Health Information Management

CMS tells payers to fix claims by hand

HIPAA Weekly Advisor, March 15, 2004

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CMS tells payers to fix claims by hand

 

If your Medicare secondary payer (MSP) can't process your claim, the payer may have to make the claim HIPAA-compliant instead of sending it back to you. CMS this month said in a program transmittal that the Medicare common working file doesn't recognize individual-relationship codes in the HIPAA transaction and code sets. Because of this problem, the agency instructed intermediaries to manually repair any CWF errors resulting from their trying to use invalid codes on claims. The CMS transmittal includes a conversion chart for payers to use to convert HIPAA individual-relationship codes to CWF patient-relationship codes. To read transmittal R12MSP, go to http://www.cms.hhs.gov/manuals/transmittals/comm_date_dsc.asp



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