M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 001 CODE EXTERNAL NARRATIVE AHIC# FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. APR03 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED AT003 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED AT004 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED AT008 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED AT011 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED AT012 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED A0001 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED A0010 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED A4356 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED A99XX FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CWF CICS SYSTEM ABEND A9990 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 002 CODE EXTERNAL NARRATIVE A9991 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. A9992 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B01LC FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02D1 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02D2 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02RX FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02R0 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02R1 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02R2 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02R3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02R4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02R5 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02R6 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02R7 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02R8 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02R9 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02U1 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02U2 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02U3 RETURN (T, U), REJECT (R) AND DENY (D) STATUS MUST HAVE AT LEAST ONE (1) REASON CODE PRESENT ON THE CLAIM. B8002 RETURN (T, U), REJECT (R) AND DENY (D) STATUS MUST HAVE AT LEAST ONE (1) REASON CODE PRESENT ON THE CLAIM. B9980 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B9981 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 003 CODE EXTERNAL NARRATIVE B9982 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CEWF0 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CHIC# FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CRT01 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT001 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CR TRAILER 01 RECEIVED . REASON CODE NOT CURRENTLY USED CT002 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CR TRAILER 02 RECEIVED . REASON CODE NOT CURRENTLY USED CT003 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CR TRAILER 03 RECEIVED . REASON CODE NOT CURRENTLY USED CT004 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CR TRAILER 04 RECEIVED . REASON CODE NOT CURRENTLY USED CT005 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISP CR WITH 05 TRAILER . REASON CODE NOT CURRENTLY USED CT006 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISP CR WITH 05 TRAILER . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 004 CODE EXTERNAL NARRATIVE CT007 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISP CR WITH 05 TRAILER . REASON CODE NOT CURRENTLY USED CT008 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CR TRAILER 08 RECEIVED . REASON CODE NOT CURRENTLY USED CT009 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CR TRAILER 08 RECEIVED . REASON CODE NOT CURRENTLY USED CT010 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CR TRAILER 10 RECEIVED . REASON CODE NOT CURRENTLY USED CT011 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CR TRAILER 10 RECEIVED . REASON CODE NOT CURRENTLY USED CT012 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . 12 TRAILER RETURNED WITH BENE OR REP PAYEE ADDRESS . REASON CODE NOT CURRENTLY USED CT013 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CR TRAILER CODE 13 . REASON CODE NOT CURRENTLY USED CT014 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CODE 'CR', TRAILER CODE 14 RECEIVED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 005 CODE EXTERNAL NARRATIVE CT014 . REASON CODE NOT CURRENTLY USED CT015 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . CR DISPOSITION, TRAILER 15 RECEIVED . REASON CODE NOT CURRENTLY USED CT016 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CODE 'CR', TRAILER CODE 16 RECEIVED . REASON CODE NOT CURRENTLY USED CT017 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED . DISPOSITION CR TRAILER CODE 17 . REASON CODE NOT CURRENTLY USED CT018 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . CWF DISPOSITION CR, TRAILER 18 RECEIVED . REASON CODE NOT CURRENTLY USED CT020 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED . A TRAILER 20 IS BEING RECEIVED ON A DISPOSITION CODE CR . REASON CODE NOT CURRENTLY USED CT023 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - DISPOSITION CR RECEIVED WITH TRAILER 23 CWFBO FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CWFB0 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CWFB1 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CWFB2 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 006 CODE EXTERNAL NARRATIVE CWFRC FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C0042 CREDIT ADJUSTMENT IS REJECTED BECAUSE DEBIT FAILED; CWF ERROR RECEIVED IN CONJUNCTION WITH A "CR" CWF ERROR (SUCH AS 7090) ON COORDINATING RECORD. - FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C0043 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C524P FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C524Q FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C5609 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C61X4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C6104 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 007 CODE EXTERNAL NARRATIVE C6114 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C6124 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C6134 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C6144 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C6154 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C6164 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C6174 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C6184 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 008 CODE EXTERNAL NARRATIVE C6184 . REASON CODE NOT CURRENTLY USED C6194 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SPECIAL LOCATION TO WORK LTR CLAIMS . REASON CODE NOT CURRENTLY USED C7010 THE SERVICE DATES ON THIS CLAIM OVERLAP THE SERVICE DATES FOR A HOSPICE CLAIM. FURTHER, THE CLAIMS CONTAIN THE SAME DIAGNOSIS. THE PROVIDER MAY BILL THE HOSPICE FOR SERVICES APPROVED BY THE HOSPICE. IF THE SERVICES WERE NOT APPROVED, THE BENEFICIARY IS RESPONSIBLE FOR PAYMENT. IF THE BENEFICIARY HAS REVOKED THIS BENEFIT, THE HOSPICE MUST REQUEST THAT HCFA'S RECORDS BE UPDATED TO REFLECT THE REVOCATION. ***IF THE REVOCATION INDICATOR IS '0', YOU NEED TO CONTACT HOSPICE TO UPDATE THE INDICATOR TO '1', INDICATING IT HAS BEEN REVOKED. C7020 OUTPATIENT CLAIM WITH TOB 12X AND FROM AND THRU DATES EQUAL POSTED OUTPATIENT 73X SERVICE DATES AND EQUAL TO SPAN 72 FROM AND THRU DATES AND DATES OF SERVICES ARE NOT EQUAL TO SPAN 74 DATES OF SERVICE. C7030 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED . THE SERVICE DATES ON THE OUTPATIENT CLAIM OVERLAP A HOSPICE CLAIM WITH THE SAME DIAGNOSIS, THEREFORE NO MEDICARE PAYMENT CAN BE MADE. C7040 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED . SNF CLAIM SERVICE DATES OVERLAP A HOSPICE PERIOD AND OVERLAP A HOSPICE CLAIM WITH THE SAME DIAGNOSIS. C7050 AN OUTPATIENT CLAIM WITH TYPE OF BILL 12X, 13X, 14X, 22X, 24X, 71X, 72X, 73X, 74X, 75X, 83X, OR 85X HAS FROM/THRU DATES (OR IF PRESENT OCCURRENCE SPAN CODE 72 FROM /THUR DATES) WHICH ARE EQUAL TO, OVERLAP OR ARE WITHIN THE FROM/THRU DATES ON A HOSPITAL INPATIENT CLAIM OR SNF (TYPE OF BILL 11X, 21X OR 41X) IN HISTORY, THE PROVIDER NUMBER ON THE INCOMING CLAIM IS THE SAME AS THE PRO- VIDER NUMBER ON THE HISTORY CLAIM: --OR-- AN OUTPATIENT CLAIM WITH TYPE OF BILL 12X, 13X, 14X, 22X, 23X, 33X, 34X, 74X OR 75X FOR PHYSICAL THERAPY (REVENUE CODES 420-429), OCCUPATIONAL THERAPY (REVENUE CODES 430-439), AND/OR SPEECH THERAPY (REVENUE CODES 440-449) HAS M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 009 CODE EXTERNAL NARRATIVE C7050 FROM/THRU DATES (OR IF PRESENT OCCURRENCE SPAN CODE 72 FROM/THRU DATES) WHICH ARE EQUAL TO, OVERLAP OR ARE WITHIN THE FROM/THRU DATES ON AN SNF INPATIENT CLAIM (TYPE OF BILL 18X, 21X, 28X, OR 51X) FOR PHYSICAL THERAPY, OCCUPATIONAL THERAPY, OR SPEECH THERAPY AND THE PROVIDER NUMBER ON THE INCOMING CLAIM IS THE SAME AS THE PROVIDER NUMBER ON THE HISTORY CLAIM **TO CORRECT YOUR CLAIM** **THE SYSTEM WILL AUTO REJECT THIS CLAIM** FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7055 OUTPATIENT SERVICES ENTERED WITH BILL TYPE '13X', '14X', OR '83X' ON THE INCOMING, OR ASSOCIATED, HISTORY CLAIM, ARE BEING BILLED WITH FROM/THRU DATES THAT ARE EQUAL TO, WITHIN, OR OVERLAPPING THE FROM/THRU DATES ON AN AMBUL- ATORY SURGERY CENTER CLAIM (ASC- BILL TYPE '83X'). THE PROVIDER NUMBER ON BOTH CLAIMS IS THE SAME. