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Check here for a status of EDI systems and a log of resolved EDI issues.

Claim Processing Issues LogClaim Payment Alerts

Updated: 04.02.2025

Please reference this page for information about confirmed, system-related issues before you reach out to Customer Service. Click on the description to view details and check back often for updates that we post when they become available.

Closed issues remain on the active log for approximately 60 days before they move to the resolved issues archive list at the bottom of the page.

If you still have questions, please contact Customer Service or use one of our self-service tools.

Date Reported Description

03.11.2025

This issue affects home health (HH) claims for patients that have been on HH for 37 or more consecutive periods in a single admission. The Common Working File (CWF) can only hold the 36 most recent periods of care on HHEH for any beneficiary. Periods that precede the most recent 36 will be dropped off the file and are not retrievable online. When the admission period drops from CWF (also drops from the beneficiary's eligibility record), claims for periods 37 and later cannot find the admission period and the claim is returned to provider (RTP) with reason code U537I "The FROM and THROUGH dates on the HH claim fall outside of an HH Admission period for the same provider."

11.14.2024

Reason Codes 17729 & 17730: Hospice certifying physician edits applied to claims without occurrence code 27 in error. Please see the billing guidance for claim submission errors below.

07.03.2024

Reason Codes 326XX: One or more payer only codes may assign to a claim and cause it to return to provider (RTP) in error.

08.01.2023

Reason Code 19963: Some home health claims returned to provider (RTP'd) in error because the corresponding NOA is offline.

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