Article Detail - JE Part A
Drug Pricing Claim Hold - Resolved 05/16/22
Provider/Supplier Type(s) Impacted: Providers that bill Outpatient Types of Bill
Reason Codes: Not applicable
Claim Coding Impact: Manually Priced HCPCS drug codes such as unlisted drugs
Description of Issue: Claims with manually priced HCPCS Drug codes are not pricing correctly. This only impacts rates with something other than zero in the third decimal spot. This issue began on 04/18/22.
Noridian Action Required: Noridian is holding impacted claims in Status/Location S/M1501 until the pricing is corrected by the Shared System Maintainer (FISS).
Provider/Supplier Action Required: No action at this time
Proposed Resolution/Solution: FISS has scheduled a fix for 05/31/22.
05/16/22 - FISS updated the system ahead of schedule on 05/16/22. Noridian is resuming regular processing.
Date Reported: 05/10/22
Date Resolved: 05/16/22