MMP Edits Update Effective February 29, 2016 - Clarification

CMS is continuing enhancements to the Medicare-Medicaid Processing System. In order to ensure syntactically correct Medicaid encounters are received, CMS has determined a need to revise the list of re-activated Common Edit Module (CEM) edits effective February 29, 2016 to a total of eight (8) edits. The following CEM edits will be re-activated effective February 29, 2016:

Edit Reference	Edit Description	Comprehensive Resolution/Prevention

Professional and DME: X222.091.2010AA.N301.070 X222.091.2010AA.N302.060 Institutional: X223.087.2010AA.N301.070 X223.087.2010AA.N302.060	CSCC A7: Acknowledgement/Rejected for Invalid Information… CSC 503: "Entity's Street Address" EIC: 85 Billing Provider	A Post Office Box address cannot be used for the Billing Provider on Professional, DME or Institutional encounters.
Professional and DME: X222.351.2400.SV101-7.020 Institutional: X223.424.2400.SV202-7.025	CSCC A8: Acknowledgement/Rejected for relational field in error CSC 306 "Detailed description of service" 2400.SV101-7 must be present when 2400.SV101-2 is present on the table of procedure codes that require a description.	A more descriptive meaning of the procedure code must be present when using a not otherwise classified or generic HCPCS procedure code.
Dental Only: X224.086.2010AA.N301.050 X223.086.2010AA.N302.040	CSCC A7: Acknowledgement/Rejected for Invalid Information… CSC 503: "Entity's Street Address" EIC: 85 Billing Provider	A Post Office Box address cannot be used for the Billing Provider on Professional, DME or Institutional encounters.

Last Updated: 02/09/2016