Please refer to the CMS Medicare Secondary Claims Processing Manual for further details on including Occurrence Codes, Condition Codes, or Value Codes. When sending a MSP claim for conditional payment, Occurrence Code 24 and date primary insurance denied must be included on the claim.
1. If necessary, navigate to Accounts | Billing and then click the firstREV tab to access the firstREV interface.
2. Access the desired claim form in firstREV.
3. While viewing the patient claim form, scroll to Occurrence Codes sections 31-36.
4. If necessary, add any other occurrence codes or occurrence span codes using the Code fields, along with the appropriate Date for each code.
The Value Code is the indicator for the type of Open MSP Provision showing online in the Medicare Beneficiaries Common Working File (CWF). This information is added under the Medicare Secondary payer in firstREV.
1. While viewing the patient claim form, scroll to Value Codes sections 39-41.
● If necessary, add any other value codes. If a value code already exists in 39 (a), add additional value codes in fields 40 (a) and/or 41 (a), and so forth.
2. Click inside the Code field and then click the drop-down arrow to display a list of all available value codes. Select the appropriate code that describes the patient's open MSP file online in the CWF.
3. Click Apply.
4. Within the same line as the newly added value code, enter the specific number value in the Amount column.
After any applicable value and/or occurrence codes have been added, continue with the MSP billing process by adding primary payer details.
