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Important 4010 - 5.1 Rejection Information

As of July 1st submitters who send ASC X12 version 4010 Claims and Claim Status Inquiries or version 5.1 National Council for Prescription Drug Programs (NCPDP) claims transactions to Medicare Fee-for-Service (FFS) will have their transactions rejected. Rejection responses will vary among the different Part A and Part B Medicare Administrative Contractors (MACs) and the Common Electronic Data Interchange (CEDI) contractor since versions 4010 and 5.1 did not standardize the acknowledgement responses. Version 5010/D.0 enforcement discretion ends July 1st. Any Medicare FFS claims received in version 4010 or 5.1 formats after normal close of business on June 29th will be rejected back to the submitter using the following rejection messages from the MACs.