Dialysis 90999 vs 90935

Nature of Issue: Inaccurate Denial of CPT 90935

Date Identified: 3/29/2024

Dates of Service Impacted: 01/01/2023 to
Current

Product Line Impacted: MMP and Medicaid

Summary of Issue: Inaccurate Denial configured on CPT 90935 after provider bills CPT 90945. Configuration has been updated and fix is in production as of 5/21/2024.

New Claim Submission Issue Resolution Date: 5/21/2024

Prior Claim Correction Issue Resolution Date: 8/1/2024

Any action required by the provider if applicable: N/A - System update in progress, global adjustments project expected to be finalized by 8/1/2024.