FISS Narrative:

  • Value code 12 through 16 and 41 through 43 and 47 for Medicare Secondary Payer data must not contain any reference to Medicare in line A of item 50
  • Note the 4th digit of the reason code reflects the value code occurrence in which the error occurred. The sequence is 1-0 (0 denotes the tenth occurrence) and A-Z (Z denotes the 36th occurrence).

Explanation and Suggestion:

  • The only scenario where Medicare would be entered into line A of Form Locator (FL) 50 is if Medicare is considered to be the primary payer
  • If Medicare is the secondary payer for your claim, enter Medicare on Line B
  • The primary payer should be listed on line A and the applicable MSP Value Code (Value Code 12-16, 41-43, or 47) and the corresponding amount should be listed in FL 39-41

Contact Palmetto GBA JM Part A Medicare

Provider Contact Center: 855-696-0705

Email Part A

Contact a specific JM Part A department

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