Medicare rejection Code H21084
For those clients getting a H21084 denial from Medicare please read this:
NOTICE- PROVIDER NOTIFICATION RELATED TO CROSSOVER WITH REJECTION CODE H21084
Recently Medicare issued medical provider letters indicating that claims marked for crossover were not crossed due to a claim data error or rejection by the supplemental insurer. The letters identify Internal Control Number (ICN), Health Insurance Claim (HIC), Coordination of Benefits Agreement (COBA) Insurer, patient name, date of service, rejection code, and a description of the rejection code.
Letters Containing Rejection Code "H21084" The description of rejection code H21084 is "The qualifier XX was not found, but was expected because of the National Provider Identifier (NPI)." CMS activated error code H21084 in an effort to address large volumes of non-acceptance of crossover claims by some of the crossover trading partners whose translators were programmed to expect NPI as of May 23, 2008, in the secondary provider fields. Not all crossover claims were or will be impacted. The affected claims will contain a Julian date prior to May 23, 2008 (08144). Providers do not have to correct any information on inbound claims to Medicare.
Please do not resubmit these claims to Medicare. In order for you to receive supplemental payment, you must submit the claim directly to the trading partner.
In Short Medicare is asking that you are responsible for billing your secondary insurance carrier.
Additional Medical Billing and Coding questions are answered here: Online Medical Coding and Billing Courses
Medical Billing and Coding Keyword Tags: medical billings and claims, medical billings claims, medical claims electronic billing, claim billing software, electronic medical claim billing, lytec medical billing software, medical billing schools, medical coding and billing schools, medical billing schools online, medical coding and billing schools online, medical billing classes online, online medical billing school, medical billing and coding courses online, courses online, medical billing classes, chiropractic software, online courses medical billing, medical office billing software, medical coding schools,
Labels:
Medicare
MEDICARE IS GIVING ME A REJECTION CODE OF U5200 WHICH I DO NOT UNDERSTAND. ANY HELP WOULD BE APPRECIATED
ReplyDeleteHello,
ReplyDeleteHere are some common Medicare Insurance Claim Denials and Details of how to fix them:
U5200 - CMA indicates that the beneficiary is not entitled to Medicare Coverage for the type of "services" billed on the claim. Therefore, no Medicare Payment can be made
1. Check to make sure you are submitting the correct Medicare ID#
2. Check to make sure the birthday, name and patient information is setup correctly.
3. Check to verify you are billing a valid Procedure Code that is payable by Medicare.
4. Identify if a Modifier is required for the procedure being billed. Or is a ABN form required?
U5210 - The beneficiary's entitlement for Medicare Coverage was terminated prior to the first date for services provided on the claim. Therefore, no Medicare payment can be made.
U5233 - No Medicare payment can be made because the 'statement covered period' falls within or overlaps an enrollment period in a risk HMO. For inpatient PPS claims, the admission date falls within the enrollment period of a risk HMO.
1. Verify the Admission date from and through dates
2. Inpatient SNF claims and Non-PPS providers must submit the services rendered during the HMO enrollment period to the appropriate HMO. Any services not rendered during the HMO enrollment period should be billed to the intermediary. Split the claim and rebill.
3. Acute care teaching hospitals billing for indirect medical education IME) payments must be billed with both a condition code 04 and 69.
Resubmit after corrections made,if appropriate.
38032 - This outpatient claim is a duplicate of a previously processed outpatient claim.
38200 - The claim is an exact duplicate of a previously submitted claim where the following fields on the history and processing claim are the same
I hope this helps!
Jennifer