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  • Posting Date: 07/18/2025
    38105

    Avoiding/Correcting This Error Verify billing and if appropriate, correct and resubmit the claim.   To prevent this error on future claims: Ensure that the correct bill type is submitted once you have received all charges from all [...]

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  • Posting Date: 07/18/2025
    38032

    Avoiding/Correcting This Error If duplicate claim was submitted in error, no additional provider action is necessary. If it is determined that the claim was due to additional charges for a patient for a specific date of service, wait for the [...]

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  • Posting Date: 07/18/2025
    39929

    Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Resubmit as appropriate. Line level reason code(s) appear on the right view of claim page two [...]

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  • Posting Date: 07/18/2025
    7K073

    Avoiding/Correcting This Error If the beneficiary is entitled to Medicare Part B, an ancillary claim may be submitted to your MAC. Related Content Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) [...]

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  • Posting Date: 07/18/2025
    C7010

    Avoiding/Correcting This Error If services are unrelated to hospice stay, resubmit with condition code 07 (treatment of nonterminal illness for hospice patient). Verify hospice enrollment prior to claim submission by reviewing the CWF, HETS [...]

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  • Posting Date: 07/18/2025
    U5200

    Avoiding/Correcting This Error Part of the eligibility verification process should include ensuring the dates of service fall within the Medicare entitlement period. Use the FISS/DDE Provider Online System, HETS or NGSConnex to verify [...]

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  • Posting Date: 07/18/2025
    U5233

    Avoiding/Correcting This Error Verify the admission date, from, and through dates on the claim and compare the dates to the MAO/HMO entitlement dates. Outpatient facilities and IPPS and IRF hospitals, or LTCH billing services within an [...]

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  • Posting Date: 07/17/2025
    Prior Authorization Outpatient Department Claim Billing

    Prior Authorization Outpatient Department Claim Billing Providers may observe an increase in claim denials for PA services due to a mismatch of information provided on the PAR compared to the information supplied on the claim. Prior [...]

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