Proper use of ‘Medicare Treatment Authorization’ field
The “Medicare Treatment Authorization” field must contain blanks or valid Medicare data, or the claim will be returned to the provider (RTP) for correction starting January 5, 2015.
Starting January 5, 2015, the “Medicare Treatment Authorization” field must contain blanks or valid Medicare data in the first 14 bytes of the treatment authorization field for direct data entry (DDE) and hardcopy claims and at the loop 2300 REF02 (REF01=G1) segment for the ASC X12 837 claim.
Institutional claims submitted without blanks or valid data (see list below) will be returned to the provider with reason code 30729 for correction. PC-ACE Pro32 users should remove any invalid values being reported in the Add’l Ref No/Type field on the Extended Payer Tab of the Institutional Claim form.
Providers using another Vendor’s software should work with their system representatives or vendors to ensure the field complies with these instructions.
Valid data for the ‘Medicare Treatment Authorization’ field
The following list represents the current valid data used in the “Medicare Treatment Authorization field”; any other data (other than blanks or the valid data values listed below) will be returned to the provider (RTP) with reason code 30729.
Valid data in the loop 2300 REF02 (REF01=G1) segment for the ASC X12 837 claim may be any of the following values:
- Unique Tracking Number (UTN) = FIRST TWO POSITIONS OF UTN MUST BE ALPHA-NUMERIC AND NOT CONTAIN SPACES, THIRD POSITION OF UTN IS AN A OR H, LAST 11 POSITIONS OF UTN MUST BE NUMERIC AND NOT CONTAIN SPACES.
- TRIAL 49
- SPN66
- 64
- 56
- A/B REBILLING
- 54
- SPN65
- 07
- 08
- Valid 18-byte OASIS Treatment Number for Home Health claims
