RESOLVED: Multiple Procedure Payment Reduction (MPPR) TOB 22X, 23X and 85X


Resolved: Multiple Procedure Payment Reduction (MPPR) TOB 22X, 23X and 85X

Current Status

Date

 

Resolved

07/27/2021

All affected claim adjustments have been processed.

Initial

5/7/2021

Status:
Palmetto GBA will initiate a mass adjustment for the impacted claims within 90 days.

Provider Action:
There is no provide action required.

Identified

4/27/2021

Issue 

Some skilled nursing facility (SNF) type of bills (TOB) 22X and 23X and Critical Access Hospital (CAH) TOB 85x with dates of service January 1 through April 11, 2021, processed prior to April 12, 2021, did not have the Multiple Procedure Payment Reduction (MPPR) applied on them. The system was updated on April 12, 2021, when the fix was installed. These TOBs with Revenue Code 042X, 043X or 044X present with more than 1 units or Revenue Code 042X, 043X or 044X present on more than one line with the same line item date of service, are scheduled for mass adjustment.


Article Update Notification


Would you like to know when this article is updated? Sign up for Article Update Notifications below and we'll send you an email with the new version automatically.

Please check your spam/junk folder as your notification email maybe delivered there.

Email Address:
Please enter this four-digit number in the CAPTCHA Code field: 0103






Last Updated: 05/07/2021