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Posting Date: 01/29/2020
About PC Print
About PC Print The PC Print software is available for providers to view and print HIPAA-compliant ERAs from their own computer. The PC Print software is available to you at no cost. This software is easy to use and will save you both time and [...]
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Posting Date: 01/29/2020
Minimum System Requirements and Support
Minimum System Requirements and Support PC Print is only compatible with officially supported Microsoft Windows Operating Systems. Please note that PC Print v4.2.6 is the only version compatible with Windows XP. PC Print software allows [...]
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Posting Date: 01/29/2020
Key Features
Key Features PC Print offers several different report displays and the ability to print the reports as needed. The Single Claim Report includes the activity at the claim and detail line items for a single claim. The All Claims Report [...]
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Posting Date: 11/17/2020
Download PC-ACE
Download PC-ACE Download PC-ACE If you intend to administer the COVID-19 vaccines when they become available, or the new monoclonal antibody bamlanivimab, especially if you intend to roster bill these codes, please download and install the [...]
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Posting Date: 11/19/2018
View and Print ERA in PC-ACE
View and Print ERA in PC-ACE PC-ACE offers the ability to translate an ERA to either view and/or print for both institutional and professional ERAs after they have been downloaded. ERAs viewed/printed in PC-ACE provides the same data that is [...]
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Posting Date: 03/28/2022
PC-ACE Quick Reference Guide: Medicare Secondary Payer
PC-ACE Quick Reference Guide: Medicare Secondary Payer The following are Medicare A (Institutional) instructions for entering line item and claim information into PC-ACE when Medicare is the secondary payer. Situations where Medicare is the [...]
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Posting Date: 09/25/2024
Counseling to Prevent Tobacco Use
In an effort to raise awareness and increase utilization of tobacco use counseling, we’ll focus on the effects of nicotine dependence including affected health consequences during this webinar. Medicare coverage, coding, billing and [...]
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Posting Date: 09/25/2024
PECOS: View and Manage Reassignments through Group Enrollment
During this webinar, we’ll provide an understanding of how to view and manage reassignments through the group enrollment in Provider Enrollment, Chain and Ownership System (PECOS), including to add or terminate reassignments. Individual [...]
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Posting Date: 09/26/2024
MLN Connects® Newsletter: September 26, 2024
MLN Connects® Newsletter: September 26, 2024 News CMS Roundup (September 20, 2024) Cardiovascular Disease: Talk with Your Patients about Screening Claims, Pricers, & Codes Cardiology CPT Code 75580: Issue with Claims Returned to [...]
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Posting Date: 05/11/2018
Medically Unlikely Edits and Related Billing Clarifications
Medically Unlikely Edits and Related Billing Clarifications An MUE is the maximum number of UOS allowable under most circumstances for a single HCPCS/CPT code billed by a provider for a particular date of service for a single beneficiary. [...]
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Posting Date: 09/26/2024
Physical/Occupational Therapy Billing
Join us as we review billing guidelines for physical and occupational therapy. We'll review when to apply the KX modifier and the importance of appropriate medical documentation. National Government Services has a Local Coverage Determination [...]
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Posting Date: 09/16/2024
Podiatry Services - Routine Foot Care and Debridement of Nails
While the Medicare Program generally excludes routine foot care services from coverage, there are specific indications or exceptions under which there are program benefits. Medicare payment may be made for routine foot care when the patient has [...]
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Posting Date: 06/01/2023
How to Avoid and Correct Duplicate Claim Denials
How to Avoid and Correct Duplicate Claim Denials A duplicate claim submission occurs when a physician or other qualified healthcare professional resubmits a claim either on paper or electronically for a single encounter and the service is [...]
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Posting Date: 09/16/2024
Third Quarter Top Ten EDI Institutional Edits
Third Quarter Top Ten EDI Institutional Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the third quarter. Visit Quarterly Top Ten EDI Institutional Edits to view the edits and their description, and learn how you can [...]
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Posting Date: 09/16/2024
Third Quarter Top Ten EDI Part B Edits
Third Quarter Top Ten EDI Part B Edits Using data analysis we’ve updated the Top Ten EDI Edits for the third quarter. Visit Quarterly Top Ten EDI Part B Edits to view the edits and their description, and learn how you can quickly identify the [...]
