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Claims Processing Issues Log
Listed below are current system-related claims processing issues. Issues are shown by date reported with the most recently reported issue listed first. This log is updated frequently, as soon as information becomes available. CGS encourages you to review this log often and prior to contacting the Provider Contact Center. A list of resolved issues is also available at the end of this list. If you still have questions, please contact the Provider Contact Center or use one of our self-service tools.
Date Reported |
Description of Issue |
11.20.2023 |
Claims for CPT codes 90480, 91318, 91319, 91320, 91320, 91321, and 91322 were denied in error. |
Status |
Provider Type Impacted |
Reason Codes |
Claim Coding Impact |
Date Resolved |
Open |
Ohio PART B providers that billed CPT Codes 90480,91318,91319,91320,91320,91321, and 91322 |
CO 05 – M77 The procedure code/type of bill is inconsistent with the place of service. Missing/incomplete/invalid/inappropriate place of service |
CPT codes 90480, 91318, 91319, 91320, 91320, 91321, and 91322 |
11.20.2023 |
Updates |
|
MAC Action |
A mass adjustment will be done to reprocess the claims that were denied in error. |
Provider Action |
NO ACTION REQUIRED |
Proposed Resolution |
CGS Audit was updated. We will do a mass adjustment. |
|
10.31.2023 |
Some claims received on October 11th and 12th were priced at $26.14 for services in error. This only impacted services that pay under the Physicians Fee Schedule and were performed in a facility setting. |
Status |
Provider Type Impacted |
Reason Codes |
Claim Coding Impact |
Date Resolved |
Open |
Part B Providers |
N/A |
Multiple |
|
Updates |
|
MAC Action |
We will perform a mass adjustment to correct the allowed amounts. |
Provider Action |
No action is required. |
Proposed Resolution |
We have updated the pricing for all MPFS procedure codes in OH and will perform a mass adjustment to allow claims to be priced correctly. |
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