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Caution: Chronic care management claims denied in error

Providers operating within the jurisdiction of National Government Services (NGS) should take stock of their recent chronic care management (CCM) claims. You may be seeing errant denials on good claims.
NGS, which covers Connecticut, Illinois, New York and seven other states, issued an "urgent news" bulletin Jan. 14, stating that "claims billed with procedure code 99490, that processed between 12/19/2018 and 1/9/2019, denied in error."

The Medicare administrative contractor (MAC) identified the claims-processing error on Jan. 10 and reports that 99490 claims are now processing correctly. Covering more than 380,000 Medicare-eligible providers, NGS' snafu may be affecting a sizable number of CCM claims, which Part B News reporting has shown are on the upswing -- and poised to grow significantly in 2019.

NGS reported that it began making claims adjustments on the denied 99490 claims on Jan. 14 and that it will automatically reprocess those claims that denied in error. Therefore, your practice does not have to resubmit claims, although you may see a delay in the time it takes to gain payment for the services.

In addition to the states mentioned above, NGS also covers Part B providers in Maine, Massachusetts, Minnesota, New Hampshire, Rhode Island, Vermont and Wisconsin.

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