In Billing
Jun 28th, 2018
Effective July 2, CMS-1500 hard copy claims should not list the same ICD-10-CM diagnosis code twice within item 21. Medicare Administrative Contractors (MACs) and Durable Medical Equipment (DME) MACs have been instructed to return these claims as unprocessable. Here’s Why Medicare is implementing systems changes to ensure that all Part B 837 coordination of benefits/Medicare ...
In Billing
Mar 16th, 2012
There  reportedly has been a high incidence of crossover claims being rejected. According to Palmetto GBA, many physician offices and durable medical equipment (DME) suppliers are receiving provider notification letters from their servicing Medicare administrative contractor (MAC) or carrier that includes an H40142 error code and the description “Discharge date (DTP-01=096) was not expected b...
In Billing
Aug 11th, 2011
The Centers for Medicare & Medicaid Services (CMS) recently announced the results of its first National Version 5010 Testing Day, held June 15. No significant errors were detected, according to the agency, but participation was low, as was the confidence level of trading partners that they will be ready to implement the new electronic standard in ...
In Billing
Jul 29th, 2011
The Centers for Medicare & Medicaid Services (CMS) is updating specific 5010 837P and 837I transaction edits, which will be implemented by July 31, 2011. Due to the urgency with which these modifications must be made, the most current 837P and 837I Edit Spreadsheets do not reflect these changes. However, the January 2012 5010 837P ...
In Billing
Oct 1st, 2010
Recent updates have been made to the Health Care Provider Taxonomy Code (HPTC) list, which Parts A and B Medicare administrative contractors (A/B MACs) will use to process electronic claims effective Jan. 1, 2011. The HPTC set is maintained by the National Uniform Claim Committee (NUCC) and updated twice a year with changes effective April ...