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CSSC Operations / Medicare Medicaid Plans / FAQs / If rejecting at the claim level for the...

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CSSC Operations
/ Medicare Medicaid Plans / FAQs
If rejecting at the claim level for the Medicaid file, is the compliant portion reformatted to a compliant 837 transaction?

Answer:

Syntactical edits are applied based on the TR3.  A list of edits can be found in the CMS edit spreadsheets on the CMS web site.  The spreadsheets can be sorted by 999R, 999E and 277T to identify the edits that may be applied.