Multiple Procedure Payment Reduction Calculation Issue - Resolved 03/31/21

Provider/Supplier Type(s) Impacted: Outpatient claims

Reason Codes: Not applicable.

Claim Coding Impact: HCPCS Codes subject to Multiple Procedure Payment Reduction (MPPR)

Description of Issue: Noridian is aware of a system issue with claims that did not apply the MPPR starting 01/01/21. This resulted in overpayments on claims.

Noridian Action Required: Noridian will make system updates and will mass adjust the claims to correct the payment.

03/05/21 - Noridian completed the system updates so claims will process appropriately. Noridian will start the mass adjustment process.

03/16/21 - Noridian identified an additional issue with the calculation. Additional system updates will be made, and the claims will be readjusted.

03/31/21 - Noridian initiated the adjustments.

Provider/Supplier Action Required: No provider action is needed to correct the claims. Providers should follow the regular process for paying any overpayments on the claims that processed in error.

Proposed Resolution/Solution: Noridian will mass adjust the claims.

Date Reported: 02/26/21

Date Resolved: 03/31/21


Last Updated Tue, 06 Apr 2021 17:06:18 +0000