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Reason Code Search and Resolution

Disclaimer: This is not a complete list of reason codes.

The Reason Code Search and Resolution tool allows you to view a reason code description and determine how to prevent/resolve the edit. You may search by reason code or keyword. All records matching your search criteria will be returned for your review. You may also select "Show all Reason Codes" to view the complete list.

If the reason code you enter does not display here, you may access any reason code description in the Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE) Reason Codes Inquiry Menu (Option 17) . For additional information, please reference the FISS DDE User Manual.

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Reason Code 31755

Description:

  • One line item date of service (LIDOS) must match the date of service (DOS) billed on the 0023 revenue line, OR
  • When the "FROM" date and the "ADMIT" date" are equal, the DOS billed with the 0023 revenue line must also match.

Resolution:

  • Check "STMT DATES FROM" date (FL 6) and "ADMIT DATE" (FL 12) fields on FISS Page 01.
  • If the dates are equal, check the "SERV DATE" field (FL 45) on the 0023 revenue line on FISS Page 02. The date in this field on this line must be the same as the date in FL 6 and FL 12 AND must reflect the date of the first visit in the episode.

FISS Page 01

31755

FISS Page 02

31755

Final Claims Only:

  • The "SERV DATE" field for one visit or service line must match the "SERV DATE" field on the 0023 revenue line.
    • NOTE: You may need to press the F6 button to view additional revenue code pages to see all of the visits submitted on the home health final claim.

FISS Page 02

31755

Updated: 10.11.12

Disclaimer: CGS' online tools and calculators are informational and educational tools only, designed to assist suppliers and providers in submitting claims correctly. CGS makes no guarantee that this resource will result in Medicare reimbursement for services provided. Although we've made every reasonable effort to provide effective resources, CGS is not responsible for the consequences of any decisions or actions taken in reliance upon or as a result of the information that these tools provide. CGS is not responsible for any human or mechanical errors or omissions.

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