Voluntary Prior Authorization Wheelchair Accessory Codes

Provider/Supplier Type(s) Impacted: Suppliers of Prior Authorization Voluntary Wheelchair Accessory HCPCS codes with dates of service on and after 04/06/23.

Reason Codes: CARC 16 and RARC 284

Claim Coding Impact: Voluntary Prior Authorization Wheelchair Accessory Codes

Description of Issue: Claims may reject if the Unique Tracking Number (UTN) is submitted on claims lines that were not submitted for a Prior Authorization.

Noridian Action Required: Claims are being researched.

Provider/Supplier Action Required: Submit the UTN only on claim lines for Voluntary PA items for which a Prior Authorization was requested. If a Prior Authorization was not requested on the accessory codes, resubmit the claim without the UTN. The UTN should be submitted in loop 2400 - Service Line loop in the Prior Authorization reference (REF) segment where REF01 = "G1" qualifier and REF02 = UTN.

Proposed Resolution/Solution: Claims are being researched.

Date Reported: 05/16/23

Date Resolved:


            Last Updated Thu, 08 Jun 2023 15:41:06 +0000