States Applicable to Alert: Hawaii, Nevada, Guam, American Samoa, Northern Mariana Islands, Northern California and Southern California
Background Information: Claims were being denied incorrectly due to miscalculation of the follow-up diabetes education training hours during a calendar year. The problem has been resolved and the affected claims will be reprocessed.
Applies To Procedure Code(s): G0108 and G0109
Modifier(s): N/A
Remark /Reason Codes:
119 - Benefit maximum for this time period or occurrence has been reached.
MAC Action:
A mass adjustment was completed for Codes G0108 and G0109 on May 6, 2009. Northern California had 22 claims adjusted and Southern California had 16 claims adjusted. There were no claims adjusted for Hawaii or Nevada as none from these regions matched the mass adjustment criteria.
Provider Action: No action required
Date Reported: February 26, 2009
Date Resolved: May 6, 2009