The following information is provided by Novitas Soluations.
UPDATE: After further review of this issue and the remittance advice codes that were applied, it has been determined that adjustments are not necessary to generate new remittances for COBC or quality measurement reporting as the message does not affect the quality based reporting process. No further provider action is required.
UPDATE: Novitas has completed additional analysis on this issue. The Part B claims that contained certain non-payable measurement codes which also contained other payable services did actually cross over to the COBC. The claims with the payable services were received and accepted by the COBC and sent to the appropriate supplemental insurers for processing.
The non-payable measurement services which contained the dash (-) in the standard message field and where the ERA showed OA 121 were also accepted by the COBC but did not contain sufficient information for the supplemental insurers to make a determination on responsibility/liability for the non-payable measurement code service. Although there should not be a change in payment, Novitas will be performing adjustments on these claims to correct the system outputs. No action is required by providers at this time.
ISSUED 07/11/2014 @ 3:58PM: Due to a system error, Part B claims containing certain non-payable measurement codes were not being crossed over to the Coordination of Benefits Contractor (COBC). Although the measurement codes are non-payable, if the claim contained a non-payable measurement code and another payable service, the system error prevented the entire claim from being crossed over to the COBC. In these situations, the provider remittance shows a message that the claim was crossed over to the COBC, however, the system error prevented the claim from being accepted by the COBC. In addition, the system error may have caused the paper remittance to show a dash (-) in the standard message field, and the ERA may show qualifier OA and message 121 for the impacted services. The system error impacted claims finalizing between July 1 and July 10. Novitas is currently identifying all claims that were impacted by this error, and will perform adjustments on the claims to correct the system error and the corrected claims will be sent to the COBC for further processing. We will update this notice as we work through the adjustment process. We apologize for any inconvenience this has caused. No action is necessary at this time by providers.
Medicare Enrollment Podcasts Now Available
In this week's Medicare Insights Weekly podcast, we review incomplete or missing items from the enrollment form. Listen to this podcast to avoid common errors that delay your enrollment processing. This is the first in a series. Keep listening every week for more helpful tips!
Participating Provider versus Non-Participating Provider
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