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A3H - Max # Ser FSM Ref MC

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Background:

The maximum number of units allowed for this service code have been reached.

For example, G512A (Palliative care) is limited to a quantity of 1 per week. Should G512A be submitted at a quantity higher than one, the service will be rejected with A3H.

Solution:

  • Check in the Schedule or contact your assessor to confirm the maximum allowable limits, then reduce the number of units of the code to the allowable maximum and submit the claim.
  • If applicable, apply an alternate service code for the overages, decrease the original service to the allowable limit and submit the claim.
  • Flag the claim for manual review, submit the claim, and forward documentation in support of the billing to your assessor.
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