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7060 OUTPATIENT CLAIM SERVICE DATES EQUAL PREVIOUS OUTPATIENT CLAIM FOR THE SAME PROVIDER NUMBER, REVENUE CODE AND TOTAL CHARGES. . REASON CODE NOT CURRENTLY USED C7070 THE LAST SERVICE DATE ON THE OUTPATIENT CLAIM EQUALS OR IS ONE DAY EARLIER THAN THE INPATIENT ADMISSION DATE FROM YOUR FACILITY. THEREFORE, NO MEDICARE PAYMENT CAN BE MADE. C7080 AN OUTPATIENT CLAIM HAS A FROM/THRU DATE THAT OVERLAPS AN INPATIENT CLAIM AND THE PROVIDER NUMBERS ARE DIFFERENT OR A HOME HEALTH CLAIM HAS A DETAIL LINE ITEM DATE OF SERVICE THAT OVERLAPS AN INPATIENT, SNF OR RNHCI CLAIM ON HISTORY. **TO CORRECT YOUR CLAIM** THE SYSTEM WILL AUTO REJECT YOUR CLAIM. FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7090 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED . PART B NON-PHYSICIAN SERVICE DATES OVERLAP INPATIENT (EXCLUDING SNF) STAY DATES. C7108 CML 10/13/05 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 010 CODE EXTERNAL NARRATIVE C7108 . . THIS REJECT IS BEING USED TO DETECT DUPLICATE BILLINGS BY THE SAME PROVIDER OR BENEFICIARY RECEIVING SAME SERVICES FROM MULTIPLE PROVIDER SPECIALTIES THAT CAN PERFORM PHYSICAL, SPEECH AND/OR OCCUPATIONAL THERAPY SERVICES. C7109 AN OUTPATIENT CLAIM WITH THE THRU DATE, OR IF PRESENT, THE OCCURRENCE SPAN CODE '72' THRU DATE, GREATER THAN THE INPATIENT ADMISSION DATE MINUS FOUR DAYS, OR IS EQUAL TO THE INPATIENT ADMISSION DATE AND ONE OR MORE DIAGNOSTIC REVENUE CODES ARE PRESENT. NOTE: THE DATE CRITERIA FOR THIS EDIT IS: IF CONDITION CODE '65' IS PRESENT ON THE INPATIENT HISTORY CLAIM AND THE OUTPATIENT FROM DATE IS GREATER THAN 12/31/90 AND LESS THAN 10/31/94. *********** WHEN THE INCOMING CLAIM FROM DATE IS GREATER THAN 12/31/90 AND THE THRU DATE IS EQUAL TO, OR WITHIN THREE DAYS PRIOR TO THE HISTORY INPATIENT ADMISSION DATE, AND THERE IS AN INPATIENT CLAIM WITH A BILL TYPE OF '11X' OR '41X' THE PROVIDERS ARE THE SAME, AND THE OUTPATIENT REVENUE CODE IS '030X', '031X', '032X', '035X', '040X', '046X', '0481', '482', '483', '489', '061X','073X', '074X', '092X', '0254', '0255', '0341', '0371', '0372', '0471', '0621' OR '0622' SET THE '7190', ERROR CODE. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** C7111 THE DISCHARGE DATE OF THIS CLAIM IS EQUAL TO THE ADMISSION DATE OF A POSTED CLAIM. THE PATIENT STATUS SHOULD BE CORRECTED TO REFLECT A TRANSFER STATUS INSTEAD OF A DISCHARGE STATUS. C7112 INPATIENT CLAIM OVERLAPS AN OUTPATIENT BILL WITH A CWF SOURCE CODE 2 OR 3 FOR THE SAME PROVIDER. NOTE: THE DATE CRITERIA FOR THIS EDIT IS: IF THE OUT- PATIENT HISTORY FROM DATE OR, IF PRESENT THE SPAN CODE 72 FROM DATE IS LESS THAN 10/01/91. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7113 AN INPATIENT CLAIM WITH THE ADMISSION DATE LESS THAN FOUR DAYS FROM THE OUT- PATIENT HISTORY THRU DATE, OR IF PRESENT THE OCCURRENCE SPAN CODE '72' DATE, AND THE OUTPATIENT CLAIM IS FOR DIAGNOSTIC SERVICES ONLY. NOTE: THE DATE CRITERIA FOR THIS EDIT IS: - IF CONDITION CODE 65 IS PRESENT ON THE INPATIENT CLAIM AND THE OUTPATIENT HISTORY FROM DATE OR THE OCCURRENCE SPAN CODE '72' FROM DATE IS GREATER THAN 12/31/90 AND LESS THAN 10/31/94. - IF CONDITION CODE 65 IS NOT PRESENT ON THE INPATIENT CLAIM AND THE OUT- PATIENT HISTORY FROM DATE OR IF PRESENT, THE OCCURRENCE SPAN CODE '72' FROM DATE IS GREATER THAN 12/31/90 ********** M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 011 CODE EXTERNAL NARRATIVE C7113 WHEN THE INCOMING INPATIENT CLAIM IS BILL TYPE OF '11X' OR '41X', AND THE OUTPATIENT HISTORY CLAIM THRU DATE IS EQUAL TO THE INPATIENT ADMISSION DATE OR WITHIN THREE DAYS PRIOR TO THE ADMISSION DATE, AND THE PROVIDERS ARE EQUAL, AND THE OUTPATIENT REVENUE CODE IS: '030X', '031X', '032X', '035X' '040X', '046X', '481', '482', '483', '489', '061X', '073X', '074X' -F6- '092X', '0254', '0255', '0341', '0371', '0372', '0471', '0621' OR '0622' **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7114 THE THROUGH DATE (OR OCCURRENCE SPAN CODE 72 THROUGH DATE) ON THIS OUTPATIENT CLAIM IS EQUAL TO OR WITHIN THREE DAYS OF THE ADMISSION DATE OF AN INPATIENT CLAIM. THE OUTPATIENT CLAIM CONTAINS THERAPEUTIC SERVICES RELATED TO THE INPATIENT STAY; THEREFORE NO MEDICARE PAYMENT CAN BE MADE. C7115 THE ADMISSION DATE ON THIS INPATIENT CLAIM IS EQUAL TO OR WITHIN THREE DAYS OF THE THROUGH DATE (OR OCCURRENCE SPAN CODE 72 THROUGH DATE) OF A PREVIOUSLY PROCESSED OUTPATIENT CLAIM CONTAINING THERAPEUTIC SERVICES RELATED TO THE INPATIENT ADMISSION. SUBMIT A CANCEL FOR THE OUTPATIENT CLAIM. AFTER THE CANCEL APPEARS ON YOUR REMITTANCE ADVICE, RESUBMIT THE INPATIENT CLAIM, INCLUDING THE OUTPATIENT THERAPEUTIC SERVICES. ANY PART B DEDUCTIBLE AND/OR COINSURANCE COLLECTED FROM THE BENEFICIARY MUST BE REFUNDED. C7119 AN OUTPATIENT CLAIM WITH THE THRU DATE, OR IF PRESENT, THE OCCURRENCE SPAN CODE '72' THRU DATE, IS EQUAL TO THE INPATIENT ADMISSION DATE, OR THE INPA- TIENT ADMISSION DATE MINUS ONE DAY, AND ONE OR MORE DIAGNOSTIC REVENUE CODES ARE ON THE OUTPATIENT CLAIM. THE INPATIENT HISTORY CLAIM HAS A CONDITION CODE OF '65'. ************** NOTE: THE DATE CRITERIA FOR THIS EDIT IS: THE OUTPATIENT FROM DATE OR THE OCCURRENCE SPAN CODE '72' FROM DATE, IS GREATER THAN 10/30/94. ******************* - WHEN THE INCOMING CLAIM FROM DATE IS GREATER THAN 10/30/94 AND THE THRU DATE IS EQUAL TO THE INPATIENT ADMISSION DATE OR THE DAY PRIOR TO THE ADMISS- ION DATE ON A HISTORY RECORD WITH BILL TYPE '12X', AND THE PROVIDERS ARE EQUAL, AND THE OUTPATIENT REVENUE CODE IS '030X', '031X', '032X', '035X', '040X', '046X', '048X', '061X', '073X', '074X', '092X', '0254', '0255', '0341', '0371', '0372', '0471', '0621', OR '0622'. - WHEN THE ABOVE CONDITION AND THE PROVIDERS ARE LTCH (XX2000-XX2299) OR IRF (XX3025-XX3099) OR THIRD DIGIT EQUALS 'T', 'R', OR 'M'. - WHEN THE INPATIENT RECORD IN HISTORY IS PROVIDER NUMBER 'XX4000-XX4499', OR 'XXSXXX'. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7120 AN INPATIENT CLAIM WITH CONDITION CODE '65' PRESENT WITH AN ADMISSION DATE, OR THE ADMISSION DATE MINUS ONE DAY, EQUAL TO THE OUTPATIENT HISTORY THRU M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 012 CODE EXTERNAL NARRATIVE C7120 DATE, OR IF PRESENT, THE OCCURRENCE SPAN CODE 72 THRU DATE, AND THE OUTPAT- IENT HISTORY CLAIM HAS ONE OR MORE DIAGNOSTIC REVENUE CODES PRESENT. ****************** NOTE: THE DATE CRITERIA FOR THIS EDIT IS: THE OUTPATIENT HISTORY FROM DATE OR, IF PRESENT, THE OCCURRENCE SPAN CODE 72 FROM DATE, IS GREATER THAN 10/30/94. ***************** - WHEN THE INCOMING CLAIM BILL TYPE IS '11X' OR '41X', AND THE THRU DATEIS EQUAL TO THE ADMISSION DATE, OR THE DAY PRIOR TO THE ADMISSION DATE, AND THE PROVIDER NUMBERS ARE EQUAL AND THE OUTPATIENT HISTORY REVENUE CODE IS EQUAL TO '030X', '031X', '032X', '035X', '040X', '046X', '048X', '061X', '073X', '074X', '092X', '0254', '0255', '0341', '0371', '0372', '0471', '0621', OR '0622'. - WHEN THE ABOVE CONDITION AND THE PROVIDERS ARE LTCH (XX2000-XX2299) -F6- OR IRF (XX3025-XX3099) OR THIRD DIGIT EQUALS 'T', 'R' OR 'M'. - WHEN THE INCOMING INPATIENT RECORD HAS A PROVIDER NUMBER 'XX4000-XX4499', OR 'XXSXXX'. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7121 THE THROUGH DATE (OR OCCURRENCE SPAN CODE 72 THROUGH DATE) ON THIS OUTPATIENT CLAIM IS EQUAL TO OR WITHIN ONE DAY OF THE ADMISSION DATE OF AN INPATIENT CLAIM. THE OUTPATIENT CLAIM CONTAINS THERAPEUTIC SERVICES RELATED TO THE INPATIENT STAY; THEREFORE NO MEDICARE PAYMENT CAN BE MADE. C7122 THE ADMISSION DATE ON THIS INPATIENT CLAIM IS EQUAL TO OR WITHIN ONE DAY OF THE THROUGH DATE (OR OCCURRENCE SPAN CODE 72 THROUGH DATE) OF A PREVIOUSLY PROCESSED OUTPATIENT CLAIM CONTAINING THERAPEUTIC SERVICES RELATED TO THE INPATIENT ADMISSION. SUBMIT A CANCEL FOR THE OUTPATIENT CLAIM. AFTER THE CANCEL APPEARS ON YOUR REMITTANCE ADVICE, RESUBMIT THE INPATIENT CLAIM, INCLUDING THE OUTPATIENT THERAPEUTIC SERVICES. ANY PART B DEDUCTIBLE AND/OR COINSURANCE COLLECTED FROM THE BENEFICIARY MUST BE REFUNDED. C7171 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED . OUTPATIENT CLAIM WITH FROM/THRU DATES OF SERVICE OR IF PRESENT OCCURRENCE SPAN CODE '72' DATES EQUAL OR OVERLAP PART B DATE OF SERVICE. C7172 OUTPATIENT OR PART B CLAIM DUPLICATE FOR SCREENING PAP SMEAR. C72AA OUTPATIENT OR PART B CLAIM DUPLICATE FOR SCREENING PAP SMEAR. C7211 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 013 CODE EXTERNAL NARRATIVE C7211 . REASON CODE NOT CURRENTLY USED . EYEWEAR CLAIM WITHOUT PREVIOUS CATARACT SURGERY ON FILE C7220 OUR RECORDS SHOW THAT PAYMENT HAS PREVIOUSLY BEEN MADE FOR EYEWEAR. THEREFORE, NO ADDITIONAL MEDICARE PAYMENT CAN BE MADE. C7230 MULTIPLE EYEWEAR ITEMS ARE REPORTED ON THIS CLAIM. DUE TO THE LIMITATION ON COVERAGE OF EYEWEAR, NO MEDICARE PAYMENT CAN BE MADE. C7240 AN OUTPATIENT OR PART B CLAIM FOR INFLUENZA VACCINE (90657, 90658, 90659 OR 90724) OR INFLUENZA VACCINE ADMINISTRATION (G0008) HAS ALREADY BEEN PAID FOR THE SAME DATE OF SERVICE. CORRECT AND RESUBMIT, IF APPROPRIATE. C7241 AN OUTPATIENT OR PART B CLAIM FOR ORTHOTICS AND PROSTHETICS HCPCS CODE (REVENUE CODE 274) HAS ALREADY BEEN PAID FOR THE SAME DATE OF SERVICE CORRECT AND RESUBMIT, IF APPROPRIATE. C7242 AN OUTPATIENT OR PART B CLAIM FOR SURGICAL DRESSINGS HCPCS CODE (REVENUE CODE 623) HAS ALREADY BEEN PAID FOR THE SAME DATE OF SERVICE. CORRECT AND RESUBMIT, IF APPROPRIATE. C7243 AN OUTPATIENT OR PART B CLAIM FOR LABORATORY SERVICES (REVENUE CODE 30X OR 31X) HAS ALREADY BEEN PAID FOR THE SAME DATE OF SERVICE. CORRECT AND RESUBMIT, IF APPROPRIATE. C7245 **UNTIL FURTHER NOTICE, NO PROVIDER ACTION NECESSARY AT THIS TIME.** . . ANTIEMETIC DRUG HCPCS CODE NOT BILLED IN CONJUNCTION WITH ORAL ANTICANCER DRUG, OR DUPLICATE ANTIEMETIC DRUG CLAIM. * **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED C7246 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - THE INCOMING PART B/DME CLAIM DOES NOT CONTAIN A CABG/PCOE DEMONSTRATION NUMBER BUT THERE IS AN INPATIENT CABG/PCOE DEMONSTRATION CLAIM IN HISTORY WITH COVERED SERVICE DATES THAT ARE EQUAL TO, WITHIN, OR OVERLAPPING THE SERVICE DATES ON THIS CLAIM - OR - THE INCOMING INPATIENT CLAIM CONTAINS A CABG/PCOE DEMONSTRATION NUMBER AND M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 014 CODE EXTERNAL NARRATIVE C7246 THERE IS A PART B/DME CLAIM IN HISTORY WITH SERVICE DATES THAT ARE EQUAL TO, WITHIN, OR OVERLAPPING THE PART A COVERED SERVICE DATES, BUT DEMONSTRATION NUMBER '06' IS NOT PRESENT ON THE HISTORY PART B/DME CLAIM. C7247 **UNTIL FURTHER NOTICE, NO PROVIDER ACTION NECESSARY AT THIS TIME.