Incorrect Coinsurance Percentage Applied for Drugs and Biologicals

Provider/Supplier Type(s) Impacted: All providers.

Reason Codes: Not applicable.

Claim Coding Impact: All drug and biological HCPCS.

Description of Issue: The MCS system maintainer has notified Medicare Administrative Contractors (MACs) of an issue where the copayment amount applied to drug and biological claims for any date of service finalized on or after 10/27/21, may have been applied at .2 percent instead of 20 percent.

Noridian Action Required: Noridian will publish additional information when additional details regarding a system fix and corrective actions are available.

Provider/Supplier Action Required: No provider action at this time.

Proposed Resolution/Solution: When the MCS shared system maintainer notifies MACs of the system fix and corrective actions needed, Noridian will provide additional information as it becomes available.

Date Reported: 11/12/21

Date Resolved:

            Last Updated Tue, 16 Nov 2021 16:34:56 +0000