-
Posting Date: 09/09/2021
Factor VIII Billing
Factor VIII Billing National Government Services has received questions on the proper billing for Factor VIII drugs. This article outlines appropriate billing for these services. If the submitted amount does not exceed $99,999.99, bill the [...]
Read More -
Posting Date: 11/15/2022
Proper Billing for LEQVIO® HCPCS Code J1306
Proper Billing for LEQVIO® HCPCS Code J1306 Table of Contents Proper Billing for LEQVIO® HCPCS Code J1306 Claim Completion Requirements Drug Wastage Related Content [Return to Top] Proper Billing for LEQVIO® HCPCS Code J1306 [...]
Read More -
Posting Date: 12/19/2016
Erythropoiesis Stimulating Agents: Clinical Indications and Coverage Criteria Overview
Erythropoiesis Stimulating Agents: Clinical Indications and Coverage Criteria Overview Table of Contents Erythropoiesis Stimulating Agents: Clinical Indications and Coverage Criteria Overview Drugs and Dosage Conditions Requiring Prior [...]
Read More -
Posting Date: 09/08/2021
Proper Billing Units for HCPCS Code J7320
Proper Billing Units for HCPCS Code J7320 National Government Services has noticed improper billing units used for HCPCS code J7320, Hyaluronan or derivative, GenVisc 850, for intra-articular injection, 1 mg. GenVisc 850 is indicated for the [...]
Read More -
Posting Date: 03/21/2024
MLN Connects® Newsletter: March 21, 2024
MLN Connects® Newsletter: March 21, 2024 News New Initiative to Increase Investments in Person-Centered Primary Care Marriage and Family Therapists & Mental Health Counselors: Get Information about Billing Medicare Electronic Funds [...]
Read More -
Posting Date: 03/21/2024
Inquiry Reference Numbers Are Now Available on the IVR
Inquiry Reference Numbers Are Now Available on the IVR You can now get an inquiry reference number through the IVR. Once the caller makes a selection from the main menu, the IVR will ask, "Would you like an inquiry reference ID?" This will [...]
Read More -
Posting Date: 02/26/2022
View Claim Details
View Claim Details Select the Claim Number hyperlink to view additional claim details. If the claim was denied, you can view the reason for denial. You can view the following claim details from the Left-Side navigation. Claim Header [...]
Read More -
Posting Date: 03/22/2024
Important Reminder: Change Healthcare Security Incident
Important Reminder: Change Healthcare Security Incident This is an important reminder related to the Change Healthcare Security Incident and the efforts of the CMS and National Government Services. Change Healthcare is a clearinghouse vendor [...]
Read More -
Posting Date: 08/30/2021
Understanding the Medicare Summary Notice and Options
Understanding the Medicare Summary Notice and Options If you get a Medicare-covered service, you’ll get an MSN in the mail every three months. The notice shows all your services that your Medicare provider of service billed to Medicare during [...]
Read More -
Posting Date: 03/25/2024
Attention Electronic Billers
Attention Electronic Billers National Government Services has experienced issues with electronic files downloaded by some of our trading partners (those who receive electronic files directly from NGS). This was not a widespread issue and only [...]
Read More -
Posting Date: 03/25/2024
Attention! New CMS-588 Electronic Funds Transfer Authorization Agreement (11/23) Version
Attention! New CMS-588 Electronic Funds Transfer Authorization Agreement (11/23) Version Effective 4/30/2024 the MACs may only accept the CMS-588 EFT (11/23) version, the outdated form will be returned. NOTE: An electronic application [...]
Read More -
Posting Date: 03/25/2024
LCD and Article Updates for March/April 2024
LCD and Article Updates for March/April 2024 Local Coverage Determinations Fluid Jet System Treatment for LUTS/BPH (L38367) The age limitation of >80 years of age has been removed, effective for services rendered on or after 4/1/2024. [...]
