U5233

FISS Narrative
Services fall within or overlap a Medicare Advantage (MA) Health Maintenance Organization (HMO) enrollment period.

Explanation and Suggestion:
Inpatient claims must be submitted with a condition code 04 when a patient is enrolled in a MA Plan for benefit tracking purposes.

Always check eligibility prior to submitting claims:

  • Direct Data Entry (DDE)
  • Interactive Voice Response (IVR)
  • Palmetto GBA's eServices
  • Verify beneficiary’s admission date, 'from' and 'through' dates on claim
  • Compare dates with MA enrollment

Contact Palmetto GBA JM Part HHH Medicare

Email HHH

Contact a specific JM HHH department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

Anonymous

 


spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer