[KarenH]

Is anyone getting CO4 denials (procedure code inconsistent with the modifier used or a required modifier is missing) on oxygen patients since the beginning of the year? I am billing E1390RR. Did something slip pass me? I should also mention that we are not in a competative bidding area. Thanks in advance for any clues...

[Michelle Gable]

Hi Karen, RGN C put out a blurb that on 1/3/2011 there was a gliche in there system these claims all denied in error. MCR internally is reprocessing these claims for you. Hope this helps.

[KarenH]

Thanks - you probably saved me hours

[KarenH]

Michelle, I didn't find it in my Region C e-mails or on the website. Any chance you can direct me to the blurb?

[HEATHER]

From the Medicare Learning Network: “DMEPOS Competitive Bidding Procedures for Upgrades” Fact Sheet

Due to an internal claim processing issue, a large number of Jurisdiction C DMEPOS claims were denied in error on January 3, 2011. The affected claims were denied with ANSI code 4, remark codes MA13 and M114. We have corrected the processing issue and will be adjusting any claims that have denied in error. Please do not resubmit these claims. We apologize for any inconvenience this may have caused.

Please note that this claim processing error is only applicable to claims processed on January 3, 2011. Claims denied with the ANSI codes mentioned above that are processed after January 3, 2011, may have denied correctly.

[KarenH]

Thanks again.

[Sleeping410]

Does anyone else have any feedback on this? We were told this morning by a Customer Service Supervisor that once the affected providers were identified (should be completed by Friday) they would begin resubmitting these claims sometime next week.