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Article Detail - JE Part B

Claims Incorrectly Setting MCS Edit for Invalid UTN - Resolved 09/08/21

Provider/Supplier Type(s) Impacted: All providers

Reason Codes: Claim Adjustment Reason Code (CARC) 284

Claim Coding Impact: Multiple codes

Description of Issue: An issue has been identified resulting in the improper rejection of Part B claims. Providers receiving the claim rejection message of “Precertification/authorization/notification/pre treatment number may be valid but does not apply to the billed services” or “Missing/incomplete/invalid treatment authorization code” should not resubmit claims at this time. A claims processing system fix is currently being researched. Once the fix is installed, claims will be reprocessed.

Noridian Action Required: Once fix is installed, mass adjustments will be completed.

Provider/Supplier Action Required: No action needed by the providers.

Proposed Resolution/Solution: Noridian will reprocess the claims once the fix has been installed.

08/04/21 - Shared system updates are expected on 08/27/21.

08/20/21 - The system updates will be loaded earlier than anticipated on 08/23/21.

08/25/21 - The fix was loaded 08/23/21. Noridian will mass adjust the claims.

09/08/21 - Mass adjustments have been initiated.

Date Reported: 07/22/21

Date Resolved: 09/08/21


            Last Updated Wed, 10 Nov 2021 19:11:09 +0000