Search Results - NGSMEDICARE

Posting Date: 10/09/2024

I thought CMS was permanently allowing the beneficiary to have telehealth sessions in their homes. Is there an end date to this?

Posting Date: 10/09/2024

Is the GT modifier not accepted for professional telehealth services after the PHE or at the end of December?

Posting Date: 10/09/2024

Will the originating site fee (Q3014) be billable for telehealth services when the patient is located in their home?

Posting Date: 10/09/2024

With the end of the PHE on 5/11/2023, will Medicare beneficiaries be required to have a physician order to receive a laboratory conducted COVID-19 test?

Posting Date: 10/09/2024

ASCA: How will I know the outcome of my Administrative Simplification Compliance Act waiver request form?

Posting Date: 10/09/2024

ASCA: How will the Administrative Simplification Compliance Act enforcement review affect me as a “small provider/supplier?” Will I be required to submit claims electronically?

Posting Date: 10/09/2024

ASCA: If my Administrative Simplification Compliance Act Waiver Request is denied, what will happen to my paper claims?

Posting Date: 10/09/2024

ASCA: What kind of supporting documentation should I attach to my Administrative Simplification Compliance Act Waiver Request?

Posting Date: 10/09/2024

APPEALS: We are a large group with many physician and nonphysician practitioners. When we submit claims for nonphysician practitioners working in different sub-specialties, we receive denials that state: D984: Coverage/program guidelines not met, N20: Service not payable with other service rendered on the same day.

Posting Date: 10/09/2024

APPEALS: Another denial we see is “This service has been provided at a frequency that is more than the medically appropriate indication by policy or regulation.” How can we avoid these denials?

Posting Date: 10/09/2024

APPEALS: Can one appeal a claim that rejected with MA130?

Posting Date: 10/09/2024

APPEALS: How can I get status of my redetermination or reopening request?

Posting Date: 10/09/2024

APPEALS: How would one submit a paper appeal?

Posting Date: 10/09/2024

APPEALS: Is documentation required for an appeal?

Posting Date: 10/09/2024

APPEALS: Is there a reference sheet to determine what constitutes an appeal?

Posting Date: 10/09/2024

APPEALS: Is there a time limit for filing an appeal?

Posting Date: 10/09/2024

APPEALS: We are a large group with many physicians and nonphysician practitioners. When we submit claims for nonphysician practitioners working in different sub-specialties, we get claim denials that state: “D463: New patient qualifications were not met or M13: Only one initial visit is covered per specialty per medical group.” How can we avoid these?

Posting Date: 10/09/2024

APPEALS: What are the top appeals submitted to NGS?

Posting Date: 10/09/2024

APPEALS: What is a Medicare appeal?

Posting Date: 10/09/2024

APPEALS: What is the appeal process?

Posting Date: 10/09/2024

APPEALS: What is the best way to get duplicate denials paid on appeal?

Posting Date: 10/09/2024

APPEALS: What is the solution to avoiding claim denials?

Posting Date: 10/09/2024

APPEALS: Where can I find the regulations on Medicare appeals?

Posting Date: 10/09/2024

CAR-T: Is Risk Evaluation and Mitigation Strategy (REMS) verified by the facility’s site name or address?

Posting Date: 10/09/2024

CAR-T: Is the KX modifier required for Part A and Part B claims?

Posting Date: 10/09/2024

CAR-T: What is the effective date for the requirement of the KX modifier for administration of CAR-T?

Posting Date: 10/09/2024

CAR-T: Will the Part A claim for CAR-T deny if it is submitted with the KX modifier?

Posting Date: 10/09/2024

CLAIMS: During the patient check in process, may we have the patient check a box on a form at each visit stating they agree to allow us to bill Medicare and have that serve as the patient’s acceptance for our filing a claim?

Posting Date: 10/09/2024

CLAIMS: How do I know if a HCPCS/CPT code is subject to MUE (medically unlikely edit)?

Posting Date: 10/09/2024

CLAIMS: How do I prevent monthly End Stage Renal Disease claims from denying?

Posting Date: 10/09/2024

CLAIMS: How do I submit documentation for an additional development request (ADR)?

Posting Date: 10/09/2024

CLAIMS: I am receiving inconsistent payments on claims billed for the same drug. How can I prevent this?

Posting Date: 10/09/2024

CLAIMS: I file all my Medicare claims electronically except for Medicare Secondary Payer (MSP) claims because I thought I had to attach the primary Explanation of Benefits (EOB). Is this the correct process?

Posting Date: 10/09/2024

CLAIMS: Medicare is the beneficiary's secondary payer and I am receiving denials when submitting using the CMS-1500 form. How can I resolve this?

Posting Date: 10/09/2024

CLAIMS: On a screening Pap smear test claim, which pointer does my diagnosis code need to be in?

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?