MSP Billing Tips

  1. If the “primary” insurer denies your claim because the policy has terminated, do not submit an MSP claim.  In this case you would bill as Medicare primary, with occurrence code 18 (beneficiary) or 19 (spouse) indicating the date the “primary” insurance terminated.  In the remarks section, indicate that the policy has terminated.
  2. If Medicare is primary, do not use occurrence code 24, or MSP value codes.
  3. If Medicare is secondary, do not use occurrence codes 18, 19 or 25.
  4. Claims submitted as Medicare secondary require a value code indicating the amount of the primary payment. 
  5. If the primary paid denied the claim, bill Medicare as primary with occurrence code 24 with the date of the denial.
  6. If your claim has been put in “RTP” status, correct the error and resubmit.  
  7. For errors, please use Palmetto's MSP Processing Tool.  ***IMPORTANT: Palmetto offers an MSP Processing Tool that can help you determine your MSP claim outcomes.****
  8. Contact Palmetto for any errors you do not understand.

There are several different reasons for which Medicare would be billed secondary, which requires a unique “process” to be billed.  Click here for the different processes on how to bill Medicare secondary.

For a list of Medicare Secondary Payer (MSP): Condition, Occurrence, Value, and Patient Relationship, and Remarks Field Codes, click here for CGS Medicare.  Click here for PalmettoGBA Medicare.

Because Barnestorm Support thinks that these tools are an excellent, comprehensive, free resource for solving MSP issues, we ask that you use the linked resources to attempt to answer your MSP question before calling Barnestorm.