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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 39929

Description:

This claim was rejected due to an untimely Notices of Election (NOEs).

Resolution:

Hospices are required to submit NOEs within 5 calendar days after the hospice admission date. In order to be considered timely, the NOE must be submitted to and accepted by CGS within 5 calendar days after the hospice admission.

Important Note: If the NOE is submitted timely, but is returned to the provider (RTPd) for correction, the NOE is not considered to be "accepted" and thus, will result in an untimely NOE. Therefore, it is extremely important that hospices verify the information entered on the NOE before submitting it to CGS. In addition, hospices must verify the patient's eligibility information to reduce the risk of a claim RTPing due to an eligibility issue.

If an NOE is not corrected out of the RTP file (T B9997) within 5 calendar days after the hospice admission date, it is considered untimely.


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