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Reason Code Search and Resolution

Disclaimer: This is not a complete listing of reason codes. Other reason codes will be added.

This Reason Code Search and Resolution tool has been designed to aid Medicare providers in reviewing reason codes and how to resolve the edit or use them for determining if other action is needed. You may search this database by reason code or keyword. All records matching your search criteria will be returned for your review. If you are aware of a reason code not listed or a description and/or a resolution is not clear, please send your suggestion for reason code addition or update to

If you wish, you may also view the entire listing of reason codes, their descriptions, resolutions, and additional billing information by clicking on the "Show all Reason Codes" option.

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 'GO', '20', or '21' present on the claim.


If ancillary services are being billed, a Part A inpatient claim (benefits exhaust or no entitlement), a 121 type of bill for ancillary services may be billed, and a 131 type of bill for ER visit only.

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