Article Detail - JD DME
Incarcerated Claim Denials
Provider/Supplier Type(s) Impacted: All
Reason Codes: Not applicable
Claim Coding Impact: Not applicable
Description of Issue: Noridian is aware of an issue with claims potentially denying for incarcerated status when the beneficiary does not have incarcerated record(s). Claims denying with CARC 258 "Claim/service not covered when patient is in custody/incarcerated. Applicable federal, state or local authority may cover the claim/service."
Noridian Action: DME claims are not able to be suspended due to system limitations. Claims may continue to deny in error until the issue is resolved.
Provider/Supplier Action Required: No action is required at this time.
Proposed Resolution/Solution: The shared systems maintainer is working to resolve the issue.
09/20/24 – No updates. Noridian is monitoring the issue and will provide updates as they are available.
09/05/24 - No updates. Noridian is monitoring the issue and will provide updates as they are available.
Date Reported: 08/15/24
Date Resolved:
