OPEN: Claim Hold on Medicare Secondary Payer Claims Receiving Edit 6802 in Error

Published 05/05/2025

OPEN: Claim Hold on Medicare Secondary Payer (MSP) Claims Receiving Edit 6802 in Error
Current Status  Date   
Update May 5,  2025 Status: The MSP edit 6802 process is not correctly performing the MSP matching process with all claim lines against the CWF MSP auxiliary records. The initial correction on April 28, 2025, did not correct this error and the CWF is currently working to correct this issue. CMS has requested all affected claims be suspended until the error code is working properly. MACs will adjust all claims rejected in error within 30 days of the actual correction of the 6802 code.
Provider Action: No action is currently required from the provider community.
Update April 30, 2025 Status: The Common Working File (CWF) correction was implemented on April 28, 2025, to address incorrect rejections of MSP impacted claims processed between April 7, 2025, and April 21, 2025. Palmetto GBA will rectify the rejected claims within 30 days.
Provider Action: No action is currently required from the provider community.
Open April 24, 2025

Status: The Centers for Medicare & Medicaid Services (CMS) requested MACs to suspend all MSP claims editing with 6802. A CWF correction will be implemented on April 28, 2025. 

Provider Action: There is no provider action needed. All impacted MSP claims will be released to continue processing on April 28, 2025.
Issue Description
The MSP edit 6802 is not setting correctly. The CWF is not performing the MSP matching process with all claim lines against the CWF MSP auxiliary records. CWF is currently correcting this issue.

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