• RESOLVED – Mass Rejection of Medicare Dialysis Claims Impacting September 2016 Claims

    As a follow up to a previous communication about the mass rejection of September 2016 Medicare dialysis claims, we have now had further information from the NRAA about the issue’s resolution. CMS should be implementing a workaround  on October 22.  Please contact your Medicare Administrative Contractor (MAC) for further details. Please see below for the information from the NRAA email.


    “We recently alerted you that the recent CMS Outpatient Prospective Payment System (OPPS) update (CR9754) effective October 1, 2016, has resulted in the incorrect rejection of dialysis claims (Bill type 72x), which is affecting ALL DIALYSIS PROVIDERS.

    CMS has responded to the NRAA’s Legislative Counsel, Mehlman Castagnetti Rosen & Thomas, that the claims processing system did experience an issue specifically related to reason code W7099 with the implementation of the October 2016 software update.

    The Medicare Administrative Contractors (MACs) were instructed to perform a workaround that will allow claims to be processed correctly. The workarounds should be implemented by October 22, after which claims should be processed appropriately. The MACs will reprocess any claims that were incorrect.”