Attention Providers - Claims Reprocessing Information
Date: 03/23/18
Please see the information below regarding claims reprocessing for certain codes.
MississippiCAN Providers:
Magnolia Health will reprocess claims that denied according to the following criteria:
Dates of Service: 9/23/2015 – 12/28/2017
CPT Codes: 96127
Denial Code: EX46-DENY: NON-COVERED SERVICE
Magnolia Health will reprocess claims that denied according to the following criteria:
Dates of Service: 5/1/17 - 8/17/17
CPT Code: 87389
Denial Code: EXyw - DENY: NOT MEDICALLY NECESSARY OR INELIGIBLE SERVICE PER CMS OR PLAN RULES
MississippiCAN and CHIP Providers:
Magnolia Health will reprocess claims that denied according to the following criteria:
Dates of Service: 1/14/16 - 10/11/2017
CPT Codes: 76801, 76805, 76811, 76815, 76816 and 76817
Denial Code: EXyw -DENY: NOT MEDICALLY NECESSARY OR INELIGIBLE SERVICE PER CMS OR PLAN RULES
and EXya-DENY: DENIED AFTER REVIEW OF PATIENT'S CLAIM HISTORY
MississippiCAN Providers:
Magnolia Health will reprocess claims that denied according to the following criteria:
Dates of Service: 7/1/2015 - 1/19/2018
CPT Codes: 90621, 90630,90647,90651,90654 and 90675
Denial Code: EX46-DENY: NON-COVERED SERVICE
Anesthesia Providers:
Magnolia Health will reprocess claims that denied according to the following criteria:
Dates of Service: 11/1/15 - 12/11/17
CPT Codes: 01967 and 01968
Denial Code: EX46-DENY: NON-COVERED SERVICE
EPSDT Providers:
Magnolia Health will reprocess claims that denied according to the following criteria:
Dates of Service: 11/1/15 - 12/11/17
CPT Codes: 99173, 92551, 96110, 99420, 96160, and 96161
Denial Code: EXZM - DENY: MUST BILL WITH HEALTH CHECK CODE
If you have any questions, please contact Magnolia Health Provider Service Department at 866-912-6285.