Voluntary Prior Authorization Wheelchair Accessory Codes - Resolved 10/10/23

Provider/Supplier Type(s) Impacted: Suppliers of Prior Authorization Voluntary Wheelchair Accessory HCPCS codes with dates of service on and after 04/06/2023.

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.

06/14/23 - Noridian will continue to monitor for claims denied in error and will reprocess claims until there is a resolution.

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.

06/14/23 - Noridian is working with the system maintainers on a resolution.

06/28/23 - Noridian is working with the system maintainers on a resolution.

07/13/23 - Noridian is working with the system maintainers on a resolution.

07/26/23 - Noridian is working with the system maintainers on a resolution.

08/10/23 - Noridian is working with the system maintainers on a resolution.

08/23/23 - Noridian is working with the system maintainers on a resolution.

09/06/23 - Noridian is working with the system maintainers on a resolution.

09/20/23 - Noridian is working with the system maintainers on a resolution.

10/04/23 - Noridian is working with the system maintainers on a resolution.

10/10/23 - Noridian will continue to work these claims as they are identified.

Date Reported: 05/16/23

Date Resolved: 10/10/23

 

Last Updated Dec 27 , 2023