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 A Medicare


Provider Contact Center: 855-696-0705

Email Part A

Contact a specific JM Part A department

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Jurisdiction J Part A MAC

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Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

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PDAC

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RRB Specialty MAC Beneficiaries

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