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Processing Issues

Modified: 1/8/2018
This table displays Part A and Part B processing issues that are being worked currently or have been resolved recently.
Modified: 1/8/2018
It had been discovered that the prior integrated outpatient code editor (IOCE) was incorrectly applying deductible and coinsurance to HCPCS code G0473. This article was revised to reflect that the IOCE update has been implemented and Medicare administrative contractors will initiate mass adjustments no later than March 3.
Modified: 12/26/2017
Due to the October implementation of 2017-2018 influenza vaccine payment allowances, the Centers for Medicare & Medicaid Services has directed contractors to reprocess claims that were processed on or after August 1.
Modified: 12/8/2017
In light of Hurricane Irma impacting Florida, Puerto Rico, and the U.S. Virgin Islands and disaster-related claims being billed, Part A providers are unnecessarily reporting OSC 70 on SNF claims billed with the CC DR/Modifier CR, resulting in rejection. Learn what to do to avoid this rejection of disaster-related claims.
Modified: 12/5/2017
Claims are rejecting in error with CWF reason codes U6816, U6817, and U6818 when Part A claims are billed with the applicable CARC codes listed in CR 8984 and CR 9009 which permits a residual payment if the services billed are covered and payable by Medicare.
Modified: 11/16/2017
Some providers may notice a difference in how deductible and coinsurance amounts are being displayed on the remittance advice for QMB claims. CMS will revert back to the previous display on December 8, and until then, CMS has provided a guide to identify Medicare cost-sharing amounts on remittance advice. No provider action is required.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
Part A