Claims
Reject reason codes
A status R claim is a claim that was rejected for reasons such as Medicare eligibility, billing issues like overlapping with another provider’s claim, Medicare Secondary Payer (MSP) provisions,…
Resolution tips for overlapping claims
This job aid was prepared by the Part A/B and home health and hospice (HHH) MAC collaboration team to help providers that experience claim rejections for overlapping dates of service.
Submitting high dollar claims for single use vials
Read this article to learn more about submitting high dollar claims for single use vials.
Submitting high dollar claims for single use vials
Read this article to learn more about submitting high dollar claims for single use vials.
SNF overlap
You must determine if the services were provided during the covered period of the SNF Part A stay or after the benefits exhausted, since consolidated billing rules may or may not apply.
Claims: Adjusting, reopening, cancelling, and resubmitting
View reasons and scenarios for adjusting, reopening, cancelling, and resubmitting claims.
Quarterly credit balance reports no longer required
Effective December 1, 2024, providers are no longer required to submit quarterly credit balance reports.
Using the KX modifier for dental services inextricably linked to covered medical services
Providers are encouraged to use the KX modifier on 837D claims submitted with dental services inextricably linked to covered medical services. Read this article to learn more.