Read More -
Posting Date: 01/06/2023
FQHC PPS Calculator
FQHC PPS Calculator 1/1/2024-12/31/2024 2023 2022 2021 2020 2019 Updated 3/26/2024
Read More -
Posting Date: 03/26/2024
Medicare Part B General Billing
Medicare Part B General Billing Claims for drugs and biologicals are mandatory assignment. Claims submitted as nonassigned will be converted to adjudicate as assigned. When billing drugs or biologicals, the drug name, dosage and invoice price [...]
Read More -
Posting Date: 03/26/2024
Patient-Supplied or Free-of-Charge Drugs
Patient-Supplied or Free-of-Charge Drugs When a patient purchases a drug and the physician administers it, the cost of the drug is not covered because it does not represent a cost to the physician. However, the administration of the drug is a [...]
Read More -
Posting Date: 11/12/2020
Providers Performing Facet Joint Injections (CPT Code 64476)
Providers Performing Facet Joint Injections (CPT Code 64476) The OIG released the results of an investigation into facet joint injections. Per the OIG report: "Facet joint injections are typically performed using radiological guidance [...]
Read More -
Posting Date: 03/26/2024
Related Content
Related Content LCD L33394 - Drugs and Biologicals, Coverage of, for Label and Off-Label Uses Drug Coverage under Different Parts of Medicare Medicare Program Discarded Drugs and Biologicals - JW Modifier and JZ Modifier Policy Frequently [...]
Read More -
Posting Date: 11/02/2021
Intravitreal Beovu (Brolucizumab-dbl) Billing
Intravitreal Beovu (Brolucizumab-dbl) Billing National Government Services has seen multiple variations of billing from providers for Intravitreal Beovu. This job aid provides clarification and proper billing for this drug. For Medicare [...]
Read More -
Posting Date: 03/27/2024
Drugs and Biologicals
Drugs and Biologicals We’ve updated the drugs and biologicals section of our website to offer easier navigation to the information you need. Updates include: Created a left-side navigation list with hyperlinks to specific information Added [...]
Read More -
Posting Date: 03/27/2024
NGSConnex Part B Claim Submission Issue – Mammography Claims
NGSConnex Part B Claim Submission Issue - Mammography Claims At this time, we are unable to accept mammography claims through Part B Claim Submission in NGSConnex. We are working to resolve the issue; please watch for Email Updates on the [...]
Read More -
Posting Date: 03/07/2022
Copy Claim Entry
Copy Claim Entry Table of Contents Copy Claim Entry Claim Lines Information – Add, Edit or Delete Ready to Submit Claim [Return to Top] Copy Claim Entry Part B providers who have a completed EDI enrollment form on file can submit [...]
Read More -
Posting Date: 02/26/2022
Check Appeal History
Check Appeal History Table of Contents Check Appeal History Attaching Additional Supporting Documentation Attachments Submit [Return to Top] Check Appeal History Click the Appeals button from the NGSConnex homepage. [...]
Read More -
Posting Date: 02/26/2022
Initiate a General Inquiry
Initiate a General Inquiry Table of Contents Initiate a General Inquiry Step 1: Provider Details Step 2: Inquiry Information Step 3: Attachments [Return to Top] Initiate a General Inquiry Click the Inquiries button from [...]
Read More -
Posting Date: 03/17/2022
Initiate a Prior Authorization Request
Initiate a Prior Authorization Request Table of Contents Initiate a Prior Authorization Request Request Details Requestor’s Information Certifying Physician Information Attachments [Return to Top] Initiate a Prior [...]
Read More -
Posting Date: 04/06/2022
Check Status of Prior Authorization Requests
Check Status of Prior Authorization Requests Table of Contents Check Status of Prior Authorization Requests View the Prior Authorization Submission Attachments [Return to Top] Check Status of Prior Authorization Requests You will [...]
Read More -
Posting Date: 10/14/2022
View Financial Claim Number Information
View Financial Claim Number Information Table of Contents View Financial Claim Number Information Financial Claim Number Patient Search [Return to Top] View Financial Claim Number Information The FCN can be found on the Medicare [...]
