E/M Service Documentation Provided By Students
(Manual Update)
The Centers for Medicare & Medicaid Services (CMS) is revising the Medicare Claims Processing Manual, Chapter 12, Section 100.1.1, to update policy on Evaluation and Management (E/M) documentation to allow the teaching physician to verify in the medical record....
LCD and Policy Article Revisions Summary for April 26,
2018-Therapeutic Shoes for Persons with Diabetes
Outlined below are the principal changes to the DME MAC Local Coverage Determinations
(LCD) and Policy Articles (PA) for Therapeutic Shoes for Persons with Diabetes that has
been revised and posted...
Bankers Medicare Supplemental Insurance Now Offering Electronic Payment & Electronic Explanation of Benefits
Bankers has now partnered with JP Morgan to utilize the Healthcare LinkSM. The Healthcare LinkSM is JP Morgan Chase's easy-to-use, convenient web-based solution that enhances providers' ability to...
News Alerts
This section provides the latest and essential industry updates as they become available.
Tips to Prevent Rejection of Certification Forms-New York
Medicaid
New York Medicaid policy requires that each provider annually recertify their Electronic Transmitter Identification Number (ETIN). If the certification is not renewed annually, claims and other transactions will be rejected after ETIN the decertification date....
Jurisdiction K Part B Providers Receiving Hardcopy Standard
Paper Remittances Moving to Weekly Mailing Schedule
Beginning 7/2/2018, NGS will change from a daily to weekly mailing schedule for JK Part B hard copy SPRs. The only exception will be SPRs that include a hard-copy check which will continue to be mailed daily....
When Will Patients Get Their New Card?
At the beginning of April, CMS began the mailing process of the new Medicare cards. The
first beneficiaries to receive the new card are those that are newly eligible for Medicare.
For Medicare beneficiaries that were entitled to Medicare prior to 4/1/2018, they have a
different mailing time...
Proper Billing for Modifier 24 and Documentation Requirements
There have been many provider submissions recently of modifier 24 without proper indication of the E/M service being unrelated to prior surgical procedure. NGS has seen this through the appeals and/or reopening process as well. As a reminder, review the CMS regulation for...
Reminder-GuildNet Discontinuing Managed Long Term Care Business in Long Island and Westchester Counties
GuildNet, a Medicaid provider of long-term care, has announced that it will no longer accept new enrollees from Suffolk, Nassau and Westchester Counties. This may well be an indication of things to come. According to GuildNet...
Suppression of the Standard Paper Remittance Advice in 45 Days if Also Receiving Electronic Remittance Advice
On 8/4/2017, CMS issued MLN article MM1015: Suppression of the Standard Paper Remittance Advice (SPR) in 45 days if also Receiving Electronic Remittance Advice (ERA)which stated beginning 1/2/2018, MACs must eliminate issuance of SPRs to providers/suppliers (or a billing agent, clearinghouse...
Payment Reduction for X-Rays Taken Using Computed Radiography
Beginning January 1, 2018, and including Calendar Years (CY) 2018-2022, a payment reduction of 7 percent applies to the technical component (and the technical component of the global fee) for computed radiography services that would otherwise be made under the Physician Fee Schedule (PFS) ...
Now Available! NGSConnex MBI Lookup Tool
On 4/2/2018, CMS started mailing new Medicare cards with the Medicare Beneficiary Identifier (MBI) to all people with Medicare and will continue to mail new Medicare cards in phases by geographic location. This means that some of your patients may have already
received their new Medicare card containing the MBI...
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