Current processing issues

May 14, 2026

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
4/1/26	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. Update 4/1/26: A permanent correction will be installed on April 6, 2026
4/1/26	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. Update 4/1/26: Since the reason codes were reactivated in January 2026, certain CAH claims were incorrectly returned with Fiscal Intermediary Shared System (FISS) reason codes 31006 and 31007 indicating that providers do not have a reassignment on file in PECOS. To address this issue, Medicare Administrative Contractors (MACs) stopped returning these claims with dates of service in 2025 and 2026. Claims were reprocessed on March 30, 2026. Payments should be issued in approximately 2 weeks. CAHs do not need to take any action.
4/17/2026	Inpatient claims, (11X), with procedure code 5A1955Z, the mechanical ventilation procedure code, are incorrectly returning to providers with reason code W2054 when the length of stay is of an appropriate length.	The Fiscal Intermediary Shared System (FISS) has identified the root cause of the issue and is working on developing a correction. Claims are now being suspended to status location SMQ263 when reason code W2054 is assigned. 4/29/26 Update: The correction was successfully installed. Claims are being released for processing today. Any claims that have been incorrectly returned should be F9'd or resubmitted.	Providers should F9 or resubmit any claims that have incorrectly been returned so they can be held until a correction is installed. We will update this posting when the system is corrected and claims can be processed.
4/29/2026	Payment Issue: Starting April 17, 2026, through April 28, 2026, the two percent sequestration deduction is being incorrectly applied twice on various claims. To identify the claims that are impacted, providers should review their remittance advice. The sequestration field on the remittance is the correct amount. The overapplied second amount, is displayed in the "Pre Pay Adj" field on the remittance. The final payment of the claim is incorrect by this dollar amount.	The issue has been reported to the Fiscal Intermediary Shared System (FISS). We will provide updates as they become available. At this time, there is no workaround and no provider action needed. Update 5/5/26: An emergency correction was installed on April 28, 2026. Claims received after that date are processing with the correct sequestration amount. We are working with FISS on identifying the incorrect claims and will automatically reprocess the claims. We will post additional information on the adjustment process when it starts to occur.	Open

Closed issues: Part A

None at this time.

Open issues: Part B

Date reported	Workload impacted	Description/claim coding impact	Proposed resolution/fix/action required	Status
4/29/2026	Part B	An issue has been identified involving claims pending in an approved to pay location for an extended period of time. This matter is being investigated as a high priority.	No provider action at this time. Update: Our system maintainer continues to work on a full resolution; most pending claims have now been finalized. Payments have already started going out, beginning with the May 11, 2026 cycle.	Open

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.