Article Detail - JA DME
External Infusion Pumps (EIP) HCPCS Codes Rejected in Error - Resolved 01/27/23
Provider/Supplier Type(s) Impacted: Not applicable.
Reason Codes: CARC 4 and RARC N519
Claim Coding Impact: A4221, A4222, A4223, A4224, A4225, A4226, A4305, A4306, A4602, A9270, A9274, E0776, E0779, E0780, E0781, E0787, E0791, E1399, J0133, J0285, J0287, J0288, J0289, J0895, J1170, J1250, J1265, J1325, J1455, J1457, J1551, J1555, J1558, J1559, J1561, J1562, J1569, J1570, J1575, J2175, J2260, J2270, J2271, J2274, J2275, J2278, J3010, J3285, J7340, J7799, J9000, J9039, J9040, J9065, J9100, J9190, J9200, J9360, J9370, K0455, K0552, K0601, K0602, K0603, K0604, K0605
Description of Issue: Claims for EIP HCPCS Codes, as noted in above, rejected incorrectly with action code 86 when submitted with no GA, GY, GZ or KX modifier. The issue impacts claims processed between 01/01/23 and 01/11/23.
Noridian Action Required: Noridian has corrected the claims system logic issue.
Provider/Supplier Action Required: Suppliers may resubmit claims rejected in error.
Proposed Resolution/Solution: The claims system logic issue has been corrected.
Date Reported: 01/10/23
Date Resolved: 01/27/23