** . . ORIGINAL CLAIM- REJECTED DUPLICATE BILLING FOR ORAL ANTI-EMETIC DRUGS * ADJUSTMENT CLAIM RTP'D **TO CORRECT YOUR CLAIM** REMOVE THE REVENUE CODE, HCPCS CODE, UNITS AND CHARGES FOR THE ANTI-EMETIC DRUG ON PAGE 2 AND F9. -FOR MORE INFORMATION REVIEW PUB 100-4, CHAPTER 17, SECTION 80. C7248 OUTPATIENT CLAIMS WITH HCPCS CODE '97504' AND '97116' CANNOT BE BILLED ON THE SAME DAY WITH THE SAME PROVIDER NUMBER. CORRECT AND RESUBMIT IF APPROPRIATE. C7249 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. C7250 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. C7251 AN OUTPATIENT CLAIM (12X, 13X, 214X, 23X, 34X, 74X, 75X, 83X, OR 85X) IS SUBMITTED WITH A THERAPY HCPCS CODE(S) AND THE DATES OF SERVICE ARE WITHIN THE SERVICE DATES OF A SNF INPATIENT PART A CLAIM (21X) OR A SNF INPATIENT PART B CLAIM (22X). CORRECT AND RESUBMIT IF APPROPRIATE. C7252 FOR AN OUTPATIENT CLAIM THE DETAIL LINE ITEM DATE OF SERVICE IS WITHIN THE ADMISSION AND DISCHARGE DATE OF A SNF INPATIENT PART A CLAIM (21X) FOR NON- THERAPY SERVICES. ********** IF THE DETAIL LINE DATE OF SERVICE IS NOT PRESENT, USE THE FROM AND THRU DATE *********** WHEN THE FROM AND THRU DATE ARE USED THE DATE MAY OVERLAP OR BE WITHIN THE POSTED SNF INPATIENT PART A CLAIM (21X) IN HISTORY. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** C7253 AN OUTPATIENT CLAIM (23X) IS SUBMITTED WITH REVENUE CODE '54X' AND THE DATES OF SERVICE ARE EQUAL TO A PART B CLAIM WITH HCPCS CODE(S) (A0380, A0390, A0425-A0436, AND A0999). CORRECT AND RESUBMIT IF APPROPRIATE. C7254 AN OUTPATIENT CLAIM (12X, 13X, 14X, 23X, 34X, 74X, 75X, 83X, OR 85X) IS SUBMITTED WITH THE SAME HCPCS CODE(S), MODIFIER(S), AND DETAIL LINE ITEM DATE OF SERVICE AS A SNF INPATIENT PART B CLAIM (22X). M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 015 CODE EXTERNAL NARRATIVE C7254 CORRECT AND RESUBMIT IF APPROPRIATE. C7255 A SNF INPATIENT PART B CLAIM 22X IS SUBMITTED WITH THE SAME HCPCS CODE(S), MODIFIER CODE(S), AND THE DETAIL LINE ITEM DATE OF SERVICE AS AN OUTPATIENT CLAIM (12X, 13X, 14X, 23X, 34X, 74X, 75X, 83X, OR 85X). CORRECT AND RESUBMIT IF APPROPRIATE. C7256 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED . AN OTPT CLAIM (12X, 13X, 14X, 23X, 34X, 74X, 75X, 83X,OR85X) IS SUBMITTED WITH THE SAME HCPCS CODE(S), MODIFIER CODE(S), AND LINE ITEM DATES OF SERVICE AS A DMERC OR PART B CLAIM. CORRECT AND RESUBMIT IF APPROPRIATE. C7257 A SNF INPATIENT PART B CLAIM 22X IS SUBMITTED WITH THE SAME HCPCS CODE(S), MODIFIER CODE(S), AND DETAIL LINE ITEM DATE OF SERVICE AS A DMERC OR PART B CLAIM. CORRECT AN RESUBMIT IF APPROPRIATE. C7262 AN OUTPATIENT CLAIM FOR INFLUENZA VACCINE HCPC 90655, 90656, 90657, 90658, 90659 OR PNEUMOCOCCAL SERVICE 90732 OR INFLUENZA VACCINE ADMINISTRATION G0008 OR G0009 HAS ALREADY BEEN PAID FOR THE SAME DATE OF SERVICE. CORRECT AND RESUBMIT, IF APPROPRIATE. C7265 A PART B CLAIM FOR INFLUENZA VACCINE HCPC 90655, 90656, 90657, 90658, 90659, OR PNEUMOCOCCAL SERVICE 90732 OR INFLUENZA VACCINE ADMINISTRATION G0008 OR G0009 HAS ALREADY BEEN PAID FOR THE SAME DATE OF SERVICE. CORRECT AND RESUBMIT IF APPROPRIATE. C7266 HCPC CODE 11055, 11056, 11057, 11719, 11720, 11721 HAS ALREADY BEEN PAID WITHIN 6 MONTHS OF G0245, G0246 ORG0247, PER CR 2444. C7267 THE INTERRUPTED STAY (SPAN CODE 74) IS GREATER THAN THE SPECIFIED NUMBER OF DAYS ALLOWED ON AN LTCH PPS PROVIDER: -IF THE INTERRUPTED STAY IS GREATER THAN '8' DAYS FOR AN ACUTE CARE HOSPITAL ('0001-0999'). -IF THE INTERRUPTED STAY IS GREATER THAN '26' DAYS FOR AN IRF PPS PROVIDER ('3025-3099'OR THIRD DIGIT A 'T'). -IF THE INTERRUPTED STAY IS GREATER THAN '44' DAYS FOR AN SNF PROVIDER ('5000-6499' OR THIRD DIGIT A 'Y'). -IF THE INTERRUPTED STAY IS GREATER THAN '44' DAYS FOR AN SWING BED PROVIDER ('1800-1999' OR THIRD DIGIT A 'U'). M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 016 CODE EXTERNAL NARRATIVE C7267 . CORRECT AND RESUBMIT C7268 A LTCH PPS PROVIDER'S ADMIT DATE IS LESS THAN SPECIFIED NUMBER OF DAYS ALLOWED FOR THE SAME LTCH PPS PROVIDER IN HISTORY BASED ON THE THRU DATE AND PATIENT STATUS OR A LTCH PPS PROVIDER'S THRU DATE AND PATIENT STATUS IS LESS THAN SPECIFIED NUMBER OF DAYS ALLOWED FOR THE SAME LTCH PPS PROVIDER'S ADMIT DATE IN HISTORY: -IF THE PATIENT STATUS IS '02' AND THE NUMBER OF DAYS IS EQUAL TO OR LESS THAN '9' DAYS. -IF THE PATIENT STATUS IS '62' AND THE NUMBER OF DAYS IS EQUAL TO OR LESS THAN '27' DAYS. -IF THE PATIENT STATUS IS '03' AND THE NUMBER OF DAYS IS EQUAL TO OR LESS THAN '45' DAYS. -IF THE PATIENT STATUS IS '61' AND THE NUMBER OF DAYS IS F6 THIS STAY SHOULD NOT HAVE BEEN SPLIT BILLED - IT MEETS THE CRITERIA TO BE AN INTERRUPTED STAY SINCE A LEAVE OF ABSENCE IS INVOLVED ** TO CORRECT YOUR CLAIM ** YOU NEED TO COMBINE THIS CLAIM WITH THE PRIOR AND/OR SUBSEQUENT CLAIM(S) AND SUBMIT IT AS ADMIT THRU DISCHARGE - YOU NEED TO UTILIZE OCCURRENCE SPAN 74 FOR THE DATES THAT THE PATIENT WAS ON LEAVE FROM YOUR FACILITY. C7270 INPATIENT CLAIM WITH FROM DATE EQUAL TO INPATIENT PPS THRU DATE IN HISTORY FOR SAME PROVIDER AND PATIENT STATUS IS NOT '30'. CORRECT AND RESUBMIT C7271 INPATIENT CLAIM WITH THRU DATE EQUAL TO INPATIENT PPS FROM DATE IN HISTORY FOR SAME PROVIDER AND PATIENT STATUS IS NOT '30'. CORRECT AND RESUBMIT. C7272 INPATIENT CLAIM WITH INCORRECT PATIENT STATUS DUE TO TRANSFER TO ANOTHER FACILITY. CORRECT AND RESUBMIT. C7273 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7274 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 017 CODE EXTERNAL NARRATIVE C7275 STANDARD NARRATIVE: THE DETAIL LINE ITEM DATE OF SERVICE IS WITHIN THE ADMSSION AND DISCHARGE DATE OF A SNF IP PART A CLAIM (21X) AND A REV CODE OF '54X' AND A MODIFIER OF 'DN'OR 'ND' IS PRESENT ************** THIS EDIT IS BYPASSED: - WHEN AN INCOMING OP CLAIM DETAIL LINE ITEM DATE OF SERVICE EQUALS THE SNF IP PART A CLAIM ADMISSION DATE IN HISTORY - WHEN AN INCOMING OP CLAIM DETAIL LINE ITEM DATE OF SERVICE EQUALS THE SNF IP PART A CLAIM ADMISSION DATE IN HISTORY AND THE PATIENT STATUS IS NOT '30' - WHEN AN INCOMING OP CLAIM IS SUBMITTED WITH ACTION CODE '4' OR '7' - WHEN AN INCOMING OP CLAIM IS SUBMITTED WITH A NO-PAY CODE OF 'B' OR 'N' - WHEN AN INCOMING OP CLAIM IS SUBMITTED WITHOUT A NO-PAY CODE BUT THE TOTAL CHARGE EQUALS THE NON-COVERED CHARGE FOR REV CODE '54X' - WHEN AN INCOMING OP CLAIM IS SUBMITTED WITH A '2' IN THE CB OV FIELD - WHEN AN INCOMING OP CLAIM IS SUBMITTED WITH A DEMO NUMBER '31' OR '37' - WHEN AN INCOMING OP CLAIM DETAIL LINE ITEM DATE OF SERVICE IS GREATER THAN THE OCCURRENCE CODE (A3, B3, OR C3) OF THE SNF IP PART A CLAIM HISTORY - WHEN HISTORY SNF IP PART CLAIM CANCEL DATE IS GREATER THAN ZERO - WHEN HISTORY SNF IP PART CLAIM HAS A NO-PAY CODE EQUAL TO 'B', 'C', 'N', OR 'R' ***************************************************************** REASON CODE ADDED WITH CWF CR23565 PAR MA4467/C2005200. REASON CODE NARRATIVE DISTRIBUTED WITH FS4518/C200521F. C7276 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7277 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7278 INPATIENT LTCH, IRF, OR IPF CLAIM WITH ADMIT DATE LESS THAN 3 DAYS FROM THE DISCHARGE DATE FROM THE SAME LTCH. . THIS IS AN INTERRUPTED STAY NEED TO COMBINE AND BILL AS ONE CLAIM - UTILIZING M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 018 CODE EXTERNAL NARRATIVE C7278 OCCUR SPAN 74 FOR THE DAYS OF INTERRUPTION IF NEEDED C7279 OUTPATIENT CLAIM FOR A LESS THAN 3 DAY INTERRUPTED LTCH STAY . UNDER THE 3 DAY OR LESS INT STAY POLICY ANY TESTS OR PROCEDURES THAT WERE ADMINISTERED TO THE PATIENT DURING THAT PERIOD OF TIME - OTHER THAN INPATIENT SURGICAL CARE AT AN ACUTE CARE HOSPITAL ARE CONSIDERED PART OF THE SINGLE EPISODE OF LTCH CARE AND BUNDLED INTO THE PAYMENT TO THE LTCH. THE LTCH IS REQUIRED TO PAY ANY OTHER PROVIDERS WITHOUT ADDITIONAL MEDICARE PAYMENT. IF ANY TESTS OR PROCEDURES WERE DELIVERED DURING THE INTERRUPTION - ALL DAYS ARE INCLUDED IN THE DAY COUNT - IF NO CARE WAS PROVIDED DURING THE INTERRUPTION THE DAYS AWAY FROM THE LTCH ARE NOT INCLUDED IN THE INPATIENT STAY(THESE DAYS WERE BE ACCOUNTED FOR BY UTILIZING THE OCC SPAN 74). . THE LTCH SHALL ADJUST THEIR BILL TO INCLUDE UNDER ARRANGEMENT SERVICES SO THAT PROPER DAYS CAN BE COUNTED FOR THE BENEFICIARY. C7280 INPATIENT ACUTE CARE HOSPITAL CLAIM FOR A LESS THAN 3 DAY INTERRUPTED LTCH STAY. . UNDER THE 3 DAY OR LESS INT STAY POLICY ANY TESTS OR PROCEDURES THAT WERE ADMINISTERED TO THE PATIENT DURING THAT PERIOD OF TIME - OTHER THAN INPATIENT SURGICAL CARE AT AN ACUTE CARE HOSPITAL ARE CONSIDERED PART OF THE SINGLE EPISODE OF LTCH CARE AND BUNDLED INTO THE PAYMENT TO THE LTCH. THE LTCH IS REQUIRED TO PAY ANY OTHER PROVIDERS WITHOUT ADDITIONAL MEDICARE PAYMENT. IF ANY TESTS OR PROCEDURES WERE DELIVERED DURING THE INTERRUPTION - ALL DAYS ARE INCLUDED IN THE DAY COUNT - IF NO CARE WAS PROVIDED DURING THE INTERRUPTION THE DAYS AWAY FROM THE LTCH ARE NOT INCLUDED IN THE INPATIENT STAY(THESE DAYS WERE BE ACCOUNTED FOR BY UTILIZING THE OCC SPAN 74). . THE LTCH SHALL ADJUST THEIR BILL TO INCLUDE UNDER ARRANGEMENT SERVICES SO THAT PROPER DAYS CAN BE COUNTED FOR THE BENEFICIARY. C7281 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7283 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE NOT CURRENTLY USED - DUPLICATE OF HISTORY '34X' RECORD WITH SAME DATE OF SERVICE. C7284 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 019 CODE EXTERNAL NARRATIVE C7284 REASON CODE NOT CURRENTLY USED - DUPLICATE OF HISTORY '34X' RECORD WITH SAME DATE OF SERVICE. C7285 HCPCS CODES G9017, G9018, G9019, G9020, G9033, G9034, G9035, OR G9036 IS PRESENT ON THE CLAIM AND THE BENE HAS ALREADY BEENCOVERED FOR TWO TREATMENTS OF AN INFLUENZA MEDICATION. THIS REASON CODE WAS ASSIGNED BY CWF BECAUSE THE BENEFICIARIES LIMIT OF TWO TREATMENTS HAS BEEN REACHED. C7286 DATES OF SERVICE FOR HCPCS CODE 'Q0496' OR 'Q0503' WITH NO 'RP' MODIFIER ARE WITHIN 6 MONTHS OF THE DATE OF DISCHARGE FROM A HOSPITAL STAY IN WHICH A VAD, AS IDENTIFIED BY PROCEDURE CODE '37.66' OR '37.63', WAS IMPLANTED. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MEDLEARNMATTERSARTICLES/ AND REVIEW CR 3931 C7287 DATES OF SERVICE FOR HCPCS CODE 'Q0496'OR 'Q0505' ARE WITHIN 6 MONTHS OF A PREVIOUSLY ALLOWED VAD UNDER PART B AND NO 'RP' MODIFIER PRESENT. