BILLING NEWS

New Edits 02161 and 02162 for Original and Adjusted Delayed Claims will Deny

New York State Medicaid is working to increase provider compliance with delay reason reporting on claims aged more than 90 days. New edits will verify the validity of Delay Reason Codes reported on the claim. Effective 8/23/2012, claims with dates of service over 90 days old may be denied with edit 02161 - Delay Reason Code 5 (Delay in Supplying Billing Forms) Invalid or edit 02162 ñ Delay Reason Code 7 (Third Party Processing Delay) Invalid. The associated HIPAA reason code will be 29-THE TIME LIMIT FOR FILING HAS EXPIRED.

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INDUSTRY NEWS TAGS: Medicaid New York


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