Processing Issues
Modified: 11/8/2018
This table displays Part A and Part B processing issues that are being worked currently or have been resolved recently.
Modified: 11/2/2018
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.
Modified: 10/26/2018
First Coast Service Options discovered that claims involving more than four concurrent anesthesia procedures have resulted in overpayments for claims paid from January 1, 2013, through July 20, 2018. First Coast started adjusting the claims August 30, 2018, to recover the overpayments.
Modified: 10/10/2018
An issue has been identified for Part B diagnostic colonoscopy claims billed with Modifier PT and screening diagnosis that have been denied in error.
Modified: 9/19/2018
Certain codes were overlooked when the 2017 and 2018 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 and 2018 files in October 2018. Providers should contact customer service to request claims reprocessing.
Modified: 9/12/2018
Certain radiation therapy codes were overlooked when the 2016, 2017 and 2018 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, and will do so until the codes are correctly added to the 2016, 2017, and 2018 files in October 2018. Providers should contact customer service to request claims reprocessing.
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