MSP Stands for Medicare Secondary Payor.  MSP codes are used to explain why Medicare is the Secondary carrier on a claim claims.   Any Claim submitted with Medicare as the secondary will require an MSP code.

The MSP codes is added in the Patient Demographics section of AdvancedMD, and not at the claim level, because the reason a patient has medicare as the secondary doesn’t typically change.

How do I add an MSP code:

  1. From Patient Demographics, click the Insurance tab, highlight the Medicare secondary carrier
  2. Select the correct MSP Code | Save

How do I know which code to select?

The reason a patient has Medicare as a secondary is specific to the patients situation.  Consult the table at the end of this article or have the patient consult their Medicare representative for clarification.

Do I need to add an MSP code to the Primary carrier also?

No, The MSP Code should only be selected on Medicare when it is the secondary.

What if I select the wrong code.

Medicare requires a code that directly relates to the reason the patient has Medicare as the secondary.  If the code sent on the claim doesn’t match Medicares records the claim will be rejected.  FK:PSBR0502:INSURANCE TYPE CODE NOT ALLOWED is an example of an exclusion for the wrong MSP code.  To resolve this issue select the correct MSP code and resubmit the claim.

MSP Code Reason
Medicare Secondary Working Aged Beneficiary or Spouse with Employer Group Health Plan
Medicare Secondary End-Stage Renal Disease Beneficiary in the Mandated Coordination Period with an Employer’s Group Health Plan
Medicare Secondary, No-fault Insurance Including Auto is Primary
Medicare Secondary Worker’s Compensation
Medicare Secondary Public Health Service (PHS)or Other Federal Agency
Medicare Secondary Black Lung
Medicare Secondary Veteran’s Administration
Medicare Secondary Disabled Beneficiary Under Age 65 with Large Group Health Plan (LGHP)
Medicare Secondary, Other Liability Insurance is Primary

Posted in Exclusions

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