Incorrectly Denied Claims – CO-56

National Government Services, Inc. recently discovered a claims processing system problem that affected all Medicare Part B New York claims received on, or in process on, April 23, 2007 and April 24, 2007. The affected claims were denied incorrectly with remittance advice denial message CO-56, “claim/service denied because procedure/treatment has not been deemed ‘proven to be effective’ by the payer.” National Government Services is treating this problem with the highest priority and is in the process of identifying all claims that have been affected by this error. All impacted claims will be reprocessed. We recommend that you resubmit your claims if you received the CO-56 denial, but wait for National Government Services to perform the claim adjustments. We apologize for any inconvenience this may have caused. CPT codes, descriptions, and other data only are copyright 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.

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