Beginning Thursday, April 7, 2011, CMS instructed FIs and A/B MACs to hold 
claims with the following criteria, until Change Request (CR) 7133R2 was 
installed into production on Monday, May 9, 2011:

§  HCPCS G0436 and/or G0437

§  Revenue Code 0942, 096X, 097X, or 098X

§  Dates of Service on or after Saturday, January 1, 2011

§  Diagnosis Code 305.1 or V15.82

§  Occurrence Code 32 not present

When CR7133R2 was installed, FIs and A/B MACs were instructed to release the 
held claims and enter condition code "15" to indicate they were clean claims in 
which payment was delayed due to CMS's processing delay and, therefore, not 
subject to claims processing timeliness standards.





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