J15 Part A Claims Processing Issues Log

Medicare Secondary Payer (MSP) claims are processing incorrectly due to changes implemented in CMS Change Request (CR) 7605 on January 7, 2013.

05.17.2013
The issue has been reported and is being researched by CMS and the Common Working File (CWF).

Medicare Secondary Payer (MSP) claims are rejecting with reason code 39071, 39072, or 39073 when a non-trauma diagnosis code is included on a liability, no-fault, or Workers' Compensation record in the Common Working File (CWF).

05.10.2013
Claims have been set to suspend to SMOSUG while the issue is researched.

04.16.2013
You may contact the Part A PCC to have an Action Request submitted to determine if the diagnosis code(s) are related/unrelated to the MSP file. However, we are experiencing delays with the Action Requests due to a high volume of requests and a claim cycling issue that occurs after the MSP file is updated.

Inpatient hospital claims are rejecting with reason code 38013 in error. This applies to the receiving hospital's same-day transfer claim.

05.10.2013
The FISS Maintainer is researching and a fix is tentatively scheduled.

01.30.2013
A workaround is currently being tested.

Some claims are reaching the payment floor (PB9996) and not moving to the finalized location (PB9997).

05.10.2013
A fix is in process.

01.30.2013
The Healthcare Integrated General Ledger Accounting System (HIGLAS) and Fiscal Intermediary Standard System (FISS) Data Centers are working to resolve the issue.