DDE: I tried to access my claim through the FISS/DDE system and it will not let me pull it up. What is the problem?

DDE: Is there some place on FISS/DDE that shows how many physical therapy (PT) or occupational therapy (OT) visits the beneficiary has had?

CLAIMS: I received a denial stating that the documentation submitted did not support the medical necessity of laboratory services. Can you tell me what I can submit to support these services?

DDE: I have a claim which was fully denied and I am attempting to use the automated denial adjustment process, but the FISS/DDE system is not allowing me to adjust my claim. Why am I not able to bring up my claim and submit the adjustment?

DDE: My name changed and I need to change the name associated to my log on ID. How do I do that?

Update-CMS Delay of Skin Substitutes Effective Date

Update-CMS Delay of Skin Substitutes Effective Date As part of the transition to a new Administration, CMS is reviewing its coverage policies for skin substitute products. CMS believes it is important to maintain patient access to skin [...]

Understanding Medicare Fraud and Abuse

Learn about fraud and abuse affecting providers and your Medicare patients to increase your awareness of integrity issues and prevent potential fraudulent and abusive practices against the Medicare Program.

Provider Enrollment Revalidation Overview

During this webinar, learn about important changes in the revalidation process, how to determine Medicare enrollment revalidation due date and information to avoid disruption in Medicare billing.

How to Avoid Duplicate Claims

Duplicate denials continue to be one of the top billing errors. Unnecessary duplicate filing of Medicare claims cost the provider's office valuable time and resources, as well as Medicare's time and money to process them. Please join us for [...]

Critical Access Hospitals, FQHC and RHC Quarterly Top Claim Errors

Do you struggle with your claim denials, rejections and return to provider (RTP) claims? Do you want to be proactive in preventing unnecessary errors? Join us for a review of top claim errors for your provider type based on recent data [...]

Four Reasons Patients Fear Quitting Tobacco

Four Reasons Patients Fear Quitting Tobacco Stress: If you rely on cigarettes to loosen up during your day, you might worry about losing this release valve. It’s essential to remember that using nicotine to relax is only a temporary fix and [...]

IDTF Procedure Codes (65 KB)

Prior Authorization CPT/HCPCS Code Inquiry Tool

The Annual Wellness Visit: Promoting Good Health Through Disease Prevention and Detection

Medicare covers many preventive services to keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain diseases. Register today for an [...]

MSP Right Hand

Helpful Resources Verification of Medicare Secondary Payer Data  

DDE: Can a provider view additional development requests (ADRs) via the FISS/DDE?

CLAIMS: How do I indicate on a Medicare claim that the services are NOT related to a liability, no fault (including medical payment) or Workers’ Compensation accident, injury or illness MSP record in the CWF?

Provider Enrollment: Completing the CMS-855B Paper Application

During this webinar, we'll provide an understanding of how to complete the CMS-855B provider enrollment paper application for a clinic, group or supplier.

Provider Enrollment: Completing the CMS-855A Paper Application

During this webinar, we’ll provide an understanding of how to complete the CMS-855A provider enrollment paper application.

Provider Enrollment: Completing the CMS-855I Paper Application

During this webinar, we’ll provide an understanding of how to complete the CMS-855I provider enrollment paper application for a group member, sole proprietor or sole owner and we’ll also focus on reassigning Medicare benefits.

Prior Authorization CPT/HCPCS Code Inquiry Tool

Prior Authorization CPT/HCPCS Code Inquiry Tool This is a self-service tool to allow ambulance service providers, hospital, or physician office staff responsible for submitting prior authorization requests (PARs), to determine if the [...]

Medicare Overpayment Process

Ensure that you are compliant and avoid financial penalties by understanding the Medicare overpayment regulations. This session will focus on identifying overpayments, using the proper forms and procedures, the timelines for repayment and the [...]

Understanding the Reopening and Appeal Process Open Forum

National Government Services is committed to reducing provider burden associated with Medicare claim denials, reopenings and appeals. Filing an inquiry on a Medicare claim can be frustrating and costly to your organization. This delay in [...]

Private Practice Physical/Occupational Therapy Billing

We invite you to join our informative webinar focused on billing guidelines for physical and occupational therapy in private practice. During this webinar, we'll review important topics such as the appropriate use of the KX modifier and the [...]

Steps to Claim Corrections

This webinar includes the top continuous errors we find at National Government Services with claim submissions. Join us to learn how to correct your claims. We will also include an interactive segment on the different claim scenarios that cause [...]

