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Current processing issues

The tables below provide an at-a-glance look at processing issues being worked currently or resolved recently.

Open issues: Part A

Last updated Issue Resolution Provider action

2/11/26

CAH Method II rendering providers, who are participating with the Quality Payment Program (QPP), certain professional service lines are incorrectly receiving reason code 32402 due to an issue with the HCPCS file.

 

https://qpp.cms.gov/ 

Until a permanent correction is able to be installed, claims with these services, will be suspended temporarily. A manual update to the HCPCS file will be done and then the claim will be released for processing. 

If CAHs have service lines that incorrectly received reason code 32404, adjust the claim charges back to covered so the claim will temporarily suspend for the HCPCS files to be manually corrected.

8/21/25

Critical access hospitals (CAHs) professional claims line-item date of service (LIDOS) with revenue codes 096X, 097X and 098X are being denied (status D) for not having physician reassignments on file

CMS has instructed the MACs to temporarily deactivate reason codes 31006 and 31007. CAHs claims that denied with these reason codes will be reprocessed.

Providers should take this opportunity to review their enrollment records and submit physician reassignment applications if necessary. Individual practitioners must complete and submit the CMS-855I form to reassign their billing rights to the CAH. The CAH must forward a copy of the CMS-855I to the Part B MAC. The practitioner must sign an attestation that clearly states the practitioner will not bill the Part B MAC for any services rendered at the CAH once reassigned to the CAH. The attestation will remain with the CAH.

The reason codes will be reactivated at a future date.

Closed issues: Part A

None at this time.

Open issues: Part B

None at this time.

Closed issues: Part B

Last updated Issue Resolution Provider action

2/19/2026

We have identified claims being incorrectly rejected for invalid modifiers. 

Claim logic is being reviewed for possible maintenance.

No provider action required at this time.

2/13/2026

We have identified claims with contractor-priced codes not pricing correctly when processing and therefore the codes are denying.

Claim logic is being reviewed for possible maintenance.

No provider action required at this time.