Method II CAH Claims Not Paying Professional Services with Revenue Codes 096x-098x
Date Reported:
12/05/2024
Status:
Open
Provider Types Impacted:
Part A CAHs in Jurisdiction K and Jurisdiction 6
Reason Code(s):
N/A
Claim Coding Impact:
Professional service revenue codes 096x-098x
Description of Issue
Certain CAH claims (TOB 85X) with professional service revenue codes 096x – 098X did not process for payment because the fee amount was not correctly retrieved during processing. The affected claims have receipt/processed dates in October 2024.
National Government Services Action
NGS has reported this issue to FISS. When adjusted by NGS, fees are successfully retrieved for payment.
Provider Action
A mass adjustment of these claims is not planned. Providers may submit claims to NGS for adjustment. Please continue to check the Production Alerts section of our website and future Email Updates.
Proposed Resolution/Fix
TDB