis related to HCPCS code J1306. We’ve published Proper Billing for LEQVIO® HCPCS Code J1306 to assist our provider community with billing [...]
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Posting Date: 11/15/2022
Multijurisdictional CAC meeting Notice on Micro-Invasive Glaucoma Surgery
Multijurisdictional CAC meeting Notice on Micro-Invasive Glaucoma Surgery Information has been posted on our website about a multijurisdictional Contractor Advisory Committee Meeting Regarding Micro-invasive Glaucoma Surgery to be held on [...]
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Posting Date: 11/15/2022
Proper Billing for TEZSPIRE™
Proper Billing for TEZSPIRE™ National Government Services has noticed improper billing of units related to HCPCS code J2356. We’ve published Proper Billing for TEZSPIRE™ HCPCS Code J2356 to assist our provider community with billing for this [...]
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Posting Date: 11/17/2022
MLN Connects® Newsletter: November 17, 2022
MLN Connects® Newsletter: November 17, 2022 News Hospital Price Transparency: Download Machine-Readable File Sample Formats & Data Dictionaries Medical Review After the COVID-19 Public Health Emergency: New FAQ [...]
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Posting Date: 04/18/2022
2022 Home Health and Hospice Medicare Administrative Contractors Collaborative Summit
Early Bird Registration is Now Open for the 2022 Home Health and Hospice Medicare Administrative Contractors Collaborative Summit The 2022 HH+H MACs Collaborative Summit: One Program, One Voice is now open for early bird registration. This [...]
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Posting Date: 03/14/2022
Credit Balance Status Lookup
About This Tool This tool can be used to check on the status of your mailed or faxed Credit Balance Report. Any reports submitted through Connex will not appear in this tool. How to Search To perform a search, enter a valid PTAN into the [...]
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Posting Date: 11/18/2022
Anesthesia CPT 00537 Being Underpaid for 2022
The 2022 Anesthesia Base Unit for 00537 was not updated for dates of service starting 1/1/2022 which has caused services being underpaid.
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Posting Date: 11/18/2022
Part A FISS Cancel Adjustment Issue
FISS Maintainer will be creating a file to identify the cancel claim records that posted to the CWF as original claims (those with a CD value of “3” instead of “4”) and will be providing those files to CWF. The CWF Maintainer will run those [...]
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Posting Date: 11/18/2022
Part A Invalid MBI Cross-Reference Issue
National Government Services is informing Part A providers of a claim processing issue causing invalid MBI cross-referencing. This is resulting in multiple, inactivated HICN being associated with the impacted claims.
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Posting Date: 09/19/2022
Setting Your Security Questions
Setting Your Security Questions Setting up Security Questions is part of the required process for establishing an EDI Gateway Self-Service Portal account. Follow these steps to set up your account Security Questions. Access the Trading [...]
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Posting Date: 10/14/2022
Cardiac, Intensive Cardiac and Pulmonary Rehabilitation Services
Cardiac, Intensive Cardiac and Pulmonary Rehabilitation Services We’ve added Cardiac, Intensive Cardiac and Pulmonary Rehabilitation information to the Cardiac Specialty section of our website. These resources provide detailed coverage and [...]
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Posting Date: 11/22/2022
LCD, Billing and Coding Article Updates for November-December 2022
LCD, Billing and Coding Article Updates for November-December 2022 New LCDs and Articles (Effective 11/1/2022) Off-Label Use of Intravenous Immune Globulin (IVIG) – (L39314) This LCD addresses off-label uses for IVIG. We define off-label as [...]
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Posting Date: 11/29/2022
January 2023 Release "Dark Days" for the Common Working File Hosts
January 2023 Release "Dark Days" for the Common Working File Hosts For the upcoming January 2023 Release: For Production, CWF will be observing the Gray Day on Thursday, 12/29/2022 and Dark Days starting Friday, 12/30/2022 through Sunday, [...]
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Posting Date: 12/08/2022
MLN Connects® Newsletter: December 8, 2022
MLN Connects® Newsletter: December 8, 2022 News CMS Proposes Rule to Expand Access to Health Information and Improve the Prior Authorization Process Rural Emergency Hospitals: New Institutional Provider Type Starting [...]
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Posting Date: 08/04/2022
Reminder for Submission of Modifier 22
Reminder for Submission of Modifier 22 National Government Services would like to remind providers of the requirement for modifier 22. The Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-04, [...]
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Posting Date: 10/19/2022
You Can Help Your Patients Quit Tobacco Use - The Great American Smokeout Is Coming!
You Can Help Your Patients Quit Tobacco Use - The Great American Smokeout Is Coming! Join us for our weekly webinar series on Medicare’s preventative service, "Counseling to Prevent Tobacco Use." Statistics show that tobacco use remains the [...]
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Posting Date: 09/16/2020
Other Options <9>
Reason Code Lookup (touchtone 1) When Reason Code Lookup is selected, the IVR will request the five-digit reason code: Clearly speak or enter the reason code. Refer to the Phonetic Alphabet for assistance with speaking alpha characters [...]
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Posting Date: 11/30/2022
National Government Services Medicare Part B Preventive Services Week
National Government Services Medicare Part B Preventive Services Week 12/6/2022 – 12/8/2022 Medicare offers many preventive service benefits that can help detect health problems early and keep your patients from getting certain diseases. [...]
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Posting Date: 04/26/2021
OIG Guidance for COVID-19 Vaccination
OIG Guidance for COVID-19 Vaccination On 4/15/2021, the HHS-OIG issued Message from HHS-OIG Leadership on the COVID-19 Vaccination Program and Provider Compliance that states: As COVID-19 vaccinations continue to be administered nationwide, [...]
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