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Processing Issues
Modified: 5/10/2012
The Centers for Medicare & Medicaid Services (CMS) has corrected a system problem that delayed payment of some inpatient and skilled nursing facility (SNF) claims processed beginning April 2. Payments for these claims will be made soon. [PERL 201205-24]
Modified: 5/8/2012
First Coast Service Options Inc. (FCSO) implemented a system enhancement May 7, 2012, that will allow customers to resume adjusting claims that had been previously medically approved but had been returned to provider (RTP) for reason code 30960.
Modified: 5/6/2012
Inpatient claims (for reporting of discharges on or after October 1, 2011) that were submitted with an ICD-9-CM code containing a present on admission exemption are being returned to provider (RTP) with reason code 34931. The Centers for Medicare & Medicaid Services has created a workaround to resolve this issue. [TDL 12137]
Modified: 5/2/2012
On April 13 and 16, 2012, Florida skilled nursing facility (SNF) inpatient claims suspended in error for reason code 5Z115.
Modified: 4/26/2012
First Coast Service Options Inc. (FCSO) has determined version 5010 claims are being returned to provider (RTP) in error for reason code 31313.
Modified: 4/26/2012
A claim processing issue has been identified for the drug Eyleaź (aflibercept), which caused incorrect payments. The issue has been corrected and all impacted claims will be automatically adjusted.
Modified: 4/20/2012
Medicare contractors have been instructed to hold 85x type of bills (TOBs), including adjustments, if a 22 modifier is present on claims for critical access hospitals. [PERL 201204-34]
Modified: 4/20/2012
Medicare contractors have been instructed to hold 72x type of bill (TOB) claims with dates of service on or after January 1, 2012, where code J3370 was billed with the AY modifier. [PERL 201204-33]
Modified: 4/17/2012
First Coast Service Options Inc. (FCSO) has recently received a number of calls concerning the ELGA and HIQA screens showing incorrect benefit period information when accessed by customers.
Modified: 4/16/2012
First Coast Service Options Inc. (FCSO) has determined that beginning in March, claims for version 5010 adjustments have been returned to provider (RTP) for reason code 30949 in error.
Modified: 4/11/2012
Contractors will hold claims for procedure C1882 when used in conjunction with procedure 33249 until implementation of the July 2012 integrated outpatient code editor, which will be implemented on July 2, 2012. [PERL 201204-14]
Modified: 4/5/2012
First Coast Service Options Inc. (FCSO) has recently received a number of calls concerning claims being returned to provider (RTP) with reason code 15202 in error.
Modified: 3/1/2012
For 5010A1 837 claims, a discharge date is required for inpatient claims when the patient was discharged from the facility and the discharge date is known. A discharge date is not to be sent unless required. [PERL 201202-75]
Modified: 11/21/2011
First Coast Service Options Inc. (FCSO) has been made aware of an issue involving certain claims for physician services -- excluded from skilled nursing facility (SNF) consolidated billing (CB) stay -- that were rejected in error by the common working file (CWF). The CWF contractor is working diligently to resolve this issue, and no provider action is required at this time.
Modified: 9/23/2010
There are no items in this section at this time.
