UPDATE Reason Code 32511

As of 10/5/09, this reason code is now editing correctly. We are still awaiting a resolution from the System Maintainer on those claims that incorrectly edited and are in a returned to provider (RTP) status after 9/8/09 but prior to 10/5/09. You can follow the directions below that were previously published on 9/24/09. Below is an excerpt from that article.

Claims that are in a RTP status with a reason code 32511 may not contain any errors. Providers with DDE access can review these claims and determine the action they want to take, as explained below:

Incorrectly Edited Claims
For providers with Direct Data Entry access, action can be taken to store incorrectly edited claims so that they can continue processing. However, the receipt date of the claim will be changed to the date the claim was stored. Here is the process:

  • Access DDE.
  • Access claims that edited with Reason Code 32511.
  • Go to page 2 of the claim and press the F11 key (MAP171E). Review each claim to confirm that it did not edit appropriately and if it did not, press the F9 key. If it did edit appropriately, refer to the section within this document titled "Correctly Edited Claims."

- OR -

Providers can take no action while we await the solution from the System Maintainer. At this time, we do not know when the solution will be available. Additional information will be provided as the information becomes available.

Correctly Edited Claims
For providers with DDE access, action can be taken to correct claims in RTP status. Here is the process:

  • Access DDE.
  • Access claims that edited with Reason Code 32511.
  • Go to page 2 of the claim and press the F11 key (map171E).
  • Correct the claim by entering data in any of the three NDC fields that are blank.
  • Press the F9 key.

After the claim is corrected and stored, the claim receipt date will reset and the claim will continue processing.

If you do not have DDE access, please call the correction line below:
Central Region: 866-580-5982
Northeast Region: 866-580-5985
Southeast Region: 866-580-5979
West Region: 866-580-5980

Page Last Updated: Thursday, 18-Mar-2010 05:49:10 CDT