Part a Open Claims Processing Issue Log

Part A Open Claims Processing Issue Log

Date Reported / Providers/ Workload Impacted / Issue/ Reason Code / Description / Updates/ Work Around/ Scheduled Fix /
11/05/12 / Part A Providers / MSN Message 38.15 / Providers may be receiving MSNs that display message 38.15 twice as a result of implementing TDL 12515. / 11/05/12: CMS has indicated that a corrected TDL will be issued to change the verbiage to its prior state.
11/01/12 / Part A Providers / U5233/EA031 / FISS is incorrectly removing Condition Code 04 on SNF HMO Medicare Advantage (MA) informational only claims (Type of Bill 21X). / 11/01/12: The FISS Maintainer has created FS6998 to correct this issue. There is currently a production date of 02/11/13.
10/24/12 / Part A Providers / 39930 / SNF TOB 22X claims are receiving reason code 39930 in error. / 10/24/12: The FISS Maintainer has created FS6848 to correct this issue. There is currently a production date of 04/01/13.
06/14/12 / Part A Providers / Location SM95HG / There are currently several adjustments suspended in location SM95HG due to various HIGLAS errors. / 06/14/12: We are working with the FISS and HIGLAS Maintainers to correct this issue.
No provider action is needed.
03/22/12 / Part A Claims / 32304 / Claims are receiving Reason Code 32304. The IDE number is not transferring between original claims and adjustments. / 03/22/12: The issue has been reported to FISS and a PAR has been opened and is currently unscheduled.
03/22/12 / Part A Claims / 32813 / Claims are receiving Reason Code 32813 incorrectly for HCPC J8530 with diagnosis code 203.00 on the claim. / 03/22/12: The issue has been reported to FISS and a PAR has been opened and is currently unscheduled.
02/28/12 / Part A Providers / Correction of MSP Covered Days / The MSP Covered days are not being properly reflected in value code 80. This should be the MSP utilized days returned from MSPPAY. Value codes 82 and 83 should also be reduced accordingly along with value codes 08, 09, and 10. / 10/24/12: The FISS Maintainer is still researching this issue.
06/27/12: This appears to still be an issue after FS6489 was installed. The FISS Maintainer is researching.
02/28/12: The FISS Maintainer has created FS6489 to correct this issue. There is currently a production date of 06/04/12.
No provider action is needed.
11/01/11 / Part A Providers / The July 2011 system release incorrectly affected Medically Unlikely Edits (MUEs) for several HCPCS/CPT codes. / Claims submitted with HCPCS/CPT codes affected by this issue are denying incorrectly with reason code 51MUE or 52MUE. / 01/06/12: An implementation date still has not been scheduled.
11/15/11: Added 52MUE as a reason code
11/01/11 Cahaba is awaiting further reprocessing instructions from the Centers for Medicare & Medicaid Services (CMS) at this time.
08/12/11 / Part A Providers / 38031, 38032, 38200 / Outpatient claims are receiving reason code 38031 (for possible duplicate) instead of 38032 or 38200 (for exact duplicate) when appropriate. / 10/24/12: FS6234 has a production date of 12/03/12.
01/06/12: FS6234 has not been scheduled for a release yet
11/23/11: FS6234 is still in research status. A fix has not been scheduled.
10/05/11: FS6234 is still in research status. A fix has not been scheduled.
09/07/11: FS6234 is still in research status. A fix has not been scheduled.
08/12/11: This problem has been reported to FISS under FS6234 and 00074414. A fix has not been scheduled.
If you feel you received a duplicate claim rejection in error, please submit an adjustment to the original claim that was processed to completion or request an appeal. Please refer to J10 AB MAC Medicare News 6/22/11 for information on how to file claims to avoid a duplicate rejection.

11/06/12