Preventive Services Codes on Eligibility Inquiry

Due to the recent CMS HIPAA Eligibility Transaction System (HETS) Quarter 1 release, Noridian implemented a section on the Eligibility inquiry screen that allows users to choose up to three Preventive Services HCPCS codes that can be checked to see when the patient is next eligible for that service. When this was implemented on the evening of April 5th, this section was required in order to perform an Eligibility inquiry, which was incorrect. The requirement of the HCPCS code selection was removed on the evening of April 8th, but the Preventive Services codes section is still available for users that wish to use this feature. Noridian will be looking into other user-friendly options to accommodate the use of the Preventive Services codes look up while still maintaining CMS regulations.

Noridian apologizes for any inconvenience and confusion this may have caused our users.

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