Claim denials for insufficient documentation is a common occurrence. For more information on submitting documentation with your appeal request visit the Appeals web page.
CERT Review Results
To obtain the results of your Comprehensive Error Rate Testing (CERT) review(s), please contact WPS Government Health Administrators at the following email address: CERTPartA@wpsic.com
Therapy Claims with V8021 V8025
Some therapy claims incorrectly denied with reason codes V8021 and V8025. This was corrected on August 19, 2016. All claims that were denied incorrectly will be adjusted starting the week of 8/22/16. We apologize for any inconvenience this may have caused.
Provider Submitted Adjustment Claim(s) - Revised
It has come to our attention that the "Voluntary Refund" adjustment reason codes (VB, VC, VD, VE, VF, VG, VH, VI, VL, VM, VN, VP, VR, VS, VV or VW) are being submitted on provider initiated adjustment claim(s). These codes are intended for Medicare Administrative Contractor (MAC) use only. Therefore, effective August 15, 2016, provider submitted adjustment claim(s) that contain a "Voluntary Refund" adjustment reason code will be returned to you for correction.
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