Palmetto GBA (Ohio/West Virginia) has implemented a specific denial message for Medicare Part B claim adjustments due to the high number of signature errors assessed by the CERT Review Contractor.
Unacceptable or Invalid Records Scenarios Resulting in Denials:
- Illegible, unrecognizable handwritten signatures or initials
- Unsigned 'typewritten' progress notes with a typed name only
- Unverified or unauthorized electronic signatures
- No indication whatsoever of the rendering practitioner
The related Remittance Advice message codes involve both a Claim Adjustment Reason Code (CARC) and Remittance Advice Remark Code (RARC). The respective narratives are as follows:
- 226: Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete
- MA81: Missing/incomplete/invalid provider/supplier signature
- Group Code CO: Contractual Obligation
Appeal Denied Services - Do Not Resubmit Claims
Providers receiving Remittance Advice notification of these denials and/or related Medicare Part B overpayments must file an appeal to Palmetto GBA (Ohio/West Virginia). The decision for denial was based upon review of medical records; therefore, claims for these services are not to be resubmitted for payment consideration. You must send a written request for a redetermination (appeal). By notifying Palmetto GBA, the offset is stopped in a timely manner while your appeal is being processed.