Skip to main content

March 1, 2016

Claims in a Suspended Status/Location (S/LOC)

CGS continues to receive a high volume of calls from home health and hospice providers regarding claims that are in a suspended S/LOC.  These claims can be identified in the Fiscal Intermediary Standard System (FISS) by a status code beginning with an “S” (example: S B0100).

All Medicare billing transactions will temporarily suspend in different S/LOCs as they process through FISS.  Generally, providers only need to take action when they have claims in the following status/locations:

  • S B6001 – An additional development request (ADR) has been requested by CGS to assist with adjudicating a Medicare claim.  For additional information about Medical Review (MR) ADRs, and non-MR ADRs, refer to the “Additional Development Request (ADR) Overview” Web page.
  • T B9997 – The claim is suspended in the Return to Provider (RTP) file.  Claims go to this status/location when there is missing or incorrect information on the claim.  Providers need to access the RTP file to correct the claim.  For additional information, refer to the “Return to Provider (RTP)” Web page.

Claims may suspend due to system issues that prevent Medicare billing transactions from processing appropriately.  Billing transactions impacted by these issues may be suspended for more than 30 days. CGS provides updates to processing issues on the “Fiscal Intermediary Standard System Claims Processing Issues” Web page.

The “Fiscal Intermediary Standard System (FISS) Common Locations” Web page is also available as a resource to questions about status/locations. 

Please review these resources to help reduce unnecessary calls to the CGS Provider Contact Center (PCC) regarding claims in a suspended S/LOC.

Two Vantage Way, Nashville, TN 37228 © CGS Administrators, LLC. All Rights Reserved