Medicare AdvantageAdministrativeMedium impact
Issue Identified and Corrected: Telehealth Claims with Code W5604
Highmark·Coding
Effective date
Apr 16, 2026
We identified it
Apr 21, 2026
Summary
Highmark identified and corrected a system error that incorrectly denied telehealth claims with place of service code 02 using denial code W5604 from March 19-April 16, 2026. All affected claims will be automatically adjusted within 45 days with no action required from providers.
Action Required
No action required: Highmark will automatically identify and adjust all incorrectly denied telehealth claims with place of service code 02 that received denial code W5604 between March 19-April 16, 2026. Adjustments will be completed within 45 days of April 21, 2026. Monitor accounts receivable for automatic adjustments.