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CPILClaim Payment Alerts

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 of Issue
04.10.2026 This is an addendum to the 04/08/2026 CPIL regarding E & M codes denying in error. Services were denied as payment made for same/similar procedure within set time frame. We've identified QPP Mass Adjustments are also impacted.
04.08.2026 Evaluation and Management codes denying in error indicating service denied because payment already made for same/similar procedure within set time frame.
03.10.2026 Quality Payment Program: Claim Adjustments to Correct Conversion FactorExternal Website - Starting in CY 2026, the update to the qualifying alternative payment model (APM) conversion factor is +0.75%, while the update to the nonqualifying APM conversion factor is +0.25%.
02.11.2026 Denials for vaccine codes when billed by pharmacies (specialty A5 type 50) in KY
01.13.2026 E & M SERVICES CONCURRENT CARE
12.10.2025 Certain clinical laboratory test claims with dates of service on October 1 – December 1, 2025, denied in error.
11.21.2025 Claims for COVID and other vaccines provided on the same day denied in error.
11.07.2025 The Common Working File (CWF) Host identified an issue that caused a subset of HMO beneficiary claims to deny (no open HMO enrollment) in error.
11.05.2025 Clinical Lab Service denying due to a missing, incomplete, or invalid Clinical Laboratory Improvement Amendments (CLIA) certification number.

Updated: 04.13.2026

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