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Posting Date: 01/18/2022
Quarterly Top Ten EDI Part B EDI Edits
Quarterly Top Ten EDI Part B EDI Edits National Government Services EDI has identified the following Top Ten Claim Edit Module (CEM) edits that were received during the third quarter on the 277CA (Claims Acknowledgement) report for 837P 5010A1 [...]
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Posting Date: 01/18/2022
Quarterly Top Ten EDI Institutional EDI Edits
Quarterly Top Ten EDI Institutional EDI Edits National Government Services EDI has identified the following top ten CEM edits that were received during the third quarter on the 277CA (Claims Acknowledgement) report for 837I 5010A1 formatted [...]
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Posting Date: 07/11/2022
Meeting Minutes
Meeting Minutes Jurisdiction 6 Illinois, Minnesota, Wisconsin Jurisdiction K Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Jurisdiction 6 and Jurisdiction K Combined Meeting 8/8/2024 4/4/2024 12/7/2023
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Posting Date: 09/16/2024
Care Management: Principal Care Management Services
As part of a continued series, National Government Services (NGS) is raising awareness on the benefits of care management. During this webinar, we’ll discuss principal care management services for patients with a single chronic condition and [...]
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Posting Date: 07/05/2022
Audit and Reimbursement
Audit and Reimbursement Cost Report Filing State/Region Contact Information Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Bobbi Jo Luciano Office: South Portland, ME [...]
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Posting Date: 11/07/2022
Who Can Bill for Diabetes Self-Management and Medical Nutrition Therapy?
Who Can Bill for Diabetes Self-Management and Medical Nutrition Therapy? Table of Contents Who Can Bill for Diabetes Self-Management and Medical Nutrition Therapy? Who Can Bill for DSMT Billable Codes for Diabetes Self-Management Training [...]
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Posting Date: 11/11/2021
Documentation to Support Spinal Manipulation for CPT Code 98942
Documentation to Support Spinal Manipulation for CPT Code 98942 It is not uncommon for chiropractic doctors to perform a full-spine or multi-level manipulation, even when the symptoms or diagnosis reflect a single region. This is a matter of [...]
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Posting Date: 11/11/2021
Limited Coverage for Services Ordered or Furnished By a Chiropractor
Limited Coverage for Services Ordered or Furnished By a Chiropractor This article is to remind chiropractors and facilities that X-rays and other diagnostic tests are statutorily excluded services when ordered or furnished by a chiropractor. [...]
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Posting Date: 11/11/2021
Proper Billing for Acupuncture
Medicare Coverage of Chiropractic Services Proper Billing for Acupuncture Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N) Reviewed 9/11/2024
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Posting Date: 11/11/2021
Medical Review Audits
Medicare Coverage of Chiropractic Services Medical Review Audits Medicare contractors perform medical review audits to ensure Medicare is paying providers for appropriately covered Medicare services. Medical review examines documentation [...]
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Posting Date: 11/11/2021
Maintenance Care for Chiropractic Services
Medicare Coverage of Chiropractic Services Maintenance Care for Chiropractic Services Medicare coverage for chiropractic services extends only to treatment by means of manual manipulation of the spine to correct a subluxation, provided such [...]
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Posting Date: 04/23/2021
Chiropractic Coverage
Medicare Coverage of Chiropractic Services Chiropractic Coverage Medicare pays chiropractors for spinal manipulation CPT codes 98940–98942, when these services are reasonably and medically necessary and meet all Medicare coverage guidelines [...]
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Posting Date: 11/11/2021
Introduction to Chiropractic Services
Medicare Coverage of Chiropractic Services Introduction to Chiropractic Services A chiropractor must be licensed or legally authorized to furnish chiropractic services by the state or jurisdiction in which the services are furnished. In [...]
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Posting Date: 06/01/2020
New York State Ambulance Services in Rural Areas (for JK providers only)
New York State Ambulance Services in Rural Areas NYS has unique requirements for the payment of paramedic intercept services when an ambulance company can provide only BLS services. Paramedic intercept services can be approved in counties and [...]
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Posting Date: 10/27/2022
Coverage of Rural Air Ambulance Services
Coverage of Rural Air Ambulance Services Section 415 of the Medicare Modernization Act of 2003 provides coverage for rural air ambulance services that are reasonable and necessary and ordered by qualified personnel. Medicare considers the [...]
