Claims
Incorrect rejections for Medicare secondary payer (MSP) claims
An issue was identified regarding incorrect Medicare secondary payer (MSP) rejections related to billing and submission errors. Claims will be held until the fix is implemented. Once the fix is…
Claims adjusted in error due to an issue that affected some professional claims for the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model
CMS is aware of an issue that occurred on July 26 that affected some 2021-2024 professional claims for the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH)…
Claims with CPT codes 90653, 90656, 90657, 90660, 90661, 90662, 90658, and 90673 priced incorrectly
2024-2025 flu season codes priced incorrectly.
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.