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Posting Date: 10/07/2022
Return/Reject
Medicare Part B 101 Manual Return/Reject While it's easy to group processed claims as either approved or denied, there are differences in the way claims are returned unpaid by Medicare. Only claims that are filed with complete and correct [...]
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Posting Date: 10/07/2022
Health Professional Shortage Area
Medicare Part B 101 Manual Health Professional Shortage Area What is a HPSA? What is the HPSA Incentive Bonus? Who is Eligible for the Incentive Bonus? How is the Bonus Billed? What Else You Should Know To Learn More [Return to [...]
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Posting Date: 10/07/2022
Assignment of Benefits
Medicare Part B 101 Manual Assignment of Benefits Table of Contents Assignment of Benefits Mandatory Assignment Collecting from Medicare Patients on Assigned Claims Related Content [Return to Top] Assignment of Benefits An [...]
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Posting Date: 10/12/2021
Advance Beneficiary Notice of Noncoverage for Not Reasonable and Necessary Denials
Medicare Part B 101 Manual Advance Beneficiary Notice of Noncoverage for Not Reasonable and Necessary Denials Table of Contents Limited Coverage Medical Necessity Expectations ICD-10-CM Coding Reasons for Noncoverage Beneficiary [...]
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Posting Date: 10/18/2024
Set Up a Beneficiary's Medicare Secondary Payer Record
Table of Contents Background: Set Up a Beneficiary’s Medicare Secondary Payer Record Step 1: Provider Receives New MSP Information for a Beneficiary Step 2: Check for a Matching Medicare Secondary Payer Record for the Beneficiary in the [...]
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Posting Date: 08/04/2022
Modifier 90 Reference to Outside Laboratory
Modifier 90: Reference to Outside Laboratory Modifier 90 is to be used when the billing laboratory refers a specimen to another laboratory for testing. In these cases, the billing laboratory is titled the “referring laboratory” while the [...]
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Posting Date: 02/26/2022
Initiate Patient Status Lookup
Initiate Patient Status Lookup Click the Eligibility Lookup button from the NGSConnex homepage. In the Select a Provider panel, click the Select button next to the applicable provider account. In the Select a Beneficiary panel, [...]
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Posting Date: 10/17/2024
Fluid Jet System Treatment for LUTS/BPH
Fluid Jet System Treatment for LUTS/BPH N/A L38367 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=38367 A56797 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56797 A58465 [...]
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