For Medicare Submitters

Noridian Custom Edits (NCE), referred to as Smart Edit on the 277CA, were created to assist providers in submitting error-free claims by pre-screening for common errors prior to processing. Informational NCEs went live on 3/27/2022. All NCEs populate in the STC elements of the 277CA, but the informational NCEs have a distinct code set that begin with A2:20:PR. Both types can be cross-referenced to the NCE Spreadsheets:

• Part A https://www.edissweb.com/web/cgpblue/reports/nce-pa
• Part B https://www.edissweb.com/web/cgpblue/reports/nce

NCEs can:

• Help identify problematic and/or certain-to-deny claims prior to Noridian claims processing.
• Alert providers of errors and potential claim processing issues around medical necessity, non-covered services, missing modifiers, and other clinical editing.
• Deliver timely and clear notifications of how to fix claim errors.
• Save administrative time tied to claim resubmissions.
• Improve transparency of claim editing and claims processing.

Provide information or reminders on claim submissions.

Message Sent:
February 7, 2023