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MEDLEARNMATTERSARTICLES/ AND REVIEW CR 3931 C7288 DATES OF SERVICE FOR HCPCS CODE 'Q0480-Q0495', 'Q0497-Q0499', 'Q0505', 'Q0502', OR 'Q0504', AND NO 'RP' MODIFIER ARE WITHIN 12 MONTHS OF THE DATE OF DISCHARGE FROM A HOSPITAL STAY IN WHICH A VAD, AS IDENTIFIED BY PROCEDURE CODE '37.66' OR '37.63', WAS IMPLANTED. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MEDLEARNMATTERSARTICLES/ AND REVIEW CR 3931 C7289 DATES OF SERVICE FOR HCPCS CODE 'Q0480- Q0495', 'Q0497-Q0499', 'Q0505', 'Q0502', OR 'Q0504', AND NO 'RP' MODIFIER ARE WITHIN 12 MONTHS OF A PERVIOUSLY ALLOWED VAD UNDER PART B AND NO 'RP'MODIFIER PRESENT. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MEDLEARNMATTERSARTICLES/ AND REVIEW CR 3931 C729A THE DETAIL LINE ITEM DATE OF SERVICE EQUALS THE DETAIL LINE ITEM DATE OF SERVICE WITH THE SAME REVENUE CODE(S), HCPCS CODE(S), MODIFIER CODE(S) (IF PRESENT) OF AN ESRD CLAIM (72X). **THE SYSTEM WILL AUTO REJECT THIS CLAIM** M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 020 CODE EXTERNAL NARRATIVE C729A -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED C729B REVENUE CODE '821', '831', '841', AND/OR '851' IS PRESENT AND THE DETAIL LINE ITEM DATE OF SERVICE EQUALS THE DETAIL LINE ITEM DATE OF SERVICE OF AN OUT- PATIENT CLAIM (13X OR 85X) WITH HCPCS CODE 'G0257'. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED C729C FOR AN ESRD CLAIM (72X) THE DETAIL LINE ITEM DATE OF SERVICE IS WITHIN THE ADMISSION AND DISCHARGE DATE OF THE INPATIENT CLAIM (11X). **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED C729H IRF PPS CLAIM WITH INPROPER DISCHARGE CODE. * **THE SYSTEM WILL AUTO REJECT YOUR CLAIM** -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED C729I FOR AN ESRD CLAIM (72X) THE DETAIL LINE ITEM DATE OF SERVICE EQUALS THE DETAIL LINE ITEM DATE OF SERVICE OF AN OUTPATIENT CLAIM (12X). **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED C7290 THE CLAIM HAS BEEN ADJUSTED BECAUSE COVERAGE/PROGRAM GUIDELINES WERE NOT MET OR WERE EXCEEDED. HCPCS G0369 OR Q0510 HAS ALREADY BEEN PAID FOR A TRANSPLANT WITHIN 1 CALANDAR YEAR OF THE DATE OF SERVICE. **THIS IS AN AUTOMATED REASON CODE, NO MANUAL INTERVENTION IS REQUIRED** - SINCE HCPCS G0369 OR Q0510 HAS ALREADY BEEN PAID FOR A TRANSPLANT WITHIN 1 CALANDAR YEAR OF THE DATE OF SERIVCE ON THIS CLAIM, THE SYSTEM WILL REJECT THIS CLAIM WITH C7290. 1) C7290 WILL APPEAR IN THE DENIAL REASON FIELD ON PAGE 32. 2) G0369 WILL BE DOWNCODED TO HCPCS G0370 OR Q0510 WILL BE DOWNCODED TO Q0511 ON PAGE 2. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MEDLEARN/MATTERS/CR 3830 OR CR 3990. C7291 HCPCS 'Q0480-Q0499' OR 'Q0501-Q0504' BILLED AND NO PART A VAD RECORD IN HISTORY. **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MEDLEARNMATTERSARTICLES/ AND REVIEW CR 3931 C7294 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 021 CODE EXTERNAL NARRATIVE C7294 - AN INCOMING DME CLAIM WITH AN IHS CODE IS PRESENT, AND A CATEGORY '3' OR '21' HCPCS AND IN HISTORY THERE IS EITHER AN OUTPATIENT OR PART B CLAIM WITH A MATCHING HCPCS IN CATEGORY '3' OR '21' ANOTHER DME WITH AN IHS CODE AND ONE OF THE HCPCS IN CATEGORY '3' OR '21'. THE DATES OF SERVICE ON THE CLAIM ARE 01/01/2005 AND AFTER. ******* AN INCOMING PART B OR OUTPATIENT CLAIM WITH A HCPCS CODE PRESENT IN CATEGORY '3' OR '21' HCPCS AND IN HISTORY THERE IS A DME CLAIM IN HISTORY WITH A MATCHING HCPCS IN CATEGORY '3' OR '21' AND AN IHS CODE. THE DATES OF SERVICE ON THE CLAIM ARE 01/01/2005 AND AFTER. C7295 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CWF HAS RETURNED CROSSOVER EDIT 7295. FQHC NOT ALLOWED FOR BOTH REVENUE CODE '0519' AND REVENUE CODE '052X', '0900', OR '0780' ON THE SAME DATE OF SERVICE. C7296 HCPCS 'G0332' ONLY ALLOWED ONCE PER DAY. **TO CORRECT YOUR CLAIM** THE SYSTEM WILL AUTO REJECT THE CLAIM. -FOR MORE INFORMATION REVIEW CR 4332. C7300 THIS EDIT WILL SET WHEN EITHER AN INCOMING HOSPICE CLAIM (HUHC) (81X OR 82X) WITH HCPC G0337 OVERLAPS A PART B CLAIM IN HISTORY (HUBC) WITH HCPC CODES 99201-99205 WITH THE SAME NPI. *** OR *** A PART B CLAIM (HUBC) IS SUBMITTED THAT CONTAINS HCPC CODES 99201-99205 AND POSTED TO HISTORY THERE IS A HOSPICE CLAIM (HUHC) WITH HCPC G0337 AND BOTH RECORDS CONTAIN THE SAME NPI. . NA TO MUTUAL - HOSPICE REASON CODE C7510 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7520 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SNF CLAIM (INITIAL ONLY) WITH NO QUALIFYING INPATIENT SERVICE DATES. . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 022 CODE EXTERNAL NARRATIVE C7530 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7531 AN INPATIENT PPS BILL (TYPE BILL 111) IS POSTED TO THE HOST HISTORY WITH A PATIENT STATUS CODE OTHER THAN 02/05/65 AND CONDITION CODE 61 IS NOT PRESENT OR THE DRG IS NOT EQUAL TO 385 OR 456 AND AN INPATIENT PPS BILL (TYPE BILL 111) WITH A FROM DATE EQUAL TO THE THROUGH DATE OF THE POSTED BILL IS BEING PROCESSED. FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7532 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7533 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7534 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7535 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7537 INPATIENT CLAIM WITH INCORRECT PATIENT STATUS DUE TO TRANSFER TO ANOTHER FACILITY. THIS IS BEING WORKED INTERNALLY NO ACTION IS REQUIRED. C7540 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . INPATIENT CLAIM ADMISSION DATE (OR ADMISSION DATE -1) EQUALS OUTPATIENT BYPASS AMBULANCE, ALL INCLUSIVE RATE PROVIDER, RENAL PROVIDER OR DME) LAST SERVICE DATE FOR SAME PROVIDER NUMBER. . REASON CODE NOT CURRENTLY USED C7545 AN INPATIENT CLAIM (TOB '11X') WITH FROM AND THRU DATES THAT EQUAL OR OVERLAP THE FROM AND THRU DATES (OR IF PRESENT, OCCURRENCE SPAN CODE '72' FROM AND THRU DATES) ON AN OUTPATIENT CLAIM (TOB '12X', '13X', '14X', '32X', '33X', '34X', '72X', '73X', '74X', '75X', '76X' OR '83X') IN HISTORY. * FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. C7546 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7548 AN IHS/TRIBAL PROVIDER TOB '12X' HAS A LIDOS THAT EQUALS OR IS THE DAY FOLLOWING THE DISCHARGE DATE OF THE SAME PROVIDER FOR AN INPATIENT STAY. **** M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 023 CODE EXTERNAL NARRATIVE C7548 THIS REASON CODE HAS BEEN REPLACED BY D7548 WITH THE IMPLEMENTATION OF CR3452S1 IN RELEASE C2005300. C7550 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . INPATIENT CLAIM STAY DATES EQUAL OR OVERLAP PART B LINEITEM FOR NONPHYSICIAN SERVICES. . REASON CODE NOT CURRENTLY USED C7555 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SNF CLAIM STAY DATES OVERLAP PART B LINE ITEM FOR DME (TYPEOF SERVICE A, I, P OR R - EXCLUDE PROSTHETIC DEVICES). . REASON CODE NOT CURRENTLY USED C7556 MEDICARE WILL NOT PAY FOR DUPLICATE BILLING BY RHC AND PHYSICIAN/PRACTITIONER **THE SYSTEM WILL AUTO REJECT THIS CLAIM** -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7560 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . INPATIENT MEDICAL OR PRO-DENIED CLAIM STAY DATES EQUAL OR OVERLAP PART B LINE ITEM PHYSICIAN SERVICE. . REASON CODE NOT CURRENTLY USED C7570 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7580 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . PART B LINE PHYSICIAN SERVICE** DATES OVERLAP DENIED INPATIENT/SNF CLAIM. . REASON CODE NOT CURRENTLY USED C7585 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . PART B LINE ITEM DME (TYPE SERVICE A, P. I OR R - EXCLUDEPROSTHETIC DEVICES) SERVICE DATES OVERLAP SNF CLAIM. . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 024 CODE EXTERNAL NARRATIVE C7610 HOME HEALTH CLAIM OVERLAPS A HOSPICE PERIOD AND SERVICE DATES EQUAL OR OVERLAP HOSPICE CLAIM (REGARDLESS OF DIAGNOSIS). . FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7620 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . INPATIENT CLAIM OVERLAPS A HOSPICE PERIOD AND SERVICE DATESEQUAL OR OVERLAP HOSPICE CLAIM (REGARDLESS OF DIAGNOSIS). C7630 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7701 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C7703 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C8100 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED C8101 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . CATARACT EXTRACTION IS BILLED MORE THAN TWICE. . REASON CODE NOT CURRENTLY USED DHIC# FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED DM001 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DM002 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED DM003 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 025 CODE EXTERNAL NARRATIVE DM003 . REASON CODE NOT CURRENTLY USED DM004 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED DM005 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED DM012 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DM013 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DM014 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DM015 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DM016 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DM041 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED DM042 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DM043 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT00F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED DT001 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 01 RECEIVED . REASON CODE NOT CURRENTLY USED DT002 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 02 RECEIVED . