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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 U5106

Description:

Hospice elections and benefit periods are posted to the Common Working File (CWF) when notice of elections (NOEs) and/or claims are processed. When another hospice NOE is submitted that overlaps the election/benefit period posted to CWF, including a duplicate NOE, the NOE will receive reason code U5106.

Resolution:

  • Ensure that the NOE you are submitting is not a duplicate of a previously submitted/processed NOE. Use FISS Option 12 to check for previously submitted NOEs. Refer to the FISS DDE Guide, Chapter Three: Inquiry MenuPDF for information about Option 12.
  • Before submitting an NOE (81A or 82A), review the beneficiary's hospice benefit periods on ELGH Page 19 or ELGA Page 18. Ensure the Admit Date on the NOE you are submitting does not fall within the START DATE and TERM DATE of the benefit period on ELGH/ELGA. Refer to the FISS DDE Guide, Chapter Two: Checking Beneficiary EligibilityPDF for information about ELGH/ELGA.

    U5106


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