Interactive Voice Response System

Interactive Voice Response System State IVR Number Hours Available* Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont 877-567-7205 Monday–Friday: 6:00 a.m.–7:00 p.m. ET [...]

MLN Connects® Newsletter: December 5, 2024

MLN Connects® Newsletter: December 5, 2024 News Clinical Laboratory Fee Schedule: CY 2025 Final Payment Determinations CMS Roundup (November 29, 2024) Advanced Primary Care Management Services: Get Information about Billing Medicare Flu [...]

Annual Logon ID Recertification for New York/Connecticut Regions

All users who access the FISS DDE system are required by the CMS to recertify their access annually. National Government Services will designate one state at a time to complete the annual logon recertification. To complete the recertification [...]

Common Working File (CWF) Host Dark Days for January 2025 Release

Common Working File (CWF) Host Dark Days for January 2025 Release  For Production, 1/1/2025 – Observe Holiday – No Cycle, CWF will be observing the Gray Day on Thursday, 1/2/2025 and Dark Days starting Friday, 1/3/2025 through Sunday, [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Written Correspondence and Inquiries [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Written Correspondence and Inquiries [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Written Correspondence and Inquiries [...]

Interactive Voice Response System

Interactive Voice Response System State IVR Hours Available* Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont 877-869-6504 Monday–Friday: 6:00 a.m.–7:00 p.m. ET Saturday: [...]

Interactive Voice Response System

Interactive Voice Response System Toll-Free Number 877-309-4290 Hours Available* Monday–Friday: 6:00 a.m.–7:00 p.m. ET Saturday: 7:00 a.m.–3:00 p.m. ET *IVR hours represent general availability for access to all menu options. The IVR is [...]

Interactive Voice Response System

Interactive Voice Response System State IVR Number Hours Available* Alaska, Arizona, California, Hawaii, Idaho, Nevada, Oregon, Washington, American Samoa, Guam, Northern Mariana Island 866-277-7287 [...]

Billing Protections for Qualified Medicare Beneficiaries

Incarcerated or Unlawfully present in the US claim rejections (U538H, U538Q)

Incarcerated or Unlawfully Present in the U.S. Claim Rejections (U538H, U538Q) This stringent claim editing process helps ensure that Medicare does not make payments for services rendered to beneficiaries who are not eligible due to being [...]

January 2025 EDI Front End Quarterly Release

January 2025 EDI Front End Quarterly Release Please be advised that while the Centers for Medicare & Medicaid Services mandated release for January 2025 will be installed the weekend of 1/5/2025, the code set updates included with this [...]

Screening Mammography, Pap Test and Pelvic Exam

Ensure that your patients obtain the preventive services they are eligible for by knowing the Medicare coverage, coding and billing guidelines for screening mammograms, pap tests and pelvic examinations, as well as where to find more [...]

Correct a Beneficiary's MSP Record

Table of Contents Background Step 1: Provider Receives Information Indicating Medicare Is the Primary Payer for a Beneficiary's Services Step 2: Prepare and Submit a Medicare Primary Claim With the Reason Medicare Is the Primary Payer [...]

Provisional Period of Enhanced Oversight for New Hospices

Provisional Period of Enhanced Oversight for New Hospices In recent years, CMS has reported a significant increase in fraudulent hospice billing practices, which cost the Medicare program millions of dollars annually. The CMS has initiated a [...]

Overcoming Barriers to Tobacco Counseling

Overcoming Barriers to Tobacco Counseling Healthcare providers may face different challenges when implementing tobacco cessation counseling into a clinical practice routine. These various factors influence the healthcare professionals’ [...]

Understanding the Approval Recommendation Process for Certified Providers

Understanding the Approval Recommendation Process for Certified Providers The certified provider completes and submits a CMS-855 enrollment application and all supporting documentation to its MAC, including any state require documentation and [...]

Certified Provider and State Survey Agency

Certified Provider and State Survey Agency Table of Contents Certified Provider and State Survey Agency Certified Providers/Suppliers Certified Providers and Certified Suppliers That Enroll Via the Form CMS-855A Certified Suppliers [...]

