License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2009 American Medical Association (AMA). All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.

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POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

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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.

Search by:

Reason Code

Keyword

Reason Code 32907

Description:

A line item date of service (LIDOS) falls outside of the "FROM" and "TO" dates billed on the home health final claim.

Resolution:

Verify the line items submitted on home health claims fall within the "FROM" and "TO" dates on the claim.

Example: Under a home health prospective payment system (HH PPS) a home health episode for March 29 to May 27 was submitted with a skilled nursing visit dated May 28 (see the boxed in revenue line #8 in the screenprint below), which falls outside of the "FROM" and "TO" date on the claim.
Example: Under the home health Patient-Driven Groupings Model (PDGM) a home health period of care for March 29 to April 27 was submitted with a skilled nursing visit dated April 28 (see the boxed in revenue line in the screenprint below), which falls outside of the "FROM" and "TO" date on the claim.
If you are unable to determine which revenue codes falls outside of the "FROM" and "TO" dates after reviewing the "SERV DATE" field on FISS Page 02, use the Fiscal Intermediary Standard System (FISS) Inquiry Option 12 or Claims Correction Menu Option 27 to determine the LIDOS causing this error. After selecting the claim, press your F8 key to page forward to FISS Page 02. Press your F2 key to access MAP171D. Scroll through the individual revenue lines using the F6 key. A message, "LINE ITEM REASON CODES 32907" will appear for the date of service outside of the "FROM" and "TO" dates submitted on the claim. See the example below in the screenprint.
Delete the revenue line with the incorrect date of service. You will need to add a new revenue line to submit the correct date of service. Another option is to submit a new claim to Medicare with the corrected information and suppress the view of the claim in your Return to Provider (RTP) file.
- Information about using FISS to add or delete revenue lines on Medicare claims, as well as, suppressing the view of claim can be found in Chapter 5- Claims Correctionof the Fiscal Intermediary Standard System (FISS) Guide.
A review of claims failing for this reason code shows episodes which span the calendar year are likely to receive this error. We encourage HHAs to have a process by which they check claims with dates of service that overlap the start of the calendar year to ensure the correct year is submitted on each line item date of service billed on the claim.

Updated: 01.17.20

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.