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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.

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Reason Code 34982

Description:

The home health claim (type of bill 32X - excluding 320 and 322) is being returned because occurrence code 50 is not present

Resolution:

Ensure that the occurrence code 50 is reported on all final claims with dates of service on or after January 1, 2020. Occurrence code 50 must be reported with the OASIS assessment completion dates (OASIS item MO090) for the start of care, resumption of care, recertification or other follow-up OASIS that occurred most recently before the claim “From” date.

Refer to the Submitting a Final Claim under the Home Health Patient-Driven Groupings Model web page for additional billing requirements.


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