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May 12, 2020

Reason Code 37253: Internet Quality Improvement and Evaluation System (iQIES) Known Issues

According to the iQIES Known IssuesExternal Website web page, some home health agencies who use the iQIES user tool to create and submit their OASIS assessments were having their claims sent to the Return to Provider (RTP) file with reason code 37253 for claims submitted between January and April 2020.  An issue was identified with the storage of the MBI in the iQIES database which impacted the claims match process.  The issue has been corrected.  If you have claims in RTP with 37253 that are affected by this issue, do not press F9 to move your claim out of RTP.  Instead, providers must resubmit the claim for processing.

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