CMS Reports Vaccine, Mammography Claims Processing Errors

No Physician Action Required

November 04, 2015 04:32 pm News Staff

Heads up to family physicians: If you should receive Medicare claims rejections for vaccine services with an error code of 32200, don't bat an eye.

[Woman touching the word

CMS made a mistake.

In the Oct. 29 issue of CMS' MLN Connects Provider eNews(www.cms.gov) from the Medicare Learning Network, The agency blamed the glitch on a "systems error" that involves vaccine services other than pneumococcal and influenza vaccines, which are the only two vaccine groups that require the reporting of condition code "A6."

Unfortunately, the claims processing system erroneously kicked out all vaccine service claims with dates of service on or after Oct. 1 that were reported without that specific code -- hence, the rejections.

But that's not all.

The same publication alerted physicians to another processing error regarding mammography claims with diagnosis code Z1231 for dates of service on or after Oct. 1. Those returned claims will be tagged with reason code "32016."

The good news is that physicians need not take any action to fix CMS' error.

In both instances, Medicare administrative contractors(www.cms.gov) will correct all claims that were erroneously returned to physicians.


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