Medicare Secondary Payer Calculator

RC 55A00 or 55A01 Denials for Denosumab

National Government Services is aware of an issue that is causing claims to deny in error with reason code 55A00 or 55A01. The claims involved are for Denosumab (J0897) - Billing and Coding article – A52399 and are firing on edit 5XX84.

Part A Claims Returning to Provider (RTP) RC 38361

Claims are continuing to incorrectly RTP even when the prior claims are not No Pay Claims.

Rural Health Claims Impacted by FS2540

This utility will adjust Rural Health claims - 71X TOB Reimbursed incorrectly with the implementation of FS2540 in the A20232CP release Installed to production on 5/15/23 Note: changes for FS2540 were backed out with FS2540R1 on 6/13/23. [...]