Steps to Claim Corrections

This webinar includes the top continuous errors we find at National Government Services with claim submissions. Join us to learn how to correct your claims. We will also include an interactive segment on the different claim scenarios that cause [...]

Proper Part B Claim Submissions

This webinar is intended to educate providers and office staff members on how to complete a clean claim to avoid claim rejections, developments or denials. We will guide you through the CMS-1500 claim form and the electronic equivalent loops [...]

Proper Part B Claim Submissions

This webinar is intended to educate providers and office staff members on how to complete a clean claim to avoid claim rejections, developments or denials. We will guide you through the CMS-1500 claim form and the electronic equivalent loops [...]

55H2B

Avoiding/Correcting This Error Ensure the submitted documentation supports the beneficiary is confined to the home. An individual shall be considered “confined to the home” (homebound) if the following two criteria are met:   [...]

U537I

Avoiding/Correcting This Error All dates of service reported on a period of care claim must be on or after the date of admission. Verify the from and through dates billed and all line-item dates of service to ensure the dates are within the [...]

31287

Avoiding/Correcting This Error Hospice claims are required to be billed monthly. Verify the month beginning and ending date and the ‘From’ and ‘To’ dates on your claim. The claim must span the entire month for continuing care claims.

30993

Verify the MBI submitted on the claim matches the MBI in the Common Working File. If a new MBI has been assigned, follow the guidelines regarding the claim submission: For dates of service before the MBI change date use old or new MBI If [...]

37236

Avoiding/Correcting This Error Verify eligibility of the attending/ordering physicians in PECOS. Print that verification and make it part of the medical record. If applicable, submit a reopen request to the Appeals Department indicating error [...]

55HTP

Avoiding/Correcting This Error Verify that the initial certification is complete and includes all necessary elements, such as the patient’s homebound status, the need for skilled services, and a face-to-face encounter with a physician or [...]

55H1L

Avoiding/Correcting This Error Clinical progress notes should show evidence of a steady decline or downward trajectory in the beneficiary’s clinical status over time. Documentation should be objective, measurable and must support a life [...]

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 [...]

Portable X-Ray Cost Analysis Survey

Understanding the 2026 Cost Analysis Survey for Medicare Allowances on Portable X-Ray Transportation Codes R0070 and R0075

Understanding the 2026 Cost Analysis Survey for Medicare Allowances on Portable X-Ray Transportation Codes R0070 and R0075 Introduction Medicare plays a critical role in ensuring beneficiaries receive medically necessary diagnostic services, [...]

PECOS: Manage Signatures and Additional Information Requests

During this webinar, we’ll give direction for the Provider Enrollment, Chain and Ownership System (PECOS) application on understanding how to manage signatures and respond to additional information request from submitted applications.

Provider Enrollment: Completing the CMS-855I Paper Application

During this webinar, we’ll provide an understanding of how to complete the CMS-855I provider enrollment paper application for a group member, sole proprietor or sole owner and we’ll also focus on reassigning Medicare benefits.

Submitting Revalidation via PECOS

During this webinar, we’ll provide an understanding of how to utilize the Centers for Medicare & Medicaid Services (CMS) Internet-based Provider Enrollment Chain & Ownership System (PECOS) to be comfortable in navigating the system to submit a [...]

Getting Access to PECOS

During this webinar, we’ll discuss how to obtain access to the Internet-based Provider Enrollment Chain & Ownership System (PECOS) and gain connection to provider enrollment record as well as understand other Centers for Medicare & Medicaid [...]

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 [...]

Provider Enrollment Revalidation Overview

During this webinar, learn about important changes in the revalidation process, how to determine Medicare enrollment revalidation due date and information to avoid disruption in Medicare billing.

Provider Enrollment: Completing the CMS-855B Paper Application

During this webinar, we'll provide an understanding of how to complete the CMS-855B provider enrollment paper application for a clinic, group or supplier.

Provider Enrollment: Completing the CMS-855A Paper Application

During this webinar, we’ll provide an understanding of how to complete the CMS-855A provider enrollment paper application.

Clinical Trials

Clinical Trials Clinical trials are interventional studies that assess treatments or diagnostics compromising experimental and control groups. Medicare coverage in these trials is guided by strict CMS rules and is limited to FDA-approved [...]

Medical Review: Targeted Probe and Educate Review Topics

Jurisdiction K Part B Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Paring or Cutting of Benign Hyperkeratotic Lesion 11055, 11056, 11057 A07 – The [...]

34538

Avoiding/Correcting This Error If this is correct: Follow MSP billing guidelines and submit the claim accordingly. If this is incorrect: As part of a provider’s eligibility verification process for Medicare beneficiaries, which is required to [...]