Error 5044 - Exact Duplicate Physician Claim

Error: The claim submitted is a duplicate of a claim previously paid for the same member, pay-to provider number, date of service, and service code. Some software systems will automatically generate "tracers" for claims that have not been posted.

Resolution: To avoid this error, post claims from your remittance advice in a timely manner to avoid rebilling previously paid claims.

Error 2505 - Member Covered By Medicare - Deny

Error: The member had Medicare coverage in addition to MassHealth on the date of service entered on the claim. Medicare must be billed before billing MassHealth.

Resolution: To avoid this error, always verify member eligibility before or on the date of service.

Error 4013 - Procedure Code Is Not Covered For Date of Service

Error: The service code entered on the claim was not covered on the date of service entered on the claim.

Resolution: Refer to Subchapter 6 of the Transportation Manual for a list of covered codes.

Error 0850 - Billing Deadline Exceeded - Detail

Error: MassHealth allows 90 days from the date of service to submit the initial claim to MassHealth. Claims submitted after 90 days will deny for this error.

Resolution: Providers should follow the procedures to obtain a 90-day waiver as outlined in Subchapter 5 of the Transportation Manual, when applicable.

Error 0542 - Recipient Ineligible for Service Date

Error: The member was not eligible for MassHealth on the date of service entered on the claim.

Resolution: To avoid this error, always verify member eligibility before or on the date of service.




This information is provided by MassHealth.