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.
| Current status | Last updated | Line of business | Issue | Resolution | Provider action |
|---|---|---|---|---|---|
| Open | 8/21/25 | Part A | 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. |
| Open | 9/30/25 | Part A | Claims for FQHC and RHC provider types are incorrectly receiving reason code C7252 for Skilled Nursing Facility (SNF) Consolidated Billing (CB) rules. |
The Common Working File (CWF) has identified the issue and has developed a correction that is scheduled to be installed on October 6, 2025.
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Providers do not need to take any action. The claims will be automatically identified and reprocessed. We will post additional information when the claims have all been initiated for adjustments. |