CMS fixing processing errors on vaccine and mammogram claims

The Centers for Medicare & Medicaid Services (CMS) is correcting a pair of systems errors it says led to the inappropriate rejection of some physician claims for vaccinations and mammograms with dates of service on or after Oct. 1.

Condition code A6 is required only for reporting pneumococcal and influenza vaccines, but claims for other vaccine services were erroneously rejected on this basis. These claims were returned with a reason code of 32200.

The agency also said it erroneously rejected claims for mammography services with diagnosis code Z1231 for dates of service on or after Oct. 1. These claims were returned with a reason code of 32016.

In both cases, your Medicare Administrative Contractor (MAC) will correct the claims and you don’t have to take any action, according to CMS.

Posted on Oct 29, 2015 by David Twiddy