Skip to main content
Corporate

Reason Code Search and Resolution

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

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. Or, 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.

If no reason code displays, access the Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE) and select Option 17 “Reason Codes” from the Inquiry Menu to review the reason code description. For additional information refer to the Chapter 3: Inquiry MenuPDF of the FISS DDE Guide.

Search by:

Reason Code 32243

Description:

A home health billing transaction (Request for Anticipated Payment, final claim or adjustment) was submitted without a 0023 revenue code line OR a revenue code line for a visit was billed without charges.

Resolution:

  • Ensure that all billing transactions submitted for services paid under the Home Health Prospective Payment System (HH PPS) include a 0023 revenue code line. See the screenprint of FISS Page 02 below. A revenue code 0003 was entered on line 1 instead of a revenue code 0023.

    32243

  • Ensure that charges are entered for all revenue code lines reporting supplies or a visit. In the example of FISS Page 02 below, revenue code lines 6, 7, and 8 were billed without charges, resulting in the claim being returned with reason code 32243.
    • Reminder: You may need to press the F5 and F6 keys when reviewing revenue code information on FISS Page 02 in order to determine which line item dates of service are missing charges.

      32243

Posted: 04.11.16


26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved