Empire Fixes NOPR Claims Denials Issues

September 12, 2006

Empire Fixes NOPR Claims Denials Issues

Attention NOPR participants billing the CMS Empire Contractor covering New York and New Jersey: Empire Medicare Service officials notified the SNM that effective September 1, 2006, the system issue for use of the QR modifier on the NOPR claims has been resolved. Empire thanks those effected for their patience as they worked to respolve the problem.

Empire will be processing qualifying denied claims, submitted with the QR modifier, for automated adjustments. The included claims will be limited to those meeting the cancer diagnosis criteria as indicated by the ICD-9 codes. It is anticipated that the readjustment process may take 2-4 weeks. Providers will not have to submit requests for redeterminations. 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.