Corporate

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 J15_PARTA_Education@cgsadmin.com.

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 39132

Description:

This is an outpatient claim (Type of Bill 12X, 13X, or 14X) in which the Outpatient Prospective Payment System (OPPS) reimbursement is greater than the covered charges reported on the claim.

Resolution:

  • Access the claim. The Remarks section will include the code(s) in question.
  • Verify the code(s), unit(s), and charges are reported correctly.
  • If correct, indicate the following in Remarks and F9/resubmit the claim: Code or codes have been verified.
  • If any of the line item information was reported incorrectly, correct the information and F9/resubmit the claim.

Reference: MLN Article 7771External PDF Prior to the initial submission of the claim, if providers are aware that the claim has a comprehensive APC that could be causing the reason code, they may indicate in Remarks that the charges have been verified. This will prevent the claim from RTPing with reason code 39132.

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