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Remember: CMS to Reject Old Claim Codes on January 1, 2020

Posted on Monday, October 28, 2019 12:19 PM

CMS has issued a reminder that starting on January 1, 2020, they will reject all claims that are submitted with Health Insurance Claim Numbers.  In addition, all eligibility transactions submitted with Health Insurance Claim Numbers will also be rejected.

Starting January 1, 2020, you must use Medicare Beneficiary Identifiers (MBIs) when billing Medicare regardless of the date of service.

If you do not use MBIs on claims after January 1, you will get:

  • Electronic claims reject codes: Claims Status Category Code of A7 (acknowledgment rejected for invalid information), a Claims Status Code of 164 (entity’s contract/member number), and an Entity Code of IL (subscriber)
  • Paper claims notices: Claim Adjustment Reason Code (CARC) 16 “Claim/service lacks information or has submission/billing error(s)” and Remittance Advice Remark Code (RARC) N382 “Missing/incomplete/invalid patient identifier”

Source: NAHC Report


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