Article Detail - JE Part B
ADR Development Errors - Resolved 09/28/22
Provider/Supplier Type(s) Impacted: Providers who received Additional Documentation Request (ADR) letter(s) dated August 17 through August 26 may be impacted.
Reason Codes: Variable
Claim Coding Impact: N/A
Description of Issue: Additional, unintended, ADRs may have been requested in error and sent to Providers. Noridian does not have a way to identify which ADRs were sent incorrectly at this time.
Noridian Action Required: Noridian is attempting to identify ADRs sent in error and remove the ADR to allow the claim(s) to process without the need for the documentation.
Provider/Supplier Action Required:
Providers should review any ADRs dated August 17 through August 26. If the ADR refers to one of the five below scenarios, follow the instructions in the ADR. If the ADR does not meet the scenarios below, providers should monitor this production alert for updates. If a paid remittance advice for the claim is received, the ADR is no longer needed and can be disregarded.
Continue to address ADRs if:
- Providers otherwise notified of being part of a review;
- Providers receiving documentation requests for Q#### CPT codes related to Amniotic services;
- Providers receiving documentation request for codes billed with a PA, PB, or PC modifier;
- Providers receiving documentation request for code 0295U; or
- Providers receiving documentation request for G0460, G0465, K1004, Q4213, 93595-93598, 97151, 97156, or codes ending in “T” (####T).
Proposed Resolution/Solution: Noridian is working on a solution. Another update will be provided the week of September 16.
09/19/22 - Noridian has identified the claims which had ADRs issued in error. The claims are being released to continue processing as normal. Affected providers, who do not need to submit documentation, will begin receiving remittance advice(s) by the end of the week.
09/28/22 - Noridian released the claims not requiring ADR.
Date Reported: 09/06/22
Date Resolved: 09/28/22
Last Updated Wed, 28 Sep 2022 18:35:32 +0000