NGS Denies Claims as Experimental in Error

National Government Services (NGS) posted on its Web site Sept. 30 a notice that the Part A/B Medicare Administrative Contractor (MAC) experienced a claims processing issue impacting Medicare Part B claims submitted from Sept. 16 through Sept. 23.

Affected claims were incorrectly denied, receiving the following error on the provider remittance:

PR-55 procedure/treatment is deemed experimental/investigational by the payer

NGS says it will identify all impacted claims and adjust them accordingly. Providers do not need to take any action.


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