This table displays Part A and Part B processing issues that are being worked currently or have been resolved recently.
CMS has added several diagnosis codes to the list of covered conditions for ICR services billed with HCPCS codes G0422 or G0423, effective February 9, 2018. When brought to its attention, First Coast will override medical policy edits to allow for processing and payment of these codes for these conditions. Providers should contact customer service to request claims reprocessing.
Claims for HCPCS code Q5110, received on and after October 1, 2018, are being held until the January 2019 quarterly I/OCE update is implemented. Once implemented January 7, 2019, First Coast will release the held claims to process as normal and correct any claims previously returned to providers in error.
Therapy claims adjusted due to the QMB remit issue are now denying for timeliness. These claims will be reprocessed by First Coast.
Certain codes were overlooked when the 2017 CWF coding files were created. When brought to its attention, First Coast will override the appropriate SNF CB edits to allow for processing and payment of these codes, and will do so until the codes are correctly added to the 2017 files in January 2019. Providers should contact customer service to request claims reprocessing.
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