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 026 CODE EXTERNAL NARRATIVE DT003 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 03 RECEIVED . REASON CODE NOT CURRENTLY USED DT004 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 04 RECEIVED . REASON CODE NOT CURRENTLY USED DT005 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 05 RECEIVED . REASON CODE NOT CURRENTLY USED DT006 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 05 RECEIVED . REASON CODE NOT CURRENTLY USED DT007 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 05 RECEIVED . REASON CODE NOT CURRENTLY USED DT008 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 05 RECEIVED . REASON CODE NOT CURRENTLY USED DT009 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 09 RECEIVED . REASON CODE NOT CURRENTLY USED DT010 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 10 RECEIVED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 027 CODE EXTERNAL NARRATIVE DT010 . REASON CODE NOT CURRENTLY USED DT011 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . CWF TRAILER 11 RECEIVED . REASON CODE NOT CURRENTLY USED DT012 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 12 RECEIVED . REASON CODE NOT CURRENTLY USED DT013 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 13 RECEIVED . REASON CODE NOT CURRENTLY USED DT014 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 14 RECEIVED . REASON CODE NOT CURRENTLY USED DT015 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION 01 TRAILER 15 RECEIVED . REASON CODE NOT CURRENTLY USED DT016 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION CODE 01 TRAILER 16 RECEIVED . REASON CODE NOT CURRENTLY USED DT017 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED . DISPOSITION 01 RECEIVED WITH 17 TRAILER . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 028 CODE EXTERNAL NARRATIVE DT018 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . CWF DISPOSITION 01, TRAILER 18 RECEIVED . REASON CODE NOT CURRENTLY USED DT020 FOR INTERMEDIARY USE ONLY. NO PROVIDER ACTION IS REQUIRED. . A TRAILER 20 IS BEING RECEIVED ON A DISPOSITION CODE 01 . REASON CODE NOT CURRENTLY USED DT021 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. . TRAILER 21 RECEIVED . REASON CODE NOT CURRENTLY USED DT023 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. . DISPOSITION 01 RECEIVED WITH TRAILER 23 . REASON CODE NOT CURRENTLY USED DT024 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. . DISPOSITION '01' RECEIVED WITH TRAILER 24 . REASON CODE NOT CURRENTLY USED DT025 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. . DISPOSITION '01' RECEIVED WITH TRAILER 25. . REASON CODE NOT CURRENTLY USED DT026 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. . DISPOSITION '01' RECEIVED WITH TRAILER 26. . REASON CODE NOT CURRENTLY USED DT027 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION '01' RECEIVED WITH TRAILER 27 M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 029 CODE EXTERNAL NARRATIVE DT027 . REASON CODE NOT CURRENTLY USED DT028 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION '01' RECEIVED WITH TRAILER 28 . REASON CODE NOT CURRENTLY USED D0106 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION '01' RECEIVED WITH TRAILER 28 . REASON CODE NOT CURRENTLY USED D5605 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SERVICES WERE RENDERED ON THE SAME DAY AS AMBULATORY SURGERY SERVICES (BILL TYPE 83X). . REASON CODE NOT CURRENTLY USED D5613 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DUPLICATE CLAIM WITH DIFFERENT DCN NUMBER. THE THREE POSITIONS OF THE BILL TYPES ARE EQUAL AND THE THIRD POSITION IS NOT EQUAL TO 5. THE THIRD POSITION OF THE PROVIDER NUMBER EQUALS S, T, OR U AND THE MATCHING HISTORY RECORD WAS FOUND. . REASON CODE NOT CURRENTLY USED D7050 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OUTPT CLAIM (BILL TYPE 13X, 23X, 33X, 34X, 74X, OR 75X) DATES OF SERVICE FOR PT, ST, AND/OR OT OVERLAP THE FROM AND THROUGH DATES OF A SNF BILL (21X OR 51X) WITH PT, ST, AND/OR OT SERVICES. D7108 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . OUTPATIENT CLAIM WITH FROM/THRU DATES OF SERVICE OR IF PRESENT OCURRENCE SPAN CODE '72' DATES EQUAL OR OVERLAP OUTPATIENT FROM/THRU OR IF PRESENT OCURRENCE SPAN CODE '72' DATES. . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 030 CODE EXTERNAL NARRATIVE D7171 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . OUTPATIENT CLAIM WITH FROM/THRU DATES OF SERVICE OR IF PRESENT OCCURRENCE SPAN CODE 72 DATES EQUAL OR OVERLAP PART B DATE OF SERVICE. . REASON CODE NOT CURRENTLY USED D7211 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED D7510 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . HOME HEALTH CLAIM SERVICE DATES OVERLAP PREVIOUS HOMEHEALTH CLAIM FOR SAME REVENUE CODE. . REASON CODE NOT CURRENTLY USED D7520 SNF CLAIM (INITIAL ONLY) WITH NO QUALIFYING INPATIENT SERVICE DATES. D7530 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7531 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED: AN INPATIENT (TOB 111) PPS (CONDITION CODE 65 NOT PRESENT) BILL IS POSTED TO THE HOST HISTORY WITH A PATIENT DISCHARGE STATUS CODE OTHER THAN 02 (DISCHARGED/TRANSFERRED TO ANOTHER ACUTE CARE FACILITY), 05 (DISCHARGED/TRANSFERRED TO ANOTHER TYPE OF INSTITUTION) OR 07 (LEFT AGAINST MEDICAL ADVICE OR DISCONTINUED CARE) AND CONDITION CODE 61 (COST OUTLIER) IS NOT PRESENT OR THE DRG IS NOT EQUAL TO 385 OR 456 AND AN INPATIENT BILL (BILL TYPE 111) PPS (CONDITION CODE 65 NOT PRESENT) BILL WITH A FROM DATE EQUAL TO THE THROUGH (DISCHARGE) DATE OF THE POSTED DATE. UPDATED NARR TYPE "S" 02/25/91. ------------------------------ EDIT IS BYPASSED WHEN: THE HISTORY INPATIENT CLAIM CONTAINS A PATIENT STATUS CODE '62'. THE HISTORY INPATIENT CLAIM CONTAINS A PATIENT STATUS CODE '63'. D7532 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7533 FOR INTERNAL USE ONLY. NO PROVIDER ACTION IS REQUIRED. D7534 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7535 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 031 CODE EXTERNAL NARRATIVE D7536 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7537 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7540 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . INPATIENT CLAIM ADMISSION DATE (OR ADMISSION DATE -1) EQUALS OUTPATIENT LAST SERVICE DATE FOR SAME PROVIDER NUMBER. . REASON CODE NOT CURRENTLY USED D7545 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7546 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE NOT CURRENTLY USED. - THE OUTPATIENT RECORD TYPE OF BILL '34X', WITH REVENUE CODE '636', HCPCS CODE 'J0630' ON HISTORY, DOES NOT HAVE THE SAME PROVIDER NUMBER AS THE INCOMING HOME HEALTH CLAIM. D7548 AN IHS/TRIBAL PROVIDER TOB '12X' HAS A LIDOS THAT EQUALS OR IS THE DAY FOLLOWING THE DISCHARGE DATE OF THE SAME PROVIDER FOR AN INPATIENT STAY. . THIS REASON CODE WILL BE INACTIVE AS MUTUAL OF OMAHA DOES NOT PROCESS CLAIMS FOR IHS/TRIBAL PROVIDERS . 07/06/05 LV D7549 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - CWF IUR CODE RETURNED WITH INFORMATIONAL UNSOLICITED RESPONSE, THIS IS INFOR- MATIONAL ONLY. HIOP RECORD RECEIVED FOR WHICH A VAD WAS IMPLANTED AND THE DISCHARGE DATE IS NOT WITHIN 6 MONTHS OF A DETAIL LINE ITEM DOS OF A DENIED HUOP RECORD IN HISTORY WITH HCPCS Q0496 OR Q0503 OR NOT WITHIN 12 MONTHS OF DETAIL LINE ITEM DOS OF A DENIED HUOP RECORD WITH HCPCS Q0480-Q0495, Q0497- Q0499, Q0501, Q0502, OR Q0504. D7550 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - CWF IUR CODE RETURNED WITH INFORMATIONAL UNSOLICITED RESPONSE, THIS IS INFOR- MATIONAL ONLY. HIOP RECORD RECEIVED FOR WHICH A VAD WAS IMPLANTED AND THE DISCHARGE DATE IS WITHIN 6 MONTHS OF A DETAIL LINE ITEM DOS OF A DENIED HUOP RECORE IN HISTORY WITH HCPCS Q0496 OR Q0503 OR NOT WITHIN 12 MONTHS OF DETAIL M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 032 CODE EXTERNAL NARRATIVE D7550 LINE ITEM DOS OF A DENIED HUOP RECORD WITH HCPCS Q0480-Q0495, Q0497-Q0499, Q0501, Q0502, OR Q0504. MODIFIER 'RP' PRESENT. D7551 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - CWF IUR CODE RETURNED WITH INFORMATIONAL UNSOLICITED RESPONSE, THIS IS INFOR- MATIONAL ONLY. HUIP RECORD RECEIVED FOR WHICH A VAD WAS IMPLANTED AND A DENIED HUOP RECORD IN HISTORY WITH HCPCS Q0500 OR Q0505. D7555 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . SNF CLAIM STAY DATES OVERLAP PART B LINE ITEM FOR DME . REASON CODE NOT CURRENTLY USED D7560 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . INPATIENT MEDICAL OR PRO-DENIED CLAIM STAY DATES EQUAL OROVERLAP PART B LINE ITEM PHYSICIAN SERVICE**. . REASON CODE NOT CURRENTLY USED D7570 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7580 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . PART B LINE PHYSICIAN SERVICE** DATES OVERLAP DENIED INPATIENT/SNF CLAIM. . REASON CODE NOT CURRENTLY USED D7585 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . PART B LINE ITEM DME SERVICE DATES OVERLAP SNF CLAIM. . REASON CODE NOT CURRENTLY USED D7610 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . HOME HEALTH CLAIM OVERLAPS A HOSPICE PERIOD AND SERVICE DATES EQUAL OR OVERLAP HOSPICE CLAIM (REGARDLESS OF DIAGNOSIS). . REASON CODE NOT CURRENTLY USED D7611 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 033 CODE EXTERNAL NARRATIVE D7611 DUPLICATE CLAIM WITH DIFFERENT DCN NUMBER . REASON CODE NOT CURRENTLY USED D7612 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DUPLICATE CLAIM WITH DIFFERENT DCN NUMBER. . REASON CODE NOT CURRENTLY USED D7613 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DUPLICATE CLAIM WITH DIFFERENT DCN NUMBER. . REASON CODE NOT CURRENTLY USED D7614 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DUPLICATE CLAIM WITH DIFFERENT DCN NUMBER. . REASON CODE NOT CURRENTLY USED D7615 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7616 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DUPLICATE CLAIM WITH DIFFERENT DCN NUMBER. . REASON CODE NOT CURRENTLY USED D7620 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7621 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. . REASON CODE NOT CURRENTLY USED D7622 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. . REASON CODE NOT CURRENTLY USED D7623 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 034 CODE EXTERNAL NARRATIVE D7623 . