Paper Claims Rejecting Incorrectly
HFS System Issue:
Paper claims are rejecting incorrectly for N01, Invalid First Diagnosis code, N02, Invalid Second Diagnosis Code, for dates of service prior to 10-01-15.
Paper claims are rejecting incorrectly N05, First DX not From ICD-CM for dates of service after 10-01-15.
Valid ICD-9-CM codes are required on claims for dates of service prior to 10-01-15. Valid ICD-10-CM codes are required on claims for dates of service on or after 10-01-15. Paper claims with valid diagnosis codes for the Date of Service are rejecting inappropriately with HFS Error Code N01, N02, and/or N05.
Non-Institutional providers billing on paper claims forms.
Procedure Codes Impacted:
Problem Begin Date:
Problem Fix Date:
Resolution for Impacted Claims:
The diagnosis system issue has been resolved. Claims must be rebilled. For claims past the 180 day timely filing deadline, providers must re-bill the Department on paper and request a time override using the HFS 1624, Override Request Form. Instructions for the paper override process are explained in detail on the Department’s Non-Institutional Providers Resources webpage. Providers will have 180 days from the fix date to qualify for an override.