08/02/2022 |
JH/JL Providers |
Claims denied in error |
Claims received on and after July 1, 2022 for procedure codes Q2049 and Q2050 were denied incorrectly. A fix was implemented on July 27, 2022. |
All impacted claims will be adjusted. |
Open |
07/28/2022 |
JH/JL Providers |
Claims paid incorrectly. |
The Centers for Medicare & Medicaid Services (CMS) has determined that certain monitored anesthesia codes were overlooked when the 2022 annual CWF coding files were created. The monitored anesthesia CPT codes 01937, 01938, 01939, 01940, 01941 and 01942 replaced CPT codes 01935 and 01936. For claims with dates of service on or after January 1, 2022, MACs (Part B), shall apply the CWF override to the appropriate SNF CB edits to allow codes 01937, 01938, 01939, 01940, 01941 and 01942 to process and pay. |
When brought to our attention, providers should be aware that if they have received payment from a SNF for claims for monitored anesthesia with CPT codes 01937, 01938, 01939, 01940, 01941, and 01942 they must return that payment to the SNF in order to receive payment from the Medicare. Providers can submit an appeal to initiate reprocessing of impacted claims using the Novitasphere appeal/reopening option, (JH) (JL), FAX or mail (JH) (JL). |
Open |
04/26/2022 |
JH/JL Ambulance Suppliers |
Claims denied in error |
Due to a CWF update effective April 1, 2022, we have identified claims that incorrectly denied for SNF consolidated billing. |
Suppliers should wait for further instructions on the denied claims. |
Open |
04/06/2022 |
JH/JL providers |
Claims denied in error |
We have identified claims that incorrectly denied for SNF consolidated billing. An update was made to the system for claims received on and after March 23, 2022. |
Update: 04/28/2022 Providers and/or suppliers who received incorrect denials can wait for claims to be adjusted or request an appeal. Any previously appealed claims that were affirmed, should be sent to the QIC for reconsideration. |
Open |
Loading...
