Wiki Revision of LCA to include retroactive dates and back billing

[mhaney]

Question regarding Noridian LCA A52966. This recently was updated with revision effective date 10/1/22 to include previously excluded diagnoses. The article states it is 'effective for dates of service on/after 2/2/14'. Can we back bill these previously denied claims and how far back? Noridian is stating the claims are over 1 year or past the 120 days for appeal from last denial date. I thought if an LCA was revised to correct an error they would reprocess claims if we brought them to their attention for reprocessing. Any thoughts? I really appreciate any help!

 

[lgardner]

Question regarding Noridian LCA A52966. This recently was updated with revision effective date 10/1/22 to include previously excluded diagnoses. The article states it is 'effective for dates of service on/after 2/2/14'. Can we back bill these previously denied claims and how far back? Noridian is stating the claims are over 1 year or past the 120 days for appeal from last denial date. I thought if an LCA was revised to correct an error they would reprocess claims if we brought them to their attention for reprocessing. Any thoughts? I really appreciate any help!

You are looking under the header "Article Text".

If you look further up, you will see that the Original Effective date of the Article was 10/1/2015
And the Revision Effective date was 10/1/2022

 

[mhaney]

Got it, thank you for your response.