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Last Modified: 5/12/2022 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
An issue was identified for inpatient claims with diagnosis codes Z28.310, Z28.311, or Z28.39, which were returning to the provider with reason code 34931 incorrectly. These claims are exempt from present on admission (POA) reporting. The issue has been corrected and providers can resubmit the affected claims.
Providers can resubmit inpatient claims that received reason code 34931 in error.
Part A
An issue has occurred with canceled claims for dates of service (DOS) from January 1-March 21. The canceled claims have posted to the common working file (CWF). Any claims canceled for a 2022 DOS through March 21 would have been impacted. First Coast is working with CMS and the Fiscal Intermediary Shared System (FISS) for a solution to the canceled claims that have already been posted.
Part A
We have identified an issue with the payment rate for HCPCS G0008, G0009 and G0010 for dates of service in 2021. Outpatient claims (Part B of A) reimbursed at the Medicare Physician Fee Schedule (MPFS) were not reimbursed at the correct rate. Claims previously processed at the incorrect rates will be automatically reprocessed.
No provider action is needed.
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