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Top Claim Submission Errors for Hospice Providers: Error 31428

Reason for error: The claim contains a hospice discipline revenue code (42X, 43X, 44X, 55X, 56X, or 57X) and is either missing or has an incorrect corresponding HCPCS code (G0151, G0152, G0153, G0155, G0156, G0299 or G0300).

Claim processing result: Return to Provider (RTP)

How to prevent/resolve:

  • Ensure that your claim contains the appropriate HCPCS code on the discipline revenue code line.

    Revenue Code (Discipline)

    HCPCS

    042X (Physical therapy)

    G0151

    043X (Occupational therapy)

    G0152

    044X (Speech-language pathology)

    G0153

    055X (Skilled nursing)

    G0299 (valid for services on or after January 1, 2016)

    G0300 (valid for services on or after January 1, 2016)

    G0154 (not valid for services on or after January 1, 2016)

    056X (Medical social services)

    G0155

    057X (Aide)

    G0156

  • Ensure that the HCPCS code is keyed using a "0" (number zero); not an "O" (letter O).
  • Ensure that the HCPCS code begins with the letter "G"; not the letter "Q".

Additional resource:

Updated: 05.20.19

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