Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 14, 2014

Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server

Question: Can issuers submit a zero (0) Amount Allowed on the EDGE Server Medical Claim Submission (ESMCS) at the claim header?

Answer: No. The Amount Allowed at the claim header must be greater than zero (0) as stated in the Interface Control Document (ICD). The Amount Allowed at the line level may be equal to or greater than zero (0), however. For issuers submitting encounters or capitated services a default value greater than one (1) may be used.

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