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Published Date:12/16/2019
Printed Date: 9/22/2015
URL: http://palmgba.com/marlowe/redesign6/article.html
Description The claim is billed as Medicare primary and occurrence code 24 and date are present; however, the MSP value code is not present. This billing is incorrect based on the IOM direction for conditional payment claim requests.
Resolution Conditional payment claim requests require several claim processing elements for 837 institutional claims format that consist of the following:
Resource CMS Internet Only Manual (IOM), Publication 100-05, chapter 5 (PDF, 1.12 MB), section 40.6 and 40.6.1.
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Last Updated: 12/16/2019