BILLING NEWS

Claims Adjudication: Error for "r;10" Units Corrected

The NHIC Medicare Claims Adjudication system was incorrectly processing claims for procedure codes 83898, 83901, 88180, 88185, 88271, 88275, 88305, 88312, 88313, 88342, 88358, 88360, 88361, 88365 and 88368 when ordered with '10 units' by processing the claims for '1 unit', causing providers to have to appeal these claims in order to obtain the appropriate reimbursement. This system error was corrected by NHIC EDI on February 26, 2007. NHIC is unable to automatically correct the miss-paid claims, because of their inability to identify the claims which appear to be properly paid in their system. Accordingly, Providers who still have improperly paid claims may request a reopening to obtain payment on the remaining unpaid 9 units.


Published by XIFIN
INDUSTRY NEWS TAGS: CMS


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