Wiki Medicare Not Accepting Corrected Claims

[dmonty]

Has anyone noticed that Medicare is no longer accepting corrected claims? I used to be able to send a 1x7 claim with a condition code D1-D9 for simple things like late charges or updated coding. Now, they keep hitting T-status stating:

Revw acct in T-status in DDE, clm rejected due to the following: A PROVIDER IS NOT PERMITTED TO ADJUST A PARTIALLY OR FULLY MEDICALLY DENIED CLAIM. THIS REASON CODE WILL EDIT WHEN MEDICALLY DENIED LINES ARE MOVED INTO A COVERED STATUS OR MEDICALLY DENIED LINES ARE ALTERED. IF YOU DISAGREE WITH THE MEDICAL DENIAL AND HAVE RECORDS TO SUPPORT SERVICES, SUBMIT A REDETERMINATION REQUEST. WHEN ADJUSTING CLAIMS WITH MEDICALLY DENIED LINE ITEMS, DO NOT MOVE THE CHARGES TO COVERED OR REMOVE THE DENIAL FROM THE LINE TO PREVENT THIS ERROR FROM OCCURRING.

I don't understand or know what I'm doing wrong, so I'm having to void the claim and start from scratch which is not ideal.

 

[ellistneal]

Yes. I ran into a similar situation. I was trying to send a corrected claim but kept getting a rejected or duplicate message. After speaking with a Medicare representative, I was told that I must either appeal the claim or resubmit another one. I hope this helps.

 

[humowitz@sbcglobal.net]

running into the same issue. They told me that I cannot send in a corrected claim or use the claim reopening form ( i needed to add an RT modifier), they told me to send in a whole new claim. this was last month... still waiting to see of those claims get paid

 

[rachaelwilleford]

Novitas requires a claims correction through their portal or the provider line. They do not not accept electronic claims corrections with a resubmission code. Not sure which MAC you're referring to, but other MACs may be similar.

 

[dmonty]

Thanks everyone! I just wanted to make sure I wasn't doing anything wrong!