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Wiki Working Medicare without Medicare FISS DDE system

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ginabren

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Westernport, MD
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Does anybody here have any advice for working Medicare denials when you don't have access to the FISS DDE system? My practice is having a terrible time getting denials fixed. Every time we resubmit something, it will get denied as "M80" which is essentially a duplicate. Medicare describes it as the claims bumping against the original. On resubmission, we enter the ICN #, condition code, and value code-which is what Medicare tells us they need, yet they continue to deny. Help!
 
When you resubmit the claim, are you submitting it as a new claim or a corrected claim? If it is submitted as a new claim, it will deny against the original. If you bill electronically, there should be a field to indicate that it is a corrected claim - I am not sure of the exact verbiage, but status 7 generally refers to a corrected claim, 1 refers to a new/initial claim, and 8 refers to a voided claim.
 
Yes, we're indicating that it's a corrected with the 7 resubmission code. We also put in the ICN number from the original claim with it. We've tried so hard to figure this out-but it seems like nothing works!:confused:
 
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