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Posting Date: 07/21/2023
Original Medicare First Level of Appeal Tips Sheet for Medicare Providers
Original Medicare First Level of Appeal Tips Sheet for Medicare Providers If you disagree with Medicare’s claim determination, you may appeal. However, please follow these important tips before you submit a first level of appeal [...]
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Posting Date: 11/11/2021
Advance Beneficiary Notice of Noncoverage Liability
Medicare Coverage of Chiropractic Services Advance Beneficiary Notice of Noncoverage Liability The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is a standardized notice that a health care provider/supplier or his/her [...]
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Posting Date: 11/11/2021
Chiropractic Resources
Medicare Coverage of Chiropractic Services Chiropractic Resources Code of Federal Regulations Code of Federal Regulations (Annual Edition) web page 42 CFR Section 410.21 describes limitations on services of a chiropractor 42 CFR [...]
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Posting Date: 03/08/2023
PECOS Starter Guide
PECOS Starter Guide Follow the steps outlined below to assist you and your staff with the PECOS processes. Table of Contents New/Initial Enrollee Revalidation Return for Corrections Change of Information Submit Pending Application [...]
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Posting Date: 09/12/2024
MLN Connects® Newsletter: September 12, 2024
MLN Connects® Newsletter: September 12, 2024 News COVID-19: Updated Vaccines for 2024–2025 Season Rural Emergency Hospital Provisions, Conversion Process, & Conditions of Participation: Revised Guidance CMS Roundup (September 6, 2024) [...]
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Posting Date: 09/12/2024
Understanding Authorized Official and Delegated Official Roles
Table of Contents Understanding Authorized Official and Delegated Official Roles Medicare Enrollment Records CMS Identity and Access Management System [Return to Top] Understanding Authorized Official and Delegated Official Roles [...]
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Posting Date: 03/07/2023
PECOS Starter Guide
PECOS Starter Guide Follow the steps outlined below to assist you and your staff with the PECOS processes. New/Initial Enrollee Revalidation Return for Corrections Change of Information Submit Pending Application Add a New [...]
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Posting Date: 09/12/2024
Portable X-Ray Pricing Update
Portable X-ray pricing fees for CY 2024 will have new fees in production by 9/6/2024.
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Posting Date: 09/12/2024
National Government Services Medicare Part B Care Management Services September Series
National Government Services Medicare Part B Care Management Services September Series According to the CDC, six in ten adults in the U.S. have a chronic disease and four in ten adults have two or more. As your Medicare Contractor for [...]
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Posting Date: 09/13/2024
Credit Balance Reporting Reminder: Submissions for Quarter Ending 9/30/2024 Start Soon!
Credit Balance Reporting Reminder: Submissions for Quarter Ending 9/30/2024 Start Soon! CBR submissions can be submitted starting on 10/1/2024 and are due within 30 days to be considered timely. Remember, even if no monies are owed to Medicare [...]
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Posting Date: 11/07/2022
Common Questions for Diabetes Self-Management Training and Medical Nutrition Therapy
Common Questions for Diabetes Self-Management Training and Medical Nutrition Therapy Table of Contents Diabetes Programs Billing for Services DSMT and MNT Telehealth Services Related Content [Return to Top] Diabetes Programs [...]
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Posting Date: 11/07/2022
Common Questions for Diabetes Self-Management Program Accreditation
Common Questions for Diabetes Self-Management Program Accreditation Does my organization need to be accredited to bill for DSMT services? Answer: Yes. In order to bill Medicare for DSMT services, your organization’s DSMT program must be [...]
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Posting Date: 11/07/2022
Medicare Diabetes Prevention Program
Medicare Diabetes Prevention Program Table of Contents Background What is the Medicare Diabetes Prevention Program? Overview of MDPP What is Covered Through the Model? How Does the Model Pay for MDPP Services? What Does this [...]
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Posting Date: 06/13/2022
Remote Physiological Monitoring and Cardiovascular Monitoring Service and Billing Information
Remote Physiological Monitoring and Cardiovascular Monitoring Service and Billing Information Table of Contents Remote Physiological Monitoring Services CPT Codes: 99091, 99453, 99454, 99457, 99458 Remote Physiological Monitoring [...]