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. . REASON CODE NOT CURRENTLY USED D7624 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. . REASON CODE NOT CURRENTLY USED D7625 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. . REASON CODE NOT CURRENTLY USED D7626 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. . REASON CODE NOT CURRENTLY USED D7630 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7631 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7632 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7633 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 035 CODE EXTERNAL NARRATIVE D7634 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7635 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7636 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7640 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7641 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPCS CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7642 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPCS CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7643 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPCS CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 036 CODE EXTERNAL NARRATIVE D7644 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPCS CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7645 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPCS CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7646 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPCS CODES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7651 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE CHARGES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7652 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE CHARGES ARE DIFFERENT. . REASON CODE NOT CURRENTLY USED D7653 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7654 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7655 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7656 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7661 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 037 CODE EXTERNAL NARRATIVE D7661 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENTINTERMEDIARIES. . REASON CODE NOT CURRENTLY USED D7662 . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENTINTERMEDIARIES. . REASON CODE NOT CURRENTLY USED D7663 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENTINTERMEDIARIES. . REASON CODE NOT CURRENTLY USED D7664 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENTINTERMEDIARIES. . REASON CODE NOT CURRENTLY USED D7665 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENTINTERMEDIARIES. . REASON CODE NOT CURRENTLY USED D7666 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENTINTERMEDIARIES. . REASON CODE NOT CURRENTLY USED D7701 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED D7702 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED D7703 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 038 CODE EXTERNAL NARRATIVE D8100 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D8101 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . CATARACT EXTRACTION IS BILLED MORE THAN TWICE. . REASON CODE NOT CURRENTLY USED D9990 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . CATARACT EXTRACTION IS BILLED MORE THAN TWICE. . REASON CODE NOT CURRENTLY USED D9991 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . CATARACT EXTRACTION IS BILLED MORE THAN TWICE. . REASON CODE NOT CURRENTLY USED D9992 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . CATARACT EXTRACTION IS BILLED MORE THAN TWICE. . REASON CODE NOT CURRENTLY USED EA001 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA002 THE HEALTH CARE FINANCING ADMINISTRATION RECORDS INDICATE THE BENEFICIARY IDENTIFICATION NUMBER IS INVALID. PLEASE VERIFY THE BENEFICIARY'S HEALTH INSURANCE CLAIM (HIC) NUMBER AND SUBMIT A NEW CLAIM. EA003 THE HEALTH CARE FINANCING ADMINISTRATION RECORDS INDICATE THE BENEFICIARY IDENTIFICATION NUMBER IS INVALID. PLEASE VERIFY THE BENEFICIARY'S HEALTH INSURANCE CLAIM (HIC) NUMBER AND SUBMIT A NEW CLAIM. EA004 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA005 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA006 INVALID DATE OF BIRTH; CORRECT AND PF9 (STORE THE CLAIM) EA007 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA008 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 039 CODE EXTERNAL NARRATIVE EA009 FOR FISCAL INTERMEDIARY USE ONLY, NO PROVIDER ACTION NEEDED. EA010 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA011 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA021 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA022 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA023 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA024 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA025 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA026 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA027 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA028 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA029 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA030 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA031 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA033 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA034 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA035 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA036 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA037 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA038 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA039 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. EA040 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 040 CODE EXTERNAL NARRATIVE EA041 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EHIC# FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - CWF RESPONSE DISPOSITION CODE ER-CONSISTENSY EDIT REJECT ERT01 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - CWF RESPONSE DISPOSITION CODE ER-CONSISTENSY EDIT REJECT ET001 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. ET002 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. ET003 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. ET004 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. ET006 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. ET007 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. ET008 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION ER TRAILER 08 RECEIVED . REASON CODE NOT CURRENTLY USED ET009 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION ER TRAILER 08 RECEIVED . REASON CODE NOT CURRENTLY USED ET011 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION ER TRAILER 08 RECEIVED . REASON CODE NOT CURRENTLY USED ET012 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION ER TRAILER 08 RECEIVED . REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 041 CODE EXTERNAL NARRATIVE ET016 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . DISPOSITION ER TRAILER 08 RECEIVED . REASON CODE NOT CURRENTLY USED ET018 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . CWF DISPOSITION ER, TRAILER 18 RECEIVED . REASON CODE NOT CURRENTLY USED ET023 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - DISPOSITION ER RECEIVED WITH TRAILER 23 EXMPT FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED E0011 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - INVALID ACTION CODE E0012 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - CWF ACTION CODE '7' IS ONLY ALLOWED ON OUTPATIENT AND HOME HEALTH CLAIMS FOR THE PURPOSE OF POSTING TO 'HISTORY ONLY'. E0013 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CABG DEMONSTRATION NUMBER '06' IS PRESENT BUT THE ADMISSION DATE IS BEFORE 05/01/1997, OR PARTICIPATING CENTER OF EXCELLENCE DEMONSTRATION NUMBER '07' IS PRESENT BUT THE ADMISSION DATE IS BEFORE 10/01/1997. OR '11D' AND THE ADMISSION DATE IS BEFORE 01/01/2002. OR DEMO NUMBER '08' IS PRESENT AND OTHER THAN TOB '11A' OR '11D' AND ADMISSION DATE IS BEFORE 01/01/2002. E0014 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. * DEMO REASON CODE-NA TO MUTUAL * M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 042 CODE EXTERNAL NARRATIVE E0014 DEMONSTRATIONNUMBERSOTHERTHAN'03','05', '06','07','08','15','30','31','38','39','40''44',46, '48'OR'49'AREINVALID E0015 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. * DEMO REASON CODE-NA TO MUTUAL * A CLAIM IS SUBMITTED AS AN ESRD MANAGED CARE DEMONSTRATION CLAIM BUT DEMO NUMBER IS NOT REPORTED. E0016 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. * DEMO REASON CODE-NA TO MUTUAL * INPATIENT CLAIM WITH PROVIDER NUMBER 670899 OR 674499 DEMONSTRATION NUMBER 31 IS NOT PRESENT OR INPATIENT CLAIM WITH DEMONSTRATION NUMBER 31 AND THE PROVIDER NUMBER IS NOT 670899 OR 674499 OR OUTPATIENT (12X, 13X, OR 14X) CLAIM PROVIDER NUMBER '670899' OR '674499' AND THE DEMOSTRATION NUMBER '31' IS NOT PRESENT OR OUTPATIENT (12X, 13X, OR 14X) CLAIM WITH DEMOSTRATION NUMBER '31' AND THE PROVIDER NUMBER IS NOT '670899' OR '674499' (F6) OR OUTPATIENT (12X, 13X, OR 14X) CLAIM WITH DEMOSTRATION NUMBER '31', PROVIDER NUMBER IS '670899' OR '674499' AND CONTRACTOR NUMBER IS NOT EQUAL TO '00400'. E0017 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. * DEMO REASON CODE-NA TO MUTUAL * DEMONSTRATION NUMBER 31 IS ALLOWED ON INPATIENT CLAIMS TYPE OF BILL 11X OR 18X OR OUTPATIENT CLAIMS TYPE OF BILL 12X, 13X OR 14X. E0018 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. * DEMO REASON CODE-NA TO MUTUAL * CLAIM IS SUBMITTED WITH DEMONSTRATION NUMBER M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 043 CODE EXTERNAL NARRATIVE E0018 31, AND THE ACTION CODE IS NOT EQUAL TO 1. E0019 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - DEMO NUMBER '07' (PARTICIPATING CENTERS OF EXCELLENCE) '08' (PROVIDER PARTNER SHIP) IS PRESENT WITH CONDITION CODE 'B1'. E0020 THE CANCEL-ONLY ADJUSTMENT BILL DOES NOT CONTAIN THE REASON CODE OR CONTAINS A CODE OTHER THAN 'A', 'B', 'C', 'D', 'E', 'F', 'H', 'P', OR 'S'. - FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0021 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - A DEMONSTRATION CLAIM IS SUBMITTED THAT HAS DATA ELEMENTS THAT SATISFY MORE THAN ONE DEMONSTRATION PROJECT. E0022 