What does the denial MA04 mean for Secondary Medicare Claims?

What does the denial MA04 mean for Secondary Medicare Claims?

MA04 means that the claim was submitted with an invalid Medicare Secondary Payer (MSP) code or an MSP code was not included. When this happens, check to ensure the information is correct in loop 2320 for an electronic claim or attach the summary notice from the primary insurer that specifically corresponds to the claim you are submitting for paper claims. Once the information is corrected, resubmit the claim to Railroad Medicare.

Here are the steps to resolve this denial:

  1. From the Billing Applet
  2. Pull Up the Patient Demographics Page
  3. Go to the Insurance Tab
  4. Single Click on the Medicare Secondary Plan
  5. Select the correct MSP Type
  6. Click the Update Insurance Plan
  7. Now pull up the denied claim and resubmit as corrected, make sure to update the Claim-Final tab with the ICN number in the Original Ref# field.



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