- Reason Codes 34919, 34929 and 34931: A system fix was implemented January 14, 2011, and claims will be released for processing.Claims receiving these reason codes are editing in error and are related to the Present on Admission (POA) indicator. Claims will suspend in location SM30PA. This is a national issue.
- Reason Code 31608: A system fix was implemented January 14, 2011, and claims will be released for processing. Reason code 31608 is editing in error indicating there is Health Maintenance Organization (HMO) involvement coding on the claim when there is not. Claims will suspend to location SMFPL2. This is a national issue.
- Reason Code 36111 or 36222: A system fix was implemented January 14, 2011, and claims will be released for processing. End Stage Renal Disease (ESRD) claims are editing in error (Return to Provider (RTP)) with reason code 36111 or 36222 for no Method 1 or Method 2 on file for home dialysis patients prior to January 1, 2011; however, there is a method selection on file. Claims will suspend to location SMFPL3. This is a national issue.
Tuesday, January 18, 2011
Part A Claims Processing Issues Update
A system fix was implemented in the Medicare claims processing system January 14, 2011. Claims suspended in locations SM30PA, SMFPL2 and SMFPL3, as indicated below, will be released for processing in this evening’s (January 18, 2011) claims processing cycle.
