Diagnosis Code Inappropriate for Age

March 17, 2025

Meridian is currently addressing multiple projects related to claims billed with diagnosis codes that are outside of the restrictions established by CHAMPS. These claims were paid in error based on the member’s date of birth, and the associated encounters were subsequently rejected by the Michigan Department of Health and Human Services (MDHHS).

To align with CHAMPS guidelines, Meridian will be adjusting affected claims. Any claims identified as containing diagnosis codes inappropriate for the member’s age will be recouped accordingly.

The estimated completion date for these projects is May 16, 2025.

We appreciate your cooperation and understanding as we work to ensure compliance with CHAMPS billing guidelines.