Claims May Suspend Temporarily for Edit 4185

Claims May Suspend Temporarily for Edit 4185

The Centers for Medicare & Medicaid Services (CMS) quarterly updates were released on Friday, January 6, 2012. The Indiana Health Coverage Programs (IHCP) is reviewing the updates and applying any necessary changes to the claims processing system. Providers submitting medical and outpatient claims received on or after January 6, 2012, may see claims suspend temporarily for edit 4185 - The claim did not process through National Correct Coding Initiative (NCCI) editing. The claim will be reprocessed or adjusted at a later date. Please monitor future remittance advice statements for processing activity related to this claim.

HP anticipates the updates will be made to the claims processing system by Tuesday, January 10, 2012. Once the updates are completed, all claims in suspense for edit 4185 will be released and processed for adjudication. HP will post an update if there are any changes to this proposed schedule.