Production Alert Details

>Part A FISS Cancel Adjustment Issue

Date Reported:
Date Updated:
Date Resolved:
Provider Types Impacted:

Jurisdiction 6 and Jurisdiction K Part A Providers

Reason Code(s):
Multiple RCs are associated with this issue; two examples are C7113 and U5600.
Claim Coding Impact:

Description of Issue

FISS Maintainer will be creating a file to identify the cancel claim records that posted to the CWF as original claims (those with a CD value of “3” instead of “4”) and will be providing those files to CWF. The CWF Maintainer will run those files through the HIMR to cancel the incorrectly posted records.

National Government Services Action

The utility process to cancel the records in CWF is complete.

Provider Action

Providers who have identified incorrectly rejected claim records relative to this issue will need to review CWF to determine whether the record that caused the rejection has been cancelled. Previously rejected claims may then be resubmitted.

If a provider identifies any XXG record(s) in status location SMXXGS, the claim(s) may not yet be resubmitted as there are internal NGS processes that need to take place first, however, NGS has determined claims in SMXXGS are minimal in number.

Proposed Resolution/Fix

Providers are advised that this issue is resolved.