What is reason code 39928?

▪ Code 39928 – claim denied due to each line of charges on the claim has been denied by NGS' Medical Review.

What is denial code 288?

Claim denied as referral is absent or missing.

What is reason code 30908?

Reason Code 30908. This error code means that the adjustments are not allowed on a Requests for Anticipated Payment (RAP) (bill type 322 or 332).

What is reason code 39929?

Reason Code 39929

All line items on the claim are rejected or rejected/denied. Resolution: Line item rejection/denial information can be obtained from the remittance advice or via the Direct Data Entry (DDE) system. Review the reason for rejection/denial and verify the information submitted on the claim.

What is reason code 38038?

A history claim is present that contains overlapping dates, with the provider numbers equal, and at least one line item date of service is equal (for OPPS services) without condition code “G0,” “20” or “21” present on the claim.

What is Denial Code CO 45?

What is reason code 37098?

Reason Code 37098 –Medicare Advantage (MA) Supplemental Wrap Around Payments. Federally Qualified Health Centers (FQHCs) that have a written contract with a MA organization are paid by the MA plan at the rate specified within their contract.

What is claim level reason code 37238?

The HCPCS G-code submitted is not reported with the correct corresponding revenue code. Reason code 37238 will display when a G-code HCPCS is submitted with an incorrect revenue code. Before submitting your claim, ensure that the G-codes listed below are reported with the corresponding revenue code.

What is reason code 38035?

38035: this outpatient claim is a duplicate to a previously submitted claim.

What is reason code 39910?

Reason code 39910 causes claims to suspend when the provider reimbursement amount is equal to zero. Reason code 37187 is the finalized claim edit that indicates the claim has completed processing and no additional payment can be made.

What is reason code 39701?

To make matters even more confusing, there are two different types of ADRs: medical review (reason code 39700) and non-medical review (reason code 39701).

What is reason code 30940?

A provider is not permitted to adjust a partially or fully medically denied claim. Reason code 30940 is received when attempting to adjust a claim with a medically denied line.

What is reason code 30949?

A: You are receiving this reason code when the type of bill (TOB) equals xx7 or xx8, but the claim change reason 'condition code' is not present on the bill.

What is reason code 30993?

Reason Code 30993

The claim was submitted with an incorrect Medicare Beneficiary Identifier (MBI), as no match is found in the Common Working File (CWF). Resolution: Please verify the MBI reported on the claim with the patient's Medicare card; correct and resubmit.

What is denial code 228?

Reason Code 228: Mutually exclusive procedures cannot be done in the same day/setting. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

What is denial code 227?

227 Information requested from the patient/insured/responsible party was not provided or was insufficient/incomplete.

What is reason code 38157?

Reason Code 38157

Description: The Fiscal Intermediary Standard System (FISS) has found a previously submitted billing transaction for the same beneficiary and dates of service with the same provider number; therefore, the second billing transaction submitted by the provider is a duplicate.

What is reason code 31699?

Claim Error Reason Code 31699

This claim has a TOB 32X other than 322, the From date is not equal to the admission date, no revenue code 042X, 043X, 044X or 055X line with covered charges is present or these revenue code lines are present but have noncovered charges, and condition code 20, 21 or 54 is not present.

What is reason code 30919?

Reason Code 30919

This claim is processing against a claim already posted to CWF (Duplicate). Resolution: Verify the billing of claim to determine if claim posted to CWF is correct.

What is reason code 39621?

Return to Provider (RTP) reason code 39621 is assigned to RCD claims for different home health or eligibility claim edits. To view these edits, home health agencies (HHAs) must review the line item pages in Direct Data Entry (DDE) or their related electronic billing software.

What is reason code 34931?

Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission.

What is reason code 0594003D?

The RETURN CODE 00000081 REASON CODE 0594003D indicates a directory in the pathname was not found which can be caused by the OMVS User Profile record's HOME directory not pointing to the CA LDAP Server USS installation directory.

What is claim level reason code 38032?

The outpatient claim is a duplicate of a previously processed outpatient claim.

What is claim level reason code 38050?

This home health claim is an exact duplicate of a previously submitted home health claim. This is one of several reason codes that indicates that a duplicate claim has been received in the Medicare claims system (FISS).

What is revenue code 82803?

CPT Code 82803: Gas, blood, any combination of pH, PCO2, PO2, CO2, HCO3, (including calculated 01 saturation).