Laboratory Services Denying as Non-Covered with Beneficiary Liability - Resolved 11/04/20

Provider/Supplier Type(s) Impacted: Not Applicable.

Reason Codes: Not Applicable.

Claim Coding Impact: 87632, 87633, 0098U, 0099U, 0100U, 0115U, 0202U, 0223U

Description of Issue: Laboratory claim lines billed with dates of service October 1, 2019 to October 13, 2020 containing procedure code 87632-87633, 0098U, 0099U, 0100U, 0115U, 0202U, or 0223U denied as Noncovered/beneficiary liable incorrectly for claims/adjustments processed on/after July 13, 2020. These should be denying as provider liable or beneficiary liable when billed with the GA modifier.

Noridian Action Required: Adjustments will be completed to reprocess claims/adjustments that were denied incorrectly.

Provider/Supplier Action Required: No action is needed by providers.

Proposed Resolution/Solution: The claims processing system has been updated effective for claims/adjustments processed on/after October 14, 2020 to use the appropriate denials and adjustments will be completed.

11/04/20 - A mass adjustment was completed on 11/03/20.

Date Reported: 10/14/20

Date Resolved: 11/04/20

Last Updated Wed, 04 Nov 2020 20:23:02 +0000