April 6, 2001

Medi-954-01

TO: ALL MEDICARE PROVIDERS

SUBJECT: HARDCOPY REMITTANCE ADVICE- STATUS CODES

PRIMARY INTEREST: BUSINESS OFFICE MANAGERS

We have received several questions about the ‘status’ field on the Hardcopy Remittance. The valid values for that field are listed below. This field is the last field under the HIC, DCN, and service dates on the hardcopy remit:

1 claim processed as primary

2 claim processed as secondary

3 claim processed as tertiary

4 claim denied

19 claim processed as primary and crossed over

20 claim processed as secondary & crossed over

21 claim processed as tertiary and crossed over

22 reversal of previous payment

Please note status codes ’19, 20, and 21’, indicate the claim crossed over to the trading partner.

THIS BULLETIN SHOULD BE SHARED WITH ALL HEALTH CARE PRACTITIONERS AND MANAGERIAL MEMBERS OF THE PROVIDER STAFF. NO COST COPIES ARE ALSO AVAILABLE FROM OUR WEB SITE AT riverbendgba.com

Please refer any questions to our office toll free at 877-296-6189.