The front-end editing process continues to be a successful tool for reducing the number of suspended and unprocessable Medicare claims. In our ongoing effort to only allow clean claims into the Medicare processing system effective December 1, 2008, the following edit was returned as a Warning, and effective January 5, 2009, this edit was returned as a Reject.
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Edit #
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Edit Message
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Edit Logic
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X3M
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Exceeded MEA Segments Submitted
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Edit sets when more than 20 iterations of the MEA segment are submitted
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Effective February 16, 2008, the following edit will be returned as a Warning, and effective March 1, 2009, this edit will be returned as a Reject.
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Edit #
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Edit Message
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Edit Logic
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X4B
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Diagnosis Pointer Invalid
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Edit sets when diagnosis point is invalid or not in proper sequence
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We continue to encourage providers to review the Response Report as soon as possible after transmission. Claims that are rejected must be corrected and resubmitted.
Please call your EDI Technology Support staff at the following numbers if you have any questions regarding these edits.
- J1 Part B - Palmetto GBA Technology Support Center: (866) 749-4301
- Ohio & West Virginia Part B - EDI Technical Support Team: (866) 308-5438
- SC Part B - Palmetto GBA Technology Support Center: (866) 749-4301
- Railroad Medicare - Railroad Medicare EDI Operations: (866) 749-4301