0362660 Current processing issues for Part A and Part B skip to content
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Last Modified: 3/9/2017 Location: FL, PR, USVI Business: Part A, Part B
Current processing issues for Part A and Part B
The table below provides an at-a-glance look at processing issues being worked currently or resolved recently. To sort by line of business (LOB), status, or date last updated, click on that column's header. Click again to change between ascending or descending order.
Provider Action
Last Updated
Part A
The Centers for Medicare & Medicaid Services (CMS) has identified overpayments related to change request (CR) 9479 and CR 9601 which caused reimbursement to be applied to the non-covered drug Healthcare Common Procedure Coding System (HCPCS) lines on Outpatient Prospective Payment System (OPPS) claims.
None. Affected claims will be adjusted.
Part A
The Centers for Medicare & Medicaid Services (CMS) has instructed Medicare administrative contractors to adjust chronic care management (CCM) claims for rural health clinics (RHCs) and federally qualified health centers (FQHCs) that were processed incorrectly.
Part B
First Coast Service Options (First Coast) has identified Part B claims billed with modifier JW (Drug amount discarded/not administered to any patient) with dates of service on or after January 1, 2017, as being rejected in error as duplicate changes. Affected claims will be adjusted.
Part A
First Coast has become aware of processing issues for pneumococcal and influenza vaccinations where in some instances the vaccination is not being priced, and in other instances, the vaccination is being priced; however, coinsurance is being applied in error. Affected claims will be mass adjusted.
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