If rejecting only the non-compliant portion of the Medicaid file, is the rejection at the transaction (ST – SE), or claim level?


Answer:

Syntactical edits are applied based on the TR3. A list of edits can be found in the CMS edit spreadsheets on the CMS web site. The spreadsheets can be sorted by 999R, 999E and 277T to identify the edits that may be applied.


Last Updated: 07/09/2014