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID CANCEL ONLY CODE FOR A HOME HEALTH RECORD. E0042 CREDIT ADJUSTMENT IS REJECTED BECAUSE DEBIT FAILED; CWF ERROR RECEIVED IN CONJUNCTION WITH A "ER" CWF ERROR (SUCH AS 6101) ON COORDINATING RECORD. - FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0043 SPECIAL LOCATION FOR LTR CLAIMS - FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0044 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0045 FOR FI USE ONLY - THE MASS ADJUSTMENT INDICATOR MUST BE VALUED 'M' OR 'O' ON MASS ADJUSTMENT CLAIMS (TYPE-OF-BILL FREQUENCY 'F', 'G', 'H', 'I', 'J', 'K', 'L','M', 'N', 'O' OR 'P'). IF THE CLAIM IS NOT A MASS ADJUSTMENT, THE MASS ADJUSTMENT INDICATOR MUST BE BLANK. E0046 FOR FI USE ONLY - AN INVALID VALUE OR ACTION CODE HAS BEEN ENTERED FOR M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 044 CODE EXTERNAL NARRATIVE E0046 THE CLAIM ADJUSTMENT FIELD. E0047 AN INVALID VALUE HAS BEEN ENTERED FOR THE 'LIAB IND' FIELD. . FOR INTERMEDIARY USE ONLY - NO PROVIDER ACTION REQUIRED E0048 AN INVALID VALUE HAS BEEN ENTERED FOR THE 'LIAB IND' FIELD. . FOR INTERMEDIARY USE ONLY - NO PROVIDER ACTION REQUIRED E0049 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0051 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0401 THE TYPE OF BILL (TOB) IS INVALID, IS INCONSISTENT WITH THE PROVIDER NUMBER, OR THE TYPE OF BILL (TOB). CODE PRESENT IS NOT ALLOWED FOR REVENUE CODE 403 (CMS MANUAL 3873.2) **************************** BILL TYPE CODE PROVIDER NUMBER RANGE ============== ================================ 11X HOSPITAL INPATIENT PART A 0001-0999, 000E-999E, 000F-999F, 1200-1299, 1300-1399, 2000-2299, 3025-3099, 3300-3399, 4000-4499, M000-M999, R000-R999 S000-S999, T000-T999, V000-V999 12X HOSPITAL INPATIENT PART B SAME AS 11X, W000-W999 13X HOSPITAL OUTPATIENT SAME AS 11X, 1800-1989, 2300-2499 (EXCEPT M000-M999, R000-R999, 1300-1399) 14X HOSPITAL OTHER PART B SAME AS 11X, 1800-1989 (EXCEPT M000-M999, R000-R999) 18X HOSPITAL SWING BED U000-U999, W000-W999, Y000-Y999, Z300-Z399, 1300-1399 21X SNF INPATIENT 5000-6499, 22X SNF INPATIENT PART B 1800-1989, 5000-6499, W000-W999, Z300-Z399 23X SNF OUTPATIENT 5000-6499 71X RURAL HEALTH CLINIC 3400-3499, 3976-3999, 8500-8999 72X ESRD CLINIC 1200-1299, 2300-2999, 3300-3399, 3500-3799 74X CLINIC OPT VALID PRIOR 4500-4599 TO 1990 ONLY VALID AFTER 9/30/1991 4600-4799, 4900-4999 THRU 3/31/1997 ONLY VALID ANYTIME 6500-6899, 6900-6989 75X CORF 3200-3299, 4500-4599, 4800-4899, M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 045 CODE EXTERNAL NARRATIVE E0401 6500-6989 76X COMMUNITY MENTAL 1400-1499, 4600-4799, 4900-4999 HEALTH CENTER 83X ASC PAYMENT LIMIT SAME AS 11X, (EXCEPT 1300-1399) 85X RURAL PRIMARY CARE 1300-1399 HOSPITAL (RPCH) **TO CORRECT YOUR CLAIM** CORRECT THE TYPE OF BILL ON PAGE 1 AND F9 --OR-- CORRECT THE PROVIDER NUMBER ON PAGE 3 AND F9. * IF A 13X WAS PROCESSED WITH A CAH PROVIDER NUMBER (XX1300-XX1399), AND AN ADJUSTMENT NEEDS TO BE DONE, YOU WILL NEED TO CANCEL THE CLAIM AND REPROCESS WITH THE CORRECT INFORMATION. -FOR MORE INFORMATION REVIEW PUB 100-4, CHAPTER 25. E0402 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - A HOSPICE LATE CHARGE CLAIM WITH TOB 815 OR 825 IS RECEIVED WITHOUT A REVENUE CODE 0657; OR REVENUE 0657 IS PRESENT WITH REVENUE CODES OTHER THAN 0657. TOB 815 OR 825 IS VALID WHEN 0657 IS THE ONLY REVENUE CODE PRESENT. E0406 FOR MAMMOGRAPHY BILLS WITH A FROM DATE AFTER 12/31/1990, THE HCPCS CODE IS '76092', A FROM DATE AFTER 04/01/2001, THE VALID HCPCS CODES ARE '76092', 'G0202', AND 'G0203', A FROM DATE OF SERVICE AFTER 01/01/2002, THE VALID HCPCS CODES ARE '76085', '76092', 'G0202', AND 'G0203'. FOR MAMMOGRAPHY BILLS WITH A FROM DATE 01/01/07 AND AFTER, THE HCPCS CODES ARE 77052, 77057, G0202 AND G0203. **TO CORRECT THE CLAIM** CLAIMS WITH A FROM DATE AFTER 123190: UPDATE THE HCPCS CODE TO BE 76092 ON PAGE 2 AND F9. CLAIMS WITH A FROM DATE AFTER 040101: UPDATE THE HCPCS CODE TO BE 76092, G0202 OR G0203 ON PAGE 2 AND F9. CLAIMS WITH A DATE OF SERVICE AFTER 010102: UPDATE THE HCPCS CODE TO BE 76085, 76092, G0202 OR G0203 ON PAGE 2 AND F9. CLAIMS WITH A DATE OF SERVICE AFTER 010107: UDPATE THE HCPCS CODE TO BE 77052, 77057, G0203 OR G0203 ON PAGE 2 AND F9. -FOR MORE INFORMATION REVIEW CR 5327 E0407 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE NOT CURRENTLY USED. - BILL TYPE NOT 34X BUT REVENUE CODE 66X IS PRESENT. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 046 CODE EXTERNAL NARRATIVE E0408 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REVENUE CODE 0403 INVALID FOR BILL TYPE 71X WITH PROVIDER RANGE 3800-3974. E041A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - TYPE OF BILL IS '11A' OR '11D' AND DEMO NUMBER '07' OR '08' IS NOT PRESENT. E0410 **TO CORRECT YOUR CLAIM** CHANGE REVENUE CODE 0250 TO 0636 AND F9. -FOR MORE INFORMATION REVIEW PUB 100-4, CHAPTER 17, SECTION 80. E0411 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. . REASON CODE NOT CURRENTLY USED E0412 ACCOMMODATION REVENUE CODES 10X THRU 21X ARE NOT ALLOWED ON INPATIENT LATE CHARGE BILLS. **TO CORRECT YOU CLAIM** GO TO PAGE TWO AND CORRECT REV CODES OR CHANGE BILL TYPE ON PAGE ONE. E0413 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIM CONTAINS A CABG OR PARTICIPATING CENTER OF EXCELLENCE OR PROVIDER PARTNERSHIP DEMONSTRATION NUMBER WHICH IS ONLY VALID FOR TYPE OF BILL '11X'. E0414 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. . BILL TYPE 81X OR 82X WITH REVENUE CODE 651 OR 652 IS SUBMITTED WITH CLAIM STATEMENT FROM DATE 10/01/97 OR AFTER AND VALUE CODE 61 IS NOT PRESENT AND/ OR THE MSA CODE (VALUE AMOUNT FIELD) IS NOT GREATER THAN ZERO. OR BILL TYPE 32X, 33X OR 34X SUBMITTED WITH STATEMENT FROM DATE 10/01/97 OR AFTER AND VALUE CODE 61 IS ENTERED BUT THE CORRESPONDING MSA CODE IS NOT PRESENT. E0415 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - THE RIC MUST BE 'W' IF THE TYPE OF BILL CODE IS '32X', AND 'V' IF TYPE OF BILL CODE IS '33X', UNLESS RIC IS 'U', THEN ALLOW EITHER TYPE OF BILL '32X' OR '33X'. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 047 CODE EXTERNAL NARRATIVE E0416 INVALID TYPE OF BILL FOR REVENUE CODE 0022. * CORRECT AND RESUBMIT. E0417 REVENUE CODE '0023' IS ONLY VALID WITH TYPE OF BILL '32X' OR '33X' WITH DATES OF SERVICE ON OR AFTER 10/1/00. ***TO CORRECT CLAIM*** EITHER CORRECT BILL TYPE ON PAGE ONE OR CORRECT REVENUE CODE 0023 ON PAGE TWO AND F9 THE CLAIM E0418 TYPE OF BILL '3X5' IS NOT ALLOWED FOR DATES OF SERVICE ON, OR AFTER, 10/1/00. ***TO CORRECT CLAIM*** ON PAGE ONE YOU SHOULD CORRECT BILL TYPE AND STORE. E0419 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID RIC BASED ON VALUE CODE SUBMITTED. E0701 PROVIDER NUMBER POSITIONS 1-2 NOT NUMERIC. **TO CORRECT YOUR CLAIM** CORRECT PROVIDER NUMBER ON PAGE THREE AND F9 THE CLAIM. E0702 MEDICARE PROVIDER NUMBER MUST BE CONSISTENT WITH BILL TYPE AND BE IN A VALID RANGE AS DEFINED TOB VALID PROVIDER RANGES POS 3 - 6 OR POS 3 OR POS 6 === ================================ ======== ===== 11X 0001-0999, 1200-1399, 2000-2299, S,T OR V E OR F 3025-3099, 3300-3399, 4000-4499 12X 0001-0999, 1200-1399, 2000-2299, S,T,OR V E OR F 3025-3099, 3300-3399, 4000-4499 13X 0001-0999, 1200-1299, 1800-1989, V E OR F 2000-2299, 3025-3099, 3300-3399, 4000-4499 14X 0001-0999, 1200-1399, 1800-1989, V E OR F 2000-2299, 3025-3099, 3300-3399, 4000-4499 18X Z300-Z399 U,W OR Y (F6) 21X 5000-6499 Y 22X 1800-1989, 5000-6499 W 23X 5000-6499 M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 048 CODE EXTERNAL NARRATIVE E0702 24X 5000-6499 28X 5000-6499, Z300-Z399 U OR Y 32X 1800-1989, 3100-3199, 7000-8499, 9000-9499 33X 1800-1989, 3100-3199, 7000-8499, 9000-9499 34X 1800-1989, 3100-3199, 7000-8499, 9000-9499 41X 1990-1999 51X 6990-6999 71X 3400-3499, 3800-3999, 8500-8999 72X 0001-0999, 1200-1299, 2300-2999, (F6) 3300-3399, 3500-3799 73X 1800-1989 74X PRIOR TO 1990 4500-4999 VALID 10/1/91 THRU 3/31/97 ONLY 4600-4799, 4900-4999 VALID ANYTIME 6500-6989 75X 3200-3299, 4500-4599, 4800-4899, 6500-6989 76X 4600-4799, 4900-4999 81X 1500-1799 82X 1500-1799 83X VALID PRIOR TO 8/1/00 FOR 0001-0999, 1200-1299, 2000-2299, V E OR F 3025-3099, 3300-3399, 4000-4499 (F6) 83X VALID ON OR AFTER 8/1/00 FOR MARYLAND HOSPITALS INDIAN HEALTH SERVICE, AMERICAN SAMOA, GUAM, SAIPAN HOSPITALS,EMERGENCY DOMESTIC/NON PARTICIPATING, FOREIGN AND ON OR AFTER 1/1/02, FOR VIRGIN ISLAND PROVIDERS. 85X 1300-1399, 1800-1989 E0703 INVALID SEX CODE FOR A SCREENING MAMMOGRAPHY CLAIM. **TO CORRECT THE CLAIM** UPDATE THE SEX CODE ON PAGE 1 AND F9. -OR- UPDATE THE REVENUE CODE AND/OR HCPCS CODE ON PAGE 2 AND F9. -OR- KEY A "Y" AND THE CORRECT HIC NUMBER IN THE "PROCESS NEW HIC" FIELD ON PAGE 1 AND F9. -FOR MORE INFORMATION REVIEW PUB 100-4, CHAPTER 18, SECTION 20. E1001 THE PRO APPROVAL INDICATOR OR CONDITION CODE IS INCORRECT OR INVALID. CORRECT AND RESUBMIT. E1501 ADMISSION DATE IS IMPOSSIBLE, OR INCOMPLETE. