Skip to Main Content

Print | Bookmark | | Font Size: + |

Claim Payment Alerts

Date Reported Provider Type Impacted Reason Codes Claim Coding Impact Description of the Issue Action Required by the MAC Action Required by the Provider Proposed Resolution/Fix Status Date Resolved
02/28/2025 Suppliers that submit claims for HCPCS code Q0511 or Q0512 for a supply fee billed with Oral Anti-Cancer Drugs or Oral Anti-Emetic Drugs. 96 Q0511 or Q0512 Claims received 02/21/2025–02/28/2025 for HCPCS Code Q0511 or Q0512 may have denied in error if billed with Oral Anti-Cancer Drugs or Oral Anti-Emetic Drugs. CGS will reprocess claims that denied in error. No action needed. Claims denied in error will be adjusted. In Progress TBD
02/01/2019 Suppliers of HCPCS codes E1020, E1028, E2368, E2369, E2370, E2375, K0015 and K0070 96 E1007, E1020, E1028, E2228, E2368, E2369, E2370, E2375, K0015 and K0070 Claims for HCPCS codes E1020, E1028, E2228, E2368, E2369, E2370, E2375, K0015 and K0070 may have denied incorrectly due to a system processing issue. NOTE: This is an ongoing issue with no ETA for resolution. The issue causing the claim processing error cannot be corrected at this time. No action required. A report will be run monthly and claims will be adjusted if the denial was incorrect. NA NA
02/01/2019 Suppliers of wheelchair accessories. 151 Wheelchair accessory HCPCS codes. Claims for wheelchair accessories may have denied as same or similar equipment incorrectly due to a system processing issue. NOTE: This is an ongoing issue with no ETA for resolution. The issue causing the claim processing error cannot be corrected at this time. No action required. A report is run monthly, and claims are adjusted if the accessories were denied incorrectly. NA NA

Updated: 02.28.2025

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved