Six of the 12 Medicare administrative contractor (MAC) jurisdictions, entwining more than two dozen states and territories across the U.S., have reported at least one claims-processing error each, according to a Part B News analysis of the MACs’ publicly reported issues.
Here's a round-up of some of the issues:
- Mammogram codes G0204 and G0206 automatically denying when providers billed the testing codes with an ICD-10 diagnosis code, even when the ICD-10 diagnosis code was correctly chosen.
- “Routine/non-payable diagnosis codes are denying incorrectly” when a routine or non-payable diagnosis code is listed on the claim in addition to a primary diagnosis code.
- Delays for chiropractic claims involving procedure codes 98940-98943.