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Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter
July 2008

MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)

Part A Information

Direct Data Entry (DDE) of Part A Claims with Rates

 

TAll Fiscal Intermediaries (FI) and Part A and Part B Medicare Administrative Contractors (A/B MAC)

CMS Joint Signature Memorandum (JSM)-08365 (June 18, 2008)

With the installation of the C20082UF Fiscal Intermediary Shared System (FISS) Release, providers began experiencing a problem when they entered claims that contained line item rates using the DDE System. After entering the claim with a line item rate, the system was removing the rate information
and the claim would Return to Provider (RTP) back to them with reason code 32213.

A fix to ensure that any rate entered remains on the claim has been created by the FISS maintainer. This fix will be installed in production on July 7, 2008, with CR FS5033R1. In the meantime, the maintainer has provided a workaround that providers can utilize to eliminate seeing these claims RTP:


To prevent the claim from Returning to the Provider during claim entry via DDE, the provider should press the “enter” key after charges have been keyed. This should cause the rate(s) to be retained. The provider may then scroll forward using the PF8 key.

Please note that this workaround resolves the dropped rate issue only if the provider is manually keying claims via the DDE system. If any sort of screen scraping process is utilized or if claims are keyed via a clearinghouse, this workaround will not apply. These providers will need to wait until the permanent fix is installed with the July 2008 Quarterly Release.

 

Disclaimer This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.

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