Why is Medicare rejecting Covid Vaccines? Please help!

michelleaapc2012

Guru
Local Chapter Officer
Messages
125
Location
Cookeville, TN
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0
Medicare is rejecting all of our claims with:
A3 : Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system.
23 : Returned to Entity. Note: This code requires use of an Entity Code.
SMARTEDITDOCPROCEDURECODE0011AMAYREQUIREADDITIONALDOCUMENTATIONFORPROCESSING

We are billing 0011A with Diagnosis Z23

At first we were billing 0011A and 91301 with Diagnosis Z23 and got rejections. Then we learned that we are supposed to only bill 0011A. Now those are rejecting. Please help.
 

SharonCollachi

True Blue
Messages
1,614
Location
Clovis, CA
Best answers
3
Here is what I found:

The claim has been rejected at the payer's end for an entity issue. With this rejection reason, the payer should send additional information indicating who the 'Entity' is. Unfortunately, sometimes this information is not included.

The Entities that may be involved are:
  • Billing Provider
  • Rendering Provider (Address and Phone are not included on claim, but they may be referencing the NPI).
  • Member/Client/Patient Insured
  • Referring Physician
 

tjking1

New
Messages
2
Location
Tuscaloosa AL
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0
Medicare is rejecting all of our claims with:
A3 : Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system.
23 : Returned to Entity. Note: This code requires use of an Entity Code.
SMARTEDITDOCPROCEDURECODE0011AMAYREQUIREADDITIONALDOCUMENTATIONFORPROCESSING

We are billing 0011A with Diagnosis Z23

At first we were billing 0011A and 91301 with Diagnosis Z23 and got rejections. Then we learned that we are supposed to only bill 0011A. Now those are rejecting. Please help.
Ours too in Alabama!! Think is needs a referring? As in the ordering referring like the labs?
 

jbhuju

New
Messages
4
Location
sierra vista, AZ
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0
we are billing those two codes to medicare and yes we are getting paid. but medicare advantage or supplement is not paying stating that needs to bill to regular medicare.
 
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