Denial, remark codes show you should bill workers' comp fund

Article Overview

This article covers a CMS update about Medicare claim denials tied to workers’ compensation Medicare Set-Aside Arrangements (WCMSAs). It is relevant to coders, billers, compliance staff, and reimbursement professionals who need to understand the types of denial and remark messaging CMS may use when a claim may be payable from a workers’ compensation-related fund instead of Medicare. The article also discusses the related CMS transmittal and the general documentation issue raised when a WCMSA has been exhausted.