NORIDIAN FIXES NOPR CLAIMS DENIALS (QR modifier) ISSUE; Empire Fix Still Pending

August 11, 2006

NORIDIAN FIXES NOPR CLAIMS DENIALS (QR modifier) ISSUE; Empire Fix Still Pending

Attention NOPR participants billing the CMS Noridian and Empire Contractors: Today, Noridian staff notified the SNM that effective August 11, 2006, the system issue for use of the QR modifier on the NOPR claims has been resolved. We applaud Noridian for their rapid attention to this issue, which the SNM brought to their attention. The SNM recommends PET facilities prepare a spreadsheet including all the claims that were denied including: the Medicare Number, the Date of Service (DOS) and the ICN number. Once this information is compiled, to obtain payment for these previously denied claims, please contact the Noridian Provider Contact Center at (800) 933-0614 to request a revision. “No appeal/reconsideration is necessary,” per Noridian officials.

The SNM has also been in contact with Empire officials regarding a similar QR modifier denial system issue. Empire staff are working on this issue and will notify the SNM with dates, times and instructions when they are available. The SNM will post this information on our web site. If SNM member PET facilities have other billing issues with your NOPR claims, contact SNM coding advisor Denise A. Merlino at dmerlino@snm.org for assistance.