Attn: Nursing Home Providers, CR 35367

August 5, 2013

A MIHMS issue has been identified where some nursing facility claims are denying in error. This is due to a recent MIHMS system change. MIHMS is currently being updated to correct this issue. Affected claims will be reprocessed and no provider action is needed.

You can identify these claims on your Remittance Advice (RA) by the following reason codes:

  • MIHMS Edit 504 - “Invalid CPT/HCPCS code” and Remittance Advice Reason Remark Code (RARC) M51 - “Missing/incomplete/invalid procedure code(s),” and Claims Adjustment Reason Code (CARC) 182 - “Procedure modifier was invalid on the date of service.”
  • MIHMS Edit 901 - “Invalid Revenue Code” and CARC 199 - “Revenue code and Procedure code do not match.”