October 31, 2025 Reprocessing Claims from the September 9, 2025, Cycle

- During the claims cycle on September 9, 2025, Gainwell Technologies identified a system error that prevented certain fee-for-service professional, outpatient hospital, and durable medical equipment (DME) claims from processing through the ClaimsXten (CXT) editing system. The claims paid without standard or National Correct Coding Initiative (NCCI) editing being applied.

Gainwell Technologies is in the process of identifying the claims from that cycle that paid in error. The original payments of those claims paid in error will be voided and then reprocessed to ensure the proper denial is applied. All other claims can be reprocessed without being voided.  

Providers can expect to see these claims reflected on their November 4, 2025, remittance advice. 

General questions related to the addition of these codes should be directed to Gainwell Technologies Provider Relations at (800) 473-2783 or (225) 924-5040.

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Surgeon General Ralph L. Abraham, M.D.

Secretary Bruce D. Greenstein

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