Medicare HETS 270/271 - Information Bulletin - MSP Diagnosis Codes - September 6, 2023

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Medicare HETS 270/271 - Information Bulletin - MSP Diagnosis Codes - September 6, 2023
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HETS 270/271

Medicare HETS 270/271 Submitters:  

Give Providers Medicare Secondary Payer (MSP) Diagnosis Codes  

Give Non-Group Health Plan (NGHP) MSP diagnosis codes to providers on eligibility responses so they know the health care services primary payer. Other payers report accident insurance diagnosis codes to CMS to determine who’s responsible for payment. When a patient has NGHP accident insurance, it usually covers all health care services related to the accident and pays first. Medicare pays first for non-accident-related covered services.    

The Medicare Secondary Payer: Don’t Deny Services & Bill Correctly fact sheet explains how to: 

  • Determine payer order 
  • Bill when you get both MSP Group Health Plan and NGHP on eligibility responses. 
  • Appeal mistakenly denied or rejected MSP claims.   

     

Please contact the Help Desk if you have any questions.