Understanding the Approval Recommendation Process for Certified Providers

Understanding the Approval Recommendation Process for Certified Providers The certified provider completes and submits a CMS-855 enrollment application and all supporting documentation to its MAC, including any state require documentation [...]

Certified Provider and State Survey Agency

Certified Provider and State Survey Agency Table of Contents Certified Provider and State Survey Agency Certified Providers/Suppliers Certified Providers and Certified Suppliers That Enroll Via the Form CMS-855A Certified Suppliers That [...]

MLN Connects® Newsletter: December 12, 2024

MLN Connects® Newsletter: December 12, 2024 News FY 2024 Medicare Fee-for-Service Improper Payment Rate Revised Home Health Change of Care Notice Form Effective February 1 Skilled Nursing Facility Value-Based Purchasing Program: December [...]

Your Lunchtime Treat! Listen to the Navigating Medicare: Part A Insights for Providers Podcast

Your Lunchtime Treat! Listen to the Navigating Medicare: Part A Insights for Providers Podcast “Lunch, listen and learn” twice a month with Medicare Part A! We have more than 15 Part A podcasts geared toward our Part A providers and their [...]

Intermittent Issues with NGSMedicare.com on 12/15/2024

Intermittent Issues with NGSMedicare.com on 12/15/2024 We will experience intermittent outages with NGSMedicare.com on Sunday, 12/15/2024 due to maintenance. NGSMedicare.com will be fully operational on Monday, 12/16/2024. We apologize for [...]

HCPCS 82947 RTPs End-Stage Renal Dialysis Providers

As of 1/1/2024, Medicare has covered HbA1c tests for diabetic screening (HCPCS 82947) when billed with ICD-10 Z13.1. Some of these claims submitted by ESRD providers have been RTP'd in error.

End Stage Renal Disease Claims Returning to Providers with Reason Code 31773

Due to an issue with the October 2024 release, ESRD facility claims, type of bill 72X, are RTPing in error.

Resources

Resources CMS Opioid Treatment Program webpage CMS Roadmap to Address the Opioid Epidemic SAMHSA (Substance Abuse and Mental Health Services Administration) MLN® Fact Sheet: A Prescribers Guide to Medicare Prescription Drug (Part D) [...]

Proper Billing for TEZSPIRE™ HCPCS Code J2356

Proper Billing for TEZSPIRE™ HCPCS Code J2356 Table of Contents Proper Billing for TEZSPIRE™ HCPCS Code J2356 Claim Completion Requirements Drug Wastage Appropriate Administration Coding Related Content [Return to Top] Proper [...]

Jurisdiction K State Licensing and Certification Websites

State Licensing and Certification Websites The following list contains helpful links to websites of some organizations within the JK jurisdictions that can be used to verify your status. Table of Contents Connecticut Maine Massachusetts [...]

DX Proc Codes ICD-10 (1B)

Chapter IV: Inquiries Submenu (01) DX Proc Codes ICD-10 (1B) Purpose The purpose of the DX/PROC CODES ICD-10 option is to provide a reference of ICD-10 code(s) used to identify a specific or various diagnosis codes or inpatient surgical [...]

Screening Mammography

Preventive Services Guide Screening Mammography A mammogram is an X-ray of the breast. Screening mammograms are routinely administered to detect breast cancer in women who have no apparent symptoms. Coverage Guidelines and Frequency Limits [...]

Jurisdiction 6 State Licensing and Certification Websites

State Licensing and Certification Websites The following list contains helpful links to websites of some organizations within the J6 jurisdictions that can be used to verify your status. Table of Contents Illinois Minnesota Wisconsin [...]

Overcoming Barriers to Tobacco Counseling 

Overcoming Barriers to Tobacco Counseling Healthcare providers do face several challenges when implementing tobacco cessation counseling into a clinical practice routine. These various factors influence the healthcare professionals’ [...]

Billing Original Fee-for-Service Medicare? You Can Help STOP Assignment Violations!

Billing Original Fee-for-Service Medicare? You Can Help STOP Assignment Violations! Table of Contents Billing Original Fee-for-Service Medicare? You can Help STOP Assignment Violations! What is the Definition of Medicare Assignment? [...]