Wednesday, May 25, 2016
Types of reopenings available via the IVR
The following types of reopening requests are not available through a CSR; you must call the IVR for the following types of requests:
• Change date of service and quantity billed
• Change diagnosis code
• Add, delete, change modifier (except modifiers listed below)
• History corrections – including entitlement, Medicare Secondary Payer, Medicare Advantage Plan change in status or update to the patients records
• Change procedure code (can also change billed amount)
• Change quantity billed (can also change billed amount)
• Change ordering or referring provider information
Types of reopenings that cannot be performed via the IVR
• Previously adjusted claims
• Pending claims
• Non-assigned claims
• Claims for certain drug codes (listed below)
CPT®/HCPCS drug codes not allowed via the IVR
J0200
J0390
J0395
J0520
J0735
J1094
J1700
J1710
J1885
J1960
J1990
J2323
J2440
J2670
J2760
J3490
J3590
J7130
J7184
J7199
J7310
J7326
J7628
J7629
J7648
J7658
J7659
J7683
J7684
J8499
J9165
J9201
J9217
J9219
J9270
J9357
J9999
Q0144
Q2027
Q2034
Q2035
Q2036
Q2037
Q2038
Q2039
Q2045
Q2046
90654
90655
90656
90657
90658
90659
90660
90667
90668
90715
90724
90779
96549
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