Palmetto GBA

 

Palmetto Telephone Claim Correction Checklist

Do you need assistance to correct a simple error made on a claim? Please see the checklist below with the type of issues that can be corrected by telephone instead of filing a Redetermination (1st level of appeal).

Please contact us at 1-866-669-5543, Monday-Friday, anytime between 7:00 a.m.-3:00 p.m. Be prepared to provide the provider's identifier and the patient's Medicare number, last name and first initial. We can handle three qualified requests per call.

Remember: Rejected claims (remark code MA130) must be resubmitted as new claims and cannot be corrected by telephone.

You may request a telephone claim correction for any issues identified below:

 

CPT Modifiers:
21, 25, 26, 50, 51, 54, 57, 58, 59, 66, 73, 74, 76, 77, 78, 79, 80, 82

HCPCS Modifiers:
AA, AD, AT, E1, E2, E3, E4, G8, G9, GV, GW, LT, KD, KX, QJ, QK, QR, QW, QX, QY, QZ, Q3, RT, SG, TC

Mathematical/computational mistakes with quantity billed field:

Note: If you submitted incorrect units (e.g., 1 instead of 2 in item 24G or its electronic equivalent), be sure to adjust the charge accordingly.

Transposed procedure/diagnosis codes

Incorrect duplicate denials:
Example: ambulance trip denied as duplicate, but there were two identical trips on the same day.

Incorrect provider identifier, use of a modifier or date of service (month and day only)

Misapplication of a fee schedule

Claim submission errors that will result in an overpayment. Palmetto GBA will initiate the overpayment process.