Article Detail - JA DME
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
