Reason Code U680B - JF Part A

Reason Code Narrative

THIS RECORD CONTAINS NO MSP AND AN MSP AUXILIARY RECORD EXISTS AT THE HOST. A COMPARE OF THE 03 TRAILER HAS BEEN COMPLETED AND THE FIRST OCCURRENCE WITH A 'Y' OR 'I' VALIDITY AND THE CLAIM DATES OF SERVICE ARE WITHIN THIS PAYORS EFFECTIVE AND TERMINATION DATES.

Common Reason Code Errors

• Claims are billed Medicare primary; however, an open ESRD file exists on CWF.

Common Reason Code Corrections

• Collect primary insurer information from beneficiary and resubmit claim with correct primary payer and Medicare as secondary payer.
• If beneficiary no longer has other primary insurance, contact Benefits Coordination and Recovery Center (BCRC) to update ESRD file.

Resources

• CMS Internet Only Manual (IOM), Publication 100-05, Medicare Secondary Payer Manual, Chapter 3
• Benefits Coordination & Recovery Center (BCRC)

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