Read More -
Posting Date: 02/26/2022
Account Suspensions
Account Suspensions Table of Contents Account Suspensions Unsuspend Your Account Invalid Login Attempts [Return to Top] Account Suspensions NGSConnex accounts may be suspended for one of the following reasons. If an [...]
Read More -
Posting Date: 02/26/2022
Create an Account - Local Security Officer (LSO)
Create an Account — Local Security Officer (LSO) Table of Contents Create an Account — Local Security Officer (LSO) Step 1 – Account Step 2 – Individual Step 3 – Business [Return to Top] Create an Account — Local Security [...]
Read More -
Posting Date: 03/02/2021
LSO Responsibilities
LSO Responsibilities Table of Contents LSO Responsibilities Approve/Decline/Modify/Remove Access [Return to Top] LSO Responsibilities The LSO is responsible for managing access for other NGSConnex users within the organization. [...]
Read More -
Posting Date: 02/26/2022
Navigation Structure
Navigation Structure Table of Contents NGSConnex Home Page Breadcrumbs Progress Bar Select a Provider Select a Beneficiary Cancel Reset Search [Return to Top] NGSConnex Home Page After you successfully log in to NGSConnex the [...]
Read More -
Posting Date: 07/14/2022
View a General Inquiry
View a General Inquiry Table of Contents View a General Inquiry Attachments [Return to Top] View a General Inquiry National Government Services, Inc. will respond to your inquiry via NGSConnex within 45-business days of the date your [...]
Read More -
Posting Date: 07/27/2022
Initiate Audit and Reimbursement Document Submissions
Initiate Audit and Reimbursement Document Submissions Table of Contents Initiate Audit and Reimbursement Document Submissions Step 1: Provider Details Step 2: Audit & Reimbursement Step 3: Document Submission Step 4: Submit [...]
Read More -
Posting Date: 02/26/2022
A&R Inquiries
A&R Inquiries Table of Contents A&R Inquiries Email Notification View/Initiate an A&R Inquiry Response Inquiry Details Step 1: Response Description Step 2: Attachments Step 3: Submit Response What to do if you [...]
Read More -
Posting Date: 02/26/2022
Initiate a Prior Authorization Request
Initiate a Prior Authorization Request Table of Contents Initiate a Prior Authorization Request Request Details Requestor’s Information Rendering Physician Information Attachments [Return to Top] Initiate a Prior Authorization [...]
Read More -
Posting Date: 03/27/2024
A/B and DME Collaborative General Documentation Requirements
A/B and DME Collaborative General Documentation Requirements The A/B and DME Collaborative General Documentation Requirements YouTube Video is available. Posted 3/27/2024
Read More -
Posting Date: 03/28/2024
MLN Connects® Newsletter: March 28, 2024
MLN Connects® Newsletter: March 28, 2024 Proposed Payment Rule FY 2025 Inpatient Rehabilitation Facility Prospective Payment System Proposed Rule News CMS Roundup (Mar 22, 2024) Hospital Price Transparency: Tools to Help Hospitals [...]
Read More -
Posting Date: 03/01/2024
April 2024
In This Issue National Government Services Articles for Part A and Part B Providers Attention Electronic Billers Attention! New CMS-588 Electronic Funds Transfer Authorization Agreement (11/23) Version Important Reminder: Change [...]
Read More -
Posting Date: 02/26/2022
Submitting Credit Balance Reports
Submitting Credit Balance Reports Table of Contents Submitting Credit Balance Reports Initiate a Credit Balance Report Credit Balance Certification Page [Return to Top] Submitting Credit Balance Reports This function allows [...]
Read More -
Posting Date: 01/25/2024
Psychological Services Coverage under the Incident to Provision for Physicians and Nonphysicians - Medical Policy Article
Psychological Services Coverage under the Incident to Provision for Physicians and Nonphysicians – Medical Policy Article psychiatric, mental A52825 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52825 90785, 90832, [...]
Read More