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Printed Date: 9/22/2015
Issue Identified: February 28, 2019
Issue: CPT codes 36470 and 36471 are denying incorrectly when billed by specialty 97 (physician assistants). Affected claims are denying with claim adjustment reason code 170 (payment is denied when performed/billed by this type of provider) and reason and remark code N95 (this provider type/provider specialty may not bill this service). Claims affected include dates of service on or after 7/1/2018.
Provider Action: There is no provider action. System editing will be updated to correct this issue and Palmetto GBA will adjust affected claims. This claims payment issue will be updated when adjustments have been completed.
April 8, 2019: Resolved. Jurisdiction J adjustments have been completed.
April 1, 2019: Adjustments have been completed for Jurisdiction M. Jurisdiction J adjustments have not been completed.
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Last Updated: 04/08/2019