Colorado interChange: Resources for your Membership
Week of August 17, 2017
Each week we'll use this newsletter to provide you with updates on the implementation of the Colorado interChange, including topics you might be hearing from your members as well as content for your membership newsletter and general updates on progress. 
Provider Buzz
  • You might have been hearing about struggles experienced by many providers related to the Healthcare Common Procedure Coding System (HCPCS) codes. We are happy to report the 2016 and 2017 HCPCS codes have been updated in the Colorado interChange.
    • The 2016 HCPCS codes were updated on July 12, 2017. All associated denied and suspended claims were reprocessed by our vendor on July 14, 2017.
    • The 2017 HCPCS codes were updated on August 10, 2017. All associated denied and suspended claims were reprocessed by our vendor on August 11, 2017.
If your members are looking for additional information about coding based on these updates, they can check out the 2016 Practitioner HCPCS Special Bulletin and the 2017 Practitioner HCPCS Special Bulletin . 
  • There was an issue with claims for certain procedure codes suspending for EOB 2862 - No rate of file for the date(s) of service. This issue has been resolved and claims were recycled by DXC on 8/4/17
    • DME: E0486, E0635, E0639, E0676, K0462, L8699, S0395
    • Laboratories: 89259, 81205, 81281, 81287, 81355
    • Physician Services: 26418, 59898, 69631, 90662, 99100, 99135, 99140, 99288, 01996, G0452, J1050, J3490, J8499, Q2039, S0316, S0613, S4993, S9083, S9088, S9141  
    • Vision: S0590, V2702, V2790
Colorado interChange Numbers
Since March 1, 2017...
  • More than $3.5 billion paid to providers
  • 19,369,476 claim shave been processed 
  • 48,680 enrolled providers
In our latest financial cycle on Friday, August 11th...
  • $124,981,730 million paid to providers
  • 784,969 claims processed
  • 64 percent of claims paid
As a reminder, the Department frequently updates its  Known Issues & Updates web page with new issues, work arounds and resolution ETA.
News You Can Use
Here's some content for membership newsletters:
 
Helpful resources for understanding Remittance Advice in the Colorado interChange
 
One area of ongoing challenge for many new Colorado interChange users are the ways in which the new Remittance Advice (RA) is different from previous formats. After years of a certain presentation, providers now need to understand multiple changes to that information. For example, in the new system suspended claims only show up once on the RA. The claim doesn't appear again on the RA until it either denies or pays. Once the claim is finalized, it will be reported on the RA and the 835. Suspended claims are not reported on the 835, only on the RA.
 
Providers in need of assistance with learning more about their RAs, how to use them, how to read them and how to format them can use these resources:
Providers looking for information on a host of topics can find them on the provider portal as easy-to-use quick guides . 

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