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Front End Edits & Reports

link to the 277CA Self-Service Tool page

Manuals

5010A1 CEDI Front-End Acknowledgements and Reports Manual Internal PDF file (828 KB) (04/29/2019)

CEDI NCPDP D.0 Front End Edits Internal PDF file (1 MB) (12/20/2019)

 

Current Front End Edits

CMS 5010 Edit Spreadsheet Internal XLS file (Effective 01/03/2020 through 07/06/2020)

CMS 276/277 Edit Spreadsheet Internal XLS file (Effective 07/01/2017 through 07/062020)

CMS NCPDP Edit Spreadsheet Internal XLS file (Effective 07/01/2017 through 07/06/2020)

 

Upcoming Front End Edits

There are no upcoming spreadsheets at this time.

 

Front End Edits Statistics

CEDI Monthly Edit Statistics Internal XLS file (01/07/2020)

CEDI Quarterly Edit Statistics Internal XLS file (01/07/2020)


DME MAC HCPCS/Modifier Tools

CGS offers an Advanced Modifier Engine to assist suppliers in billing proper Healthcare Common Procedure Coding Systems (HCPCS) codes and modifier combinations. The tool includes Durable Medical Equipment Prosthetics Orthotics and Supplies (DMEPOS) commonly billed HCPCS with billing scenarios. Based on the specific HCPCS entered and the billing scenario, the tool recommends modifiers for claim submission.

 

For Jurisdiction B, the AME tool is located at https://www.cgsmedicare.com/medicare_dynamic/jb/advanced_modifier_engine External link

For Jurisdiction C, the AME tool is located at https://www.cgsmedicare.com/medicare_dynamic/jc/advanced_modifier_engine/ External link

 

Noridian Healthcare Solutions offers a Modifier Lookup Tool to assist suppliers in determining potential modifiers that may be used in billing DMEPOS HCPCS codes.  Many pricing and informational modifiers can be found by utilizing this tool.

 

For Jurisdiction A, the Modifier Lookup Tool is located at https://med.noridianmedicare.com/web/jadme/topics/modifiers/modifier-lookup External link

For Jurisdiction D, the Modifier Lookup Tool is located at https://med.noridianmedicare.com/web/jddme/topics/modifiers/modifier-lookup External link

 

NGS CEDI cannot offer assistance or advice regarding correct HCPCS and modifiers to submit on DMEPOS claims.  Please contact the appropriate DME MAC for assistance with their tools or questions regarding HCPCS codes and modifiers.



Post Date: 1/7/20