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Q:

Why are my claims being denied by Medicare?

A:

Medicare denies claims for several reasons. The typical data entry errors are as follows: HCFA Line item 4, 7, 11a-11d must be left blank HCFA Line item 11 should have NONE typed in HCFA Line item 14 should have injury/illness onset date HCFA Line item 17 and 17a should have the referring provider information HCFA Line item 19 should have either referring provider pin number w/referral date, x-ray date, or required extra information per credentialling HCFA Line item 24e should only have DX indicator 1 HCFA Line item 32 should have clinic information HCFA Line item 33 should have rendering provider information If you claim is denied for another reason, recheck your diagnosis code vs. the CPT code being billed or modifiers used.

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