PET Scan Tracers Rejecting Incorrectly - Resolved 03/23/22

Provider/Supplier Type(s) Impacted: Part A facilities

Reason Codes: 5004N

Claim Coding Impact: A9591, A9592, A9593, A9594, A9595, and A9597

Description of Issue: In Part A, A9591, A9592, A9593, A9594, A9595, and A9597 are inappropriately rejecting when these tracer codes are not billed with a PI or PS modifier.

Noridian Action Required: Noridian has updated the system to allow these tracers without the PI or PS modifier on the tracer code. On 03/23/22 Noridian released all claims for A9591, A9592, A9593, A9594, A9595, and A9597 rejected inappropriately based on Reason Code 5004N so they will reprocess.

Provider/Supplier Action Required: N/A

Proposed Resolution/Solution: Noridian has updated the system to correct this error. On 03/23/22 Noridian released all claims for A9591, A9592, A9593, A9594, A9595, and A9597 rejected inappropriately based on Reason Code 5004N so they will reprocess.

Date Reported: 03/21/22

Date Resolved: 03/23/22

            Last Updated Mon, 28 Mar 2022 17:30:57 +0000