What is the meaning of the CMS Medicare Claim Denial Reason Code?: OA-22, OA22, OA/22 - This care may be covered by another payer per coordination of benefits.
What You Should DO:
1. Verify if the patient is still working or the spouse is still working. If the beneficiary or the spouse is still working, either full time or part time, they are normally covered through their employer group.
2. Check with the patient if there is a motor vehicle or workers' compensation claim open for the patient. If the reason for the visit is related to an motor vehicle or workers' compensation claim, then Medicare is a secondary coverage for the patient.
Useful References: CPT Code Books, CMS Website (www.cms.gov), CCI Quarterly Updates, CPT Assistant Publications, Diagnosis Code Books
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