The CGS Medicare list of the TOP 10 EDI Claim Edits during claims submission
Most claims that hit the CGS ACE pre-adjudication editing process are not forwarded to the claims processing system. If a claim receives a Smart Edit, review the information, decide if updates are needed or not, and resubmit it for processing.
To learn more about EDI Claims processing and become a CEDIAP® (Certified EDI Academy Professional), please visit our course schedule page.