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Posting Date: 11/07/2022
Medical Nutrition Therapy Tool for Billing
Medical Nutrition Therapy Tool for Billing CMS considers DSMT and MNT complementary services. This means Medicare will cover both DSMT and MNT without decreasing either benefit as long as the referring physician determines that both are [...]
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Posting Date: 01/02/2024
Medicare Part B Final Rule 2024
Medicare Part B Final Rule 2024 CMS announced finalized policy changes for Medicare payments under the PFS, and other Medicare Part B topics, effective on or after 1/1/2024. The CY 2024 PFS final rule is one of several final rules that [...]
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Posting Date: 09/13/2024
Ambulance Services and Establishing Medical Necessity for Part B Providers
This webinar will help the ambulance community understand the importance of medical necessity as it pertains to Medicare’s coverage guidelines.
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Posting Date: 09/02/2022
Check Appeal Status
Check Appeal Status Table of Contents Check Appeal Status Check Status of Requests Submitted in NGSConnex Check Status of Requests Not Submitted in NGSConnex [Return to Top] Check Appeal Status Click the Appeals button from the [...]
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Posting Date: 10/26/2022
Podiatry Coding Tips
Podiatry Billing Guide Podiatry Coding Tips Coding Information Procedure codes may be subject to NCCI edits or OPPS packaging edits. Refer to CCI and OPPS requirements prior to billing Medicare. For services requiring a [...]
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Posting Date: 10/26/2021
Related Content
Related Content CMS IOM Publication 100-01, Medicare General Information, Eligibility and Entitlement, Chapter 5, Section 70.3 CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 290: Foot Care CMS [...]
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Posting Date: 10/26/2022
Advance Beneficiary Notice of Noncoverage/National Correct Coding Initiative
Podiatry Billing Guide Advance Beneficiary Notice of Noncoverage/National Correct Coding Initiative ABN Services denied as not reasonable and medically necessary, under Section 1862(a) (1) of the Social Security Act, are subject to [...]
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Posting Date: 10/26/2021
Biopsy to Prove Onychomycosis in Routine Foot Care
Biopsy to Prove Onychomycosis in Routine Foot Care National Government Services has been made aware of a situation where podiatrists have been approached by laboratories stating that they need to biopsy their patients to make sure they have [...]
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Posting Date: 10/26/2022
Modifier Usage
Podiatry Billing Guide Modifier Usage 25 – Significant, Separately Identifiable E/M Service by the Same Physician on the Same Day of the Procedure or Other Service Medicare allows payment for an E/M service performed on the same [...]
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Posting Date: 10/26/2022
Podiatry National Coverage Determinations
Podiatry Billing Guide Podiatry National Coverage Determinations The following are in reference to CMS IOM Publication 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1. Part 1 Section 20.29 [...]
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Posting Date: 10/26/2021
Introduction to Podiatry Services
Podiatry Billing Guide Introduction to Podiatry Services Foot Care Table of Contents Treatment of Subluxation of Foot Exclusions from Coverage Exceptions to Routine Foot Care Exclusion Systemic Conditions That Might Justify Coverage [...]
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Posting Date: 10/26/2022
Podiatry Local Coverage Determinations
Podiatry Billing Guide Podiatry Local Coverage Determinations Table of Contents LCD for Routine Foot Care and Debridement of Nails (L33636) LCD for Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory [...]
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Posting Date: 12/12/2014
Billing for FQHC MAO Plan Supplemental Payment (PPS Providers)
Billing for FQHC MAO Plan Supplemental Payment (PPS Providers) Medicare will provide supplemental payments to FQHCs that contract with MAOs to cover the difference, between the payment received from the MAO and the payment to which the FQHC [...]
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Posting Date: 02/26/2024
Ambulance Duplicate Claim Denials
Ambulance Duplicate Claim Denials Duplicate trips may be reported on the same claim if the ZIP code for the point of pick-up for both trips is the same. If separate claims are submitted for the same beneficiary on the same day with the same [...]
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Posting Date: 10/31/2022
Provider Qualifications
Provider Qualifications Definition Ophthalmologist An ophthalmologist is a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) who has completed medical school and an ophthalmology residency that specialized in eye and [...]
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