Family Planning Denied Claims

January 8, 2013

Family Planning Denied Claims

Some claims for Family Planning providers have denied inappropriately for the following reasons:

MIHMS Edit 330- “Invalid Diagnosis.” CARC 11 – “The diagnosis is inconsistent with the procedure. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.”

The system has been updated and claims are being reprocessed. No provider action is needed.