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Posting Date: 01/29/2020
HCPCS Codes (14)
Chapter IV: Inquiries Submenu (01) HCPCS Codes (14) Purpose The purpose of the HCPC CODES option is to provide access to details related to the HCPCS codes available to be reported on a claim. HCPCS codes are five-digit alphanumeric [...]
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Posting Date: 02/25/2022
DX/Proc Codes ICD-9 (15)
Chapter IV: Inquiries Submenu (01) DX/Proc Codes ICD-9 (15) Purpose The purpose of the DX/PROC CODES ICD-9 option is to provide a reference of ICD-9-CM code(s) used to identify a specific or various diagnosis codes or inpatient surgical [...]
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Posting Date: 01/29/2020
Adjustment Reason Codes (16)
Chapter IV: Inquiries Submenu (01) Adjustment Reason Codes (16) Purpose An adjustment reason code is a two-digit alphanumeric code reported on a claim adjustment to identify the specific reason the claim is being adjusted. This option [...]
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Posting Date: 01/29/2020
Reason Codes (17)
Chapter IV: Inquiries Submenu (01) Reason Codes (17) Purpose FISS reason codes are five-digit alphanumeric codes that indicate the outcome of claim editing and processing. The REASON CODE option provides details to indicate why the claim [...]
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Posting Date: 01/30/2020
Claim Count Summary (56)
Chapter IV: Inquiries Submenu (01) Claim Count Summary (56) Purpose The CLAIM COUNT SUMMARY option provides a review of the total claim count and total dollar amount for claims pending in a specific location. This information is updated in [...]
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Posting Date: 01/30/2020
Invoice Number/DCN Translator (88)
Chapter IV: Inquiries Submenu (01) Invoice Number/DCN Translator (88) Purpose The purpose of the Invoice Number/DCN Translator screen is to allow the provider to identify a claim’s Invoice Number when the DCN is known. This option also [...]
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Posting Date: 01/30/2020
Community Mental Health Centers Services Payment Totals (1C)
Chapter IV: Inquiries Submenu (01) Community Mental Health Centers Services Payment Totals (1C) Purpose The purpose of the CMHC Payment Totals screen (MAP1D61) is to display the CMHC payment and outlier totals for current year and one [...]
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Posting Date: 01/30/2020
Provider Practice Address Query (1D)
Chapter IV: Inquiries Submenu (01) Provider Practice Address Query (1D) Purpose The purpose of the Provider Practice Address Query screen is to display the additional practice addresses for a facility; this includes off-campus, outpatient, [...]
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Posting Date: 03/23/2020
New HCPCS Screen (1E)
Chapter IV: Inquiries Submenu (01) New HCPCS Screen (1E) Purpose The purpose of the New HCPCS Screen (1E) is to provide information related to HCPCS pricing and allowable revenue codes related to HCPCS. HCPCS codes are five-digit [...]
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Posting Date: 05/23/2023
New Fiscal Intermediary Shared System Consistency Edit to Validate Attending Physician National Provider Identifier
New Fiscal Intermediary Shared System Consistency Edit to Validate Attending Physician National Provider Identifier Effective 5/16/2023, CMS implemented a new FISS consistency edit to validate the attending provider NPI. The attending provider [...]
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Posting Date: 08/28/2023
Part B Mass Adjustments Resulting in Overpayments
Part B Mass Adjustments Resulting in Overpayments In May 2023, the OIG released the final report titled “Medicare Paid Millions More for Physician Services at Higher Nonfacility Rates Rather Than at Lower Facility Rates While Enrollees Were [...]
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Posting Date: 08/29/2023
October 2023 Release "Dark Days" for the Common Working File Hosts
October 2023 Release "Dark Days" for the Common Working File Hosts For the upcoming October 2023 Release: For Production, CWF will be observing the Gray Day on Thursday, 9/28/2023 and Dark Days starting Friday, 9/29/2023 through Sunday, [...]
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Posting Date: 03/23/2020
Opioid Use Disorder (OUD) Demo 99 (1F)
Chapter IV: Inquiries Submenu (01) Opioid Use Disorder (OUD) Demo 99 (1F) Purpose The purpose of the OUD DEMO option is to provide claim information such as CAP (maximum number of claims that can be billed by the provider with HCPCS G2172), [...]
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Posting Date: 09/05/2018
Roster Bill Entry (87)
Chapter V: Claims/Attachments Submenu (02) Roster Bill Entry (87) Purpose Roster billing is a streamlined process for submitting Medicare claims for a large group of beneficiaries for influenza virus or pneumococcal vaccinations. Up [...]
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Posting Date: 11/18/2011
Summary of Reports (R1)
Chapter VII: Online Reports View Submenu (04) Summary of Reports (R1) Purpose This option allows the provider to review a list of all reports currently available to view online. Additionally, the provider will be able to view the data [...]
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Posting Date: 11/18/2011
FISS Reason Code/Claim Driver Overview
Resources FISS Reason Code/Claim Driver Overview The following chart outlines the association between the FISS claim drivers and the reason code ranges. Driver # Driver Definition Reason Code Range(s) 04 UB-04 [...]
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Posting Date: 09/10/2018
How to Correct a Return to Provider Claim
Resources How to Correct a Return to Provider Claim To correct a RTP claim on the FISS/DDE Provider Online System, follow these steps: Step Action 1 Select the CLAIMS CORRECTION (03) submenu from the MAIN MENU [...]
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Posting Date: 08/01/2023
New and Improved EDI Enrollment Process
New and Improved EDI Enrollment Process Our new online EDI Enrollment Process is available. This new process includes real time verification of data entered into many of the fields, which improves accuracy, reduces the time needed to complete [...]
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Posting Date: 08/30/2023
RC 34963 – Provider Enrollment Issue
An issue in the PECOS is causing some Part A claims to RTP in error with RC 34963.
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Posting Date: 09/19/2022
Resetting Your EDI Password
Resetting Your EDI Password EDI passwords have to be regularly changed or reset to maintain data security. You should note that passwords expire every 60 days and can be changed or reset prior to expiration. Follow these steps to reset your [...]
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