Activation of Validation Edits for Providers with Multiple Service Locations - Revised

Revised Article Release Date: February 5, 2024
Revised Related Change Request (CR) Number: 9613; 9907
MLN Matters Number: SE19007 Revised
Related CR Transmittal Numbers: R1704OTN; R1783OTN

Note: CMS clarified how to handle certain off-campus provider-based departments excepted from Section 603 payment policy. Substantive changes are in dark red on page 3.

SE 19007 tells you about enforcing the systematic validation edits requirements in Section 170 of the Medicare Claims Processing Manual, Chapter 1. These aren’t new requirements. CMS discussed these requirements in CRs 9613 and 9907, effective January 1, 2017. On March 24, 2020, CMS announced a delay until further notice to the activation of these for OPPS providers with multiple service locations.

Make sure your billing staff knows of these instructions.

View the complete CMS Medicare Learning Network (MLN) Matters Special Edition (SE)19007.

Last Updated Feb 15 , 2024