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Fiscal Intermediary Standard System (FISS) Common Locations

Fiscal Intermediary Shared System (FISS) Common Locations

S B0100 System processing (billing transaction is suspended).
S B6000 Billing transaction goes to this location prior to moving to S B6001 to request additional information.
S B6001 Billing transaction needs additional information from the provider. An Additional Development Request (ADR) will be generated from this location. Documentation in response to Medical Review ADRs (MR ADRs) must be received by CGS within 45 calendar days. If requested information is not received, the claim will be automatically denied on day 46. If the billing transaction has reason code 5ADR2, additional signature documentation is being requested. The documentation must be returned within 20 days. Refer to the "Medical Review Additional Development Request (ADR) Process" Web page or the "Additional Development Request (ADR) Overview" Web page for additional information.
S M50MR Medical review of documentation. The billing transaction will move to this location after the Additional Development Request (ADR) information has been received. Please note that the review process may take up to 30 days to complete or 60 days for demand denials (condition code 20).
S B90XX Data on the billing transaction is being verified with the beneficiary eligibility information posted at the Common Working File (CWF).
S MXXXX Billing transactions are suspended in this location when Medicare staff intervention is needed. May be suspended for about 30 days. Claims with Medicare Secondary Payer (MSP) information may be suspended for more than 60 days. Providers may call the appropriate customer service telephone number if a claim has been in the same "S MXXX" status/location for longer than 30 days, or 60 days for MSP claims.
S M87DR Hospice Only – acknowledgement that CGS has received the documentation for an exception request for an untimely notice of election. Refer to the "Requesting an Exception for an Untimely NOE" Web page for additional information.
S M8877 Hospice Only – if documentation for an exception request for an untimely notice of election is not received within 30 days of the initial request, the claim will move to this status/location until day 45, or until your documentation is received. If documentation is not received by day 46, the claim will be released to process as billed. Refer to the "Requesting an Exception for an Untimely NOE" Web page for additional information.
S MRADJ MSP adjustment – created after MSP adjustment received: awaiting completion.
T B9900 Billing transaction will need correction by the provider when it moves into T B9997 in the next system cycle.
T B9997 Billing transaction needing correction by providers will appear in this location. Refer to the Fiscal Intermediary Standard System Guide, "Chapter Five: Claims CorrectionPDF" for information about correcting billing transactions. Assistance is also available on the "Top Claim Submission Errors (Reason Codes) and How to Resolve" Web page.
I B9900 Billing transactions that are inactivated from Return to Provider (RTP) file; waiting to purge from FISS.
R B9997 Rejected billing transaction (finalized).
R B75XX Rejected billing transaction (suspended). It may take at least 75 days for the claim to move to the R B9997 finalized status/location.
D B9997 Denied claim (all services denied). A partially denied claim will appear in the P status.
P B7501 Post-pay MSP review.
P B7505 Post-pay MSP review.
P O9998 Archived claim. Refer to the Fiscal Intermediary Standard System Guide, "Chapter Five: Claims CorrectionPDF" for information about accessing archived claims.
P B9996 Billing transactions have been posted and are awaiting the payment floor.
P B9997 Billing transactions have been processed and paid (full or partial).

Updated: 02.12.16


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