Q&A: Rejected billing

August 15, 2008

Some billing locations require nine-digit zip codes for payment.

Q: We recently decentralized billing to our satellite locations and are having difficulty with our claims being paid from one of our locations. We get a rejection that indicates "missing/incomplete/invalid information on where the services were furnished." Box 32 contains the name and address, so we don't understand why this is happening only to that location?

A: The most logical reason is that in the fall of 2007, CMS determined there are zip code locations potentially falling into more than one payment location. For that reason, they require nine-digit zip codes for those locations. A list of updated locations requiring nine-digit zip codes was included in the MLM (Medicare Learning Matters) article MM5730. Not every zip code requires nine digits. You may access the list by going to http://www.cms.hhs.gov/mlnmattersarticles/downloads/mm5730.