Erythropoiesis Stimulating Agents (ESAs) Denials

Current Status:
6/12/2019: Outpatient hospital claims that reported HCPCS J0881 and J0885 submitted on or after April 1, 2019, were denied in error with reason codes 59276 and 59277. Palmetto GBA isolated the processing issue and will initiate a mass adjustment for claims submitted on or after April 1, 2019, to June 12, 2019. No provider action is required.

Situation Identified on May 30, 2019
Change Requests 10318, 10473, 10859 and 11005 implemented edits for National Coverage Determination (NCD) 110.21 Erythropoiesis Stimulating Agents (ESAs) in Cancer and Related Neoplastic Conditions. These edits are interlaid into the Fiscal Intermediary Shared System (FISS) and interacting incorrectly as of April 1, 2019. Palmetto GBA isolated the processing issue on June 12, 2019.

Article Update Notification
Please notify me when this article has been updated.

Would you like to know when this article is updated? Sign up for Article Update Notifications below and we'll send you an email with the new version automatically.

Please check your spam/junk folder as your notification email maybe delivered there.

Email Address:
CAPTCHA Code: 7472



Contact Palmetto GBA JM Part A Medicare


Provider Contact Center: 855-696-0705

Email Part A

Contact a specific JM Part A department

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