STOP! What you need to know about edits M402, M403, M404, M405, and M406

Date:   01/28/2008

For all Medicare Part B Trading Partners:

If you receive informational edits M402, M404, and M406 on your Batch Detail Controls Listing (BDCL), please STOP and read the following information before calling Infinedi LLC.

Why am I receiving the edit?
You are receiving the edits because Infinedi LLC is still sending legacy number or UPIN on your electronic claims. The term “legacy number” is the same as PTAN Medicare PIN, or Medicare Provider Number. These edits were implemented on January 7,2008, and are in preparation for Phase III of NPI. Phase III is scheduled to be implemented on May 23, 2008.

What will happen to my claim? Will it be deleted? Will it be denied by Medicare?
No- at this time these edits on your BDCL are strictly INFORMATIONAL. If M402, M403, M404, M405, or M406 is the only edit you receive on the claim, your claim will be passed on to the Medicare part B claims processing system for payment. Your claim will NOT be deleted and it will not be denied by Medicare for these edits. The BDCL reports are your Medicare reports located the Q Services under the Q Report tab.

NOTE: Do not remove your Tax ID from your electronic file. If the Tax ID is removed, the claim will reject.

When will these edits change to a rejection/ delete?
Anytime during March 1st - May 23, 2008, these edits can change to a rejection. If, after that date, you send a legacy number in your electronic file, your claims will be rejected/deleted and they will not be passed on to the Medicare Part B claims processing system for payment.

Provider Action:

Watch your reports for warning and rejections.