Claim Payment Alerts
| Date Reported | Provider Type Impacted | Reason Codes | Claim Coding Impact | Description of the Issue | Action Required by the MAC | Action Required by the Provider | Proposed Resolution/Fix | Status | Date Resolved |
|---|---|---|---|---|---|---|---|---|---|
| 06/30/2026 | Suppliers who submitted claims for Osteogenesis Stimulators, E0747, E0748, and E0760 for dates of service on or after 05/18/2026 through 06/30/2026 without the KF pricing modifier. | N/A | E0747, E0748, E0760 | Claims with dates of service 05/18/2026-06/30/2026 for Osteogenesis Stimulators submitted without the KF modifier. | CGS will reprocess paid claims that processed without the KF pricing modifier for HCPCS codes E0747, E0748, E0760. | To facilitate future claims and ensure proper payment, suppliers are advised to refer to the MLN Connects Newsletter for July 2, 2026 |
CGS will identify and adjust paid claims billed with HCPCS code E0747, E0748, and E0760 billed without the KF pricing modifier for dates of service May 18, 2026 through the date the revised KF pricing modifier fees are implemented. NOTE: CGS will apply the KF modifier to the relevant claims to amend the pricing. |
||
| 06/15/2026 | Suppliers who submit claims for HCPCS codes E0651, E0652, L1844, L1846, L1852, and L1932 that required Prior Authorization | 284 | E0651-E0652, L0651, L1844, L1846, L1852, and L1932 | Claims that were received between 04/13/2026 and 06/04/2026, with a date of service within the same range and an accompanying Prior Authorization submission, may have been processed inaccurately. | CGS will review and adjust claims that were processed in error. | No action required. | Claims processed in error will be adjusted. | In Progress | TBD |
| 02/01/2019 | Suppliers of HCPCS codes E1020, E1028, E2368, E2369, E2370, E2375, K0015 and K0070 | 96 | E1007, E1020, E1028, E2228, E2368, E2369, E2370, E2375, K0015 and K0070 | Claims for HCPCS codes E1020, E1028, E2228, E2368, E2369, E2370, E2375, K0015 and K0070 may have denied incorrectly due to a system processing issue. NOTE: This is an ongoing issue with no ETA for resolution. | The issue causing the claim processing error cannot be corrected at this time. | No action required. | A report will be run monthly and claims will be adjusted if the denial was incorrect. | NA | NA |
| 02/01/2019 | Suppliers of wheelchair accessories. | 151 | Wheelchair accessory HCPCS codes. | Claims for wheelchair accessories may have denied as same or similar equipment incorrectly due to a system processing issue. NOTE: This is an ongoing issue with no ETA for resolution. | The issue causing the claim processing error cannot be corrected at this time. | No action required. | A report is run monthly, and claims are adjusted if the accessories were denied incorrectly. | NA | NA |
Updated: 07.02.2026

