MMP Edits Update Effective February 29, 2016 - Clarification


CMS is continuing enhancements to the Medicare-Medicaid Processing System.  In order to ensure syntactically correct Medicaid encounters are received, CMS has determined a need to revise the list of re-activated Common Edit Module (CEM) edits effective February 29, 2016 to a total of eight (8) edits. The following CEM edits will be re-activated effective February 29, 2016:

Edit Reference  

Edit Description 

  

Comprehensive Resolution/Prevention 

Professional and DME:  

X222.091.2010AA.N301.070 X222.091.2010AA.N302.060  

Institutional:
X223.087.2010AA.N301.070 
 

X223.087.2010AA.N302.060 

CSCC A7: Acknowledgement/Rejected for Invalid Information…
CSC 503: "Entity's Street Address"
EIC: 85 Billing Provider 

A Post Office Box address cannot be used for the Billing Provider on Professional, DME or Institutional encounters.   

 

Professional and DME:  

X222.351.2400.SV101-7.020  

Institutional:  

X223.424.2400.SV202-7.025 

 

 

CSCC A8: Acknowledgement/Rejected for relational field in error
CSC 306 "Detailed description of service"
2400.SV101-7 must be present when 2400.SV101-2 is present on the table of procedure codes that require a description.
                            

A more descriptive meaning of the procedure code must be present when using a not otherwise classified or generic HCPCS procedure code. 

Dental Only: X224.086.2010AA.N301.050
X223.086.2010AA.N302.040

 

CSCC A7: Acknowledgement/Rejected for Invalid Information…
CSC 503: "Entity's Street Address"
EIC: 85 Billing Provider 

A Post Office Box address cannot be used for the Billing Provider on Professional, DME or Institutional encounters.  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

We apologize for any inconvenience this may cause and thank you for your patience as we improve our ability to respond to you better.

 

 

 

 

 

 

 


Last Updated: 02/09/2016 09:57:00 AM