Processing Disposition and Error Codes

80 - Processing Disposition and Error Codes (Rev. 4088, Issued: 07-13-18, Effective: 08-14-18, Implementation: 08-14- 18) The results of CWF processing are communicated through a set of codes categorized as either disposition or error codes. There are specific disposition codes for inquiry, transfer/not in file request, and each claim type. Claims have consistency, utilization, A/B crossover, and duplicate error codes. Transactions for End Stage Renal Disease (ESRD), Medicare Secondary Payer (MSP), and Certificate of Medical Necessity (CMN) error codes, as still applicable, are also available. If the Host rejects a claim, the A/B MAC or DME MAC shall either adjudicate the claim systematically or suspend the claim and review it. After the review is complete and corrections made, the A/B MAC or DME MAC resubmits the claim with an indication that a review was performed and corrections made.