Medicare Claims Processing Manual (Pub. 100-04), Ch. 32 § 69.11

Resolution of CWF UR 5232 Rejects

Last amended: 2005Year: 2005Length: 95 wordsOfficial source
69.11 - Resolution of CWF UR 5232 Rejects (Rev. 487, Issued: 03-04-05, Effective and Implementation: N/A) If you send a claim transaction to CWF that includes both clinical and non-clinical trial services for a managed care enrollee, the entire claim will be rejected with the UR 5232 error code. When you receive a UR 5232 error code split the claim and resubmit the clinical trial portion to CWF. Process the non-clinical trial portion of the rejected claims in the same manner that other non-clinical trial fee for service claims for managed care enrollees are handled.