We would like to inform you of changes to our PacificSource Community Solutions’ claims processing edits that will take effect May 12, 2014.
We are currently updating our claims system to utilize Medicaid NCCI edits for our Community Solutions claims. These edits will be applied to ALL claims received on or after May 12, 2014.
Examples of edits include but are not limited to:
If you receive one of these edits on a remit, please review the coding and/or the Medicaid.gov website for the most recent NCCI edits before appealing the denial. The files can be found at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Data-and-Systems/National-Correct-Coding-Initiative.html.