Important Announcement – Activation of Medicare Edits

Effective Monday 1/7/2013, Medicare will activate edits to reject claims when data is present in Loop 2000B SBR03 (Subscriber Group or Policy Number).

In response to these edits, Availity will implement the following PSE’s (payer specific edits) on Monday 1/7/2013 at noon EST.

Availity reject claims that contain a value in Loop 2000B SBR03. The rejections will be returned on the IBR and EBR.

 

	Edit #	Msg Description
Institutional	S259I	Subscriber group or policy number (loop 2000B, SBR03) must not be present.
Professional	S259P	Subscriber group or policy number (loop 2000B, SBR03) must not be present.

 

Impacted Medicare Payers:

 

Professional
CH Id	Payer Id	Payer Name
DMEREGIONB	17003	DME Region B
DMEREGIONC	18003	MEDICARE DMERC REGION C
DMEREGIOND	19003	DMERC REGION D
FLMEDICAREB	09102	FLMEDICAREB
ILMEDICAREBWPS	00952	WPS IL MEDICARE B
MIMEDICAREBWPS	08202	WPS MI MEDICARE PART B
MNMEDICAREBWPS	00954	WPS MN MEDICARE B
NORIDIANAK	02102	MEDICARE B AK
NORIDIANID	02202	MEDICARE PART B IDAHO
NORIDIANOR	02302	MEDICARE B OR
NORIDIANWA	02402	MEDICARE PART B WA
NOVITAS_CO	04112	CO MEDICARE PART B
NOVITAS_NM	04212	NM MEDICARE PART B
NOVITAS_OK	04312	OK MEDICARE PART B
NOVITAS_PA	12502	PENNSYLVANIA MEDICARE
NOVITAS_TX	04412	TX MEDICARE PART B
TRAILBLAZER_RR	00882	MEDICARE B – RR
TRAILBLAZER_VA	11302	MEDICARE B – VA
WIMEDICAREBWPS	00951	MEDICARE B WISCONSIN
Institutional
CH Id	Payer Id	Payer Name
FLMEDICAREA	09101	FLMEDICAREA
NORIDIANMN	00320	NORIDIAN MN Part A
NOVITAS_CO	04111	CO MEDICARE PART A
NOVITAS_NM	04211	NM MEDICARE PART A
NOVITAS_OK	04311	OK MEDICARE PART A
NOVITAS_PA	12501	PENNSYLVANIA MEDICARE
NOVITAS_TX	04411	TX MEDICARE PART A