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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 37541

Description:

An adjustment was submitted (Type of Bill XX7 or XXQ) with the condition code “D9” indicating “any other change” and no remarks are present in the “Remarks” field on FISS DDE page 04.

Resolution:

When submitting an adjustment, you must choose one of the following claim change reason codes that best describes the adjustment request. When “D9” is used, a detailed explanation of what is being adjusted must be included in the Remarks field (FL 80). The adjustment request will be suspended for review.

D0 - change dates of service
D1 - change charges
D2 - change revenue/HCPCS code
D7 - Change to make Medicare secondary
D8 - Change to make Medicare primary
D9* - Other/multiple changes
E0 - change patient status *

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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