Part B Claims Denied with Error 524B
Date Reported:
10/29/2024
Date Updated:
11/14/2024
Date Resolved:
11/14/2024
Status:
Closed
Provider Types Impacted:
Part B providers in JK and J6.
Reason Code(s):
524B
Claim Coding Impact:
See Description of Issue
Description of Issue
An error in CWF processing has not yet been fully corrected. The error is occurring when Demo Codes A5 (Making Care Primary-MCP) or A6 (Guiding an Improved Dementia Experience-GUIDE) are on the claim and the HIC on the claim has an active MSP record and the dates of service fall with the effective period. This error is occurring even when the claim is being processed as primary. As per CMS, the A5 and A6 demonstrations should only be excluded when the claim is being processed as secondary.
National Government Services Action
Claims that processed at CWF prior to the 10/21/2024 fix were adjusted when those claims finalized.
Provider Action
No provider action is needed.
Proposed Resolution/Fix
Impacted claims were adjusted on 11/13/2024.