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 049 CODE EXTERNAL NARRATIVE E1501 EFFECTIVE FOR DATES OF SERVICE 10/01/05 AND AFTER THIS REASON CODE IS APPLICABLE TO 12X AND 22X ROSTER BILLS WITH CONDITION CODE M1. **TO CORRECT YOUR CLAIM** CORRECT YOUR ADMISSION DATE ON PAGE ONE AND F9 THE CLAIM. E1502 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E1503 FOR SNF CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, THE DATE OF ADMISSION IS MORE THAN 30 DAYS AFTER THE "THRU" DATE OF THE QUALIFYING HOSPITAL STAY AND THERE IS NO CONDITION CODE 55, 56 OR 57 PRESENT. E1504 THE ADMISSION OR STAY COVERED FROM OR THRU DATE FOR ANIS GREATER THAN THE CURRENT DATE. . CORRECT AND RESUBMIT E1505 INPATIENT CLAIM WITH BLOOD CLOTTING FACTOR HCPCS (J7190, J7192, J7194 OR OR J7196) AND THE DATE OF SERVICE BILLED IS AFTER 09/30/94. PLEASE CORRECT AND RESUBMIT. . REASON CODE NOT CURRENTLY USED E1801 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E1803 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E2101 INVALID OR MISSING VALUE IN PATIENT STATUS FIELD OF CLAIM. CORRECT AND RESUBMIT IF APPROPRIATE. E2102 PATIENT STATUS CODE IS INCORRECT FOR THIS TYPE OF BILL. CORRECT AND RESUBMIT IF APPROPRIATE. E2103 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E2201 THE STATEMENT "FROM" DATE IS IMPOSSIBLE OR INCOMPLETE. **TO CORRECT YOUR CLAIM** CORRECT STATEMENT FROM DATE ON PAGE ONE AND F9 THE CLAIM E2202 THE STAY COVERED FROM DATE IS LATER THAN THE COVERED THRU DATE FOR AN ENCOUNTER CLAIM. - CORRECT THE FROM AND THROUGH DATE E2203 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 050 CODE EXTERNAL NARRATIVE E2203 REASON CODE NOT CURRENTLY USED. - THE STATEMENT "THRU" DATE IS AN IMPOSSIBLE OR INCOMPLETE ENTRY. NOTE: THIS EDIT IS PERFORMED ON HOSPICE NOTICE OF TERMINATION ONLY (BILL TYPES 81B AND 82B). E2204 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. * THE STATEMENT "FROM" DATE ON THIS BILL IS PRIOR TO THE EFFECTIVE DATE OF THIS ASPECT OF THE MEDICARE PROGRAM: 1. EGHP (VALUE CODE 12) A. WORKING AGED 01/01/83 B. ESRD BENEFICIARY (VAL CD 13) IN 12 MONTH COORDINATION PERIOD 10/01/81 2. CORF 07/01/81 3. HOSPICE 11/01/83 4. PPS 10/01/83 E2205 OUTPATIENT CLAIM WITH FROM DATE YEAR NOT THE SAME AS THRU DATE YEAR. . CORRECT AND RESUBMIT E2206 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID DATES OF SERVICE. THE STAY COVERED THRU DATE FOR AN ENCOUNTER CLAIM (TYPE OF BILL XXZ) IS BEFORE 07/01/97 OR THE DISCHARGE DATE ON AN IME/GME (CONDITION CODE 69) RECORD IS BEFORE 1/1/98. E2207 MAMMOGRAPHY BILL FIRST SERVICE DATE ON CLAIM, OR FIRST SPAN CODE '72' DATE MUST BE EQUAL TO, OR GREATER THAN, 01/01/1991. * CORRECT AND RESUBMIT. E2208 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E2209 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - HOME HEALTH CLAIM DATES OF SERVICE OVERLAP JULY 1, 1999, -OR- HOME HEALTH CLAIM DATES OF SERVICE OVERLAP OCOTBER 1, 2000. E2210 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 051 CODE EXTERNAL NARRATIVE E2210 - REASON CODE NOT CURRENTLY USED. - HOSPICE NOTICE OF ELECTION TYPE 8XA WITH ACTION CODE OF 2 OR 8XB WITH ACTION CODE 2 AND FIELD 29 DOES NOT CONTAIN A VALID MMDDYY ENTRY.THIS FIELD SHOULD CONTAIN THE ORIGINAL HOSPICE ELECTION PERIOD START DATE FOR BILL TYPE 8XA OR THE ORIGINAL HOSPICE REVOCATION DATE FOR 8XB. E2211 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - A RNHCI NOTICE OF ELECTION (41A), NOTICE OR REVOCATION (41B), OR NOTICE OF CANCELLATION (41D) AND THE ADMISSION DATE IS PRIOR TO JULY 1, 2000. E2212 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - TYPE OF BILL '51X' AND THE DATES OF SERVICE ARE ON, OR AFTER, JULY 1, 2000. E2213 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - TYPE OF BILL '32X' OR '33X' SHOULD NOT BE GREATER THAN 60 DAYS, WHEN THE DATES OF SERVICE ARE ON, OR AFTER, OCTOBER 1, 2000. E2214 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - A MCCD/DMD NOTICE OF ELECTION (89A), MCCD/DMD NOTICE FO REVOCATION (89B) OR MCCD/DMD NOTICE OF CANCELLATION (89D) AND THE FROM DATE IS PRIOR TO JANUARY 1, 2001. E2215 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E2216 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E2217 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E2301 BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 A BILL CONTAINS AN UTILIZATIONDAYS ENTRY OTHER THAN A NUMBER. A HOSPITAL BILL EXCEEDS 150 DAYS. A SNF BILL CONTAINS AN ENTRY OTHER THAN M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 052 CODE EXTERNAL NARRATIVE E2301 A NUMBER BETWEEN 0 AND 101 (BETWEEN 0 AND 31 FOR SNF CHRISTIAN SCIENCE). BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89: -- SNF CLAIMS BILLED FOR MORE THAN A MONTH WILL BE RETURNED FOR CORRECTION. PLEASE SPLIT THE BILL INO MONTHLY INCREMENTS AND RESUBMIT. E2302 THE SUM OF UTILIZATION DAYS PLUS NON-UTILIZATION DAYS MUST EQUAL THE DIFFERENCE BETWEEN THE THRU DATE MINUS THE FROM DATE IN THE STATEMENT COVERS PERIOD. CORRECT AND RESUBMIT AND RESUBMIT IF APPROPRIATE. E2303 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E2304 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - NO UTILIZATION DAYS ARE SHOWN ON PATIENT FILED BILL. E2305 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E2306 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - UTILIZATION DAYS ARE SHOWN AS "0", THE "STATEMENT COVERS PERIOD FROM DATE" IS NOT THE SAME AS THE "THRU DATE", A NON-PAYMENT CODE IS PRESENT, AND SOME REIMBURSEMENT IS BEING MADE. (DOES NOT APPLY TO CREDIT OR CANCEL ONLY ADJUST- MENT BILL). E2307 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. * SAME-DAY TRANSFER CLAIM WITH CONDITION CODE '40', CONTAINS EITHER INPATIENT ADMIT DATE NOT EQUAL TO INPATIENT STAY FROM DATE OR INPATIENT ADMIT DATE NOT EQUAL TO INPATIENT STAY THRU DATE OR UTILIZATION DAYS GREATER THAN '0', OR VALUE CODE 'A1', '08', OR '09', OR PATIENT STATUS IS NOT EQUAL TO '02', '03', '05', '50', '51', '61', '62', '63', '64', '65', '66', '71', OR '72'. E2308 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. * NO-PAY CODE OF 'R' MUST HAVE UTILIZED DAYS. UTILIZATION DAYS ARE SHOWN AS '0'; THE ADMISSION DATE IS NOT THE SAME AS THE THRU DATE; THE PATIENT STATUS IS NOT '02', '03', '05', '61', '62', '63', '64', '65', '66', OR '72'; AND THE NON-PAYMENT CODE IS 'R'. E2401 * NONUTILIZATION DAYS ENTRY CONTAINS AN ENTRY OTHER THAN A NUMBER. * M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 053 CODE EXTERNAL NARRATIVE E2401 CORRECT AND RESUBMIT. E2501 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E2502 COINSURANCE OR LIFETIME RESERVE DAYS EXCEED THE NUMBER OF UTILIZATION DAYS INPATIENT CLAIMS - IF OCCURRENCE CODE A3, B3, OR C3 DATE IS INCORRECT ON PAGE 2, CORRECT DATE, PF9 TO UPDATE - IF CLAIM SERVICE DATES CROSS THE END OF THE YEAR: ENTER CORRECT VALUE CODES AND AMOUNTS ON PAGE 2 SNF CLAIMS - IF OCCURRENCE CODE A3 IS INCORRECT, CORRECT OR REMOVE, PF9 TO UPDATE E2503 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E2504 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E2505 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - HOSPITAL/SNF: BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/ 89, IN A HOSPITAL BILL THE NON-LIFETIME RESERVE AND/OR LIFETIME RESERVE COINSURANCE RATE APPLICABLE TO THE CALENDAR YEAR IN WHICH THE COINSURANCE DAYS AND LIFE-TIME RESERVE DAYS OCCURRED EXCEED THE AVERAGE DAILY RATE FOR THIS BILL (TOTAL CHARGES - NONCOVERED CHARGES / UTILIZATION DAYS). IN A SNF BILL, THE COINSURANCE RATE APPLICABLE TO THE CALENDAR YEAR IN WHICH THE COINSURANCE DAYS OCCURRED EXCEEDS THE AVERAGE DAILY RATE FOR THIS BILL. SNF BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, IN A SNF BILL THE COINSURANCE RATE APPLIES TO THE CALENDR YEAR IN WHICH THE COINSURANCE DAYS OCCURRED, EXCEED THE AVERAGE DAILY RATE FOR THE BILL. THIS WILL ONLY BE DONE FOR SNF BILLS WHICH DO NOT SPAN 2 YEARS. E2506 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E2507 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E2508 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - BILLS WITH DATES OF SERVICE PRIOR TO 010189 AND AFTER 123189. COINSURANCE DAYS AND/OR LIFETIME RESERVE DAYS SHOULD NOT BE APPLIED TOWARD UTILIZATION DAYS FOR BILLING DATES FROM 010189 89 THRU 123189. E2601 LIFETIME RESERVE DAYS CAN ONLY BE BILLED ON BILL TYPE 11X, MUST BE NUMERIC, AND CANNOT BE GREATER THAN 60. CORRECT AND RESUBMIT. E2602 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 054 CODE EXTERNAL NARRATIVE E2603 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E2604 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED E2605 THE LIFETIME RESERVE RATE APPLIED, EXCEEDS THE AVERAGE DAILY RATE FOR THE BILL. (TOTAL CHARGES LESS NON-COVERED CHARGES) DIVIDED BY THE GREATER OF UTILIZATION DAYS OR COST REPORT DAYS. - FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E28#A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 'UTILIZATION DAYS' ARE GREATER THAN THE NUMBER OF DAYS FROM THE 'FROM DATE' THROUGH THE 'DATE BENEFITS EXHAUSTED' AND ON A HOSPITAL BILL, 'DATE GUARANTEE OF PAYMENT BEGAN' IS NOT PRESENT. CLAIMS WITH DATES OF SERVICE BETWEEN 01/0/89 AND 12/31/89 FOR SNF AND PSYCH- IATRIC BILLS THE EDIT REMAINS THE SAME. FOR HOSPITAL CLAIMS THAT SPAN 88-89, THE EDIT WILL ONLY APPLY TO FIRST-YEAR DAYS (UP TO 12/31/88). "FIRST YEAR UTILIZATION DAYS" ARE GREATER THAN THE NUMBER OF DAYS FROM THE 'FROM DATE' THROUGH THE 'BENEFITS EXHAUSTED DATE'. E28#B FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E28#C DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3) IS NOT GREATER THAN THE FROM DATE AND THE BILL TYPE IS EQUAL TO 12X, 22X OR 71X. **TO CORRECT YOUR CLAIM** - REMOVE OCCURRENCE CODE A3, B3 AND/OR C3 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE E28#D THE DATE OF OCCURRENCE CODE (A3, B3, OR C3 ON A PPS CLAIM IS NOT EQUAL TO THE THRU DATE OF THE OCURRENCE SPAN CODE '70' DATE. **TO CORRECT YOUR CLAIM** INPATIENT: VERIFY BENEFITS APPLIED ON CLAIM. IF BENEFITS HAVE BEEN APPLIED INCORRECTLY (EX. FULL, COINS, LTR, 70 SPANS, BENEFIT EXHAUST DATE): CORRECT FULL, COINS, LTR DAYS, 70 SPANS OR BENEFITS EXHAUST DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE E28#E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. * OCCURRENCE CODE (A3, B3, OR C3 IN ANY COMBINATION) IS PRESENT ON THE CLAIM. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 055 CODE EXTERNAL NARRATIVE E28#L MORE THAN ONE OCCURRENCE CODE 20 ON CLAIM. **TO CORRECT CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE E28#M FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. * REASON CODE NOT CURRENTLY USED. * THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28#N CLAIM INDICATES BENEFITS ARE EXHAUSTED BUT THE OCCURRENCE CODE IS INCORRECT. PRIMARY CLAIMS - OCCURRENCE CODE SHOULD BE A3 SECONDARY CLAIMS - OCCURRENCE CODE SHOULD BE B3 TERTIARY CLAIMS - OCCURRENCE CODE SHOULD BE C3 OUTPATIENT CLAIMS DO NOT REQUIRE A BENEFITS EXHAUST OCCURRENCE CODE. CORRECT AND RESUBMIT IF APPROPRIATE. E28#O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28#P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28#0 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/1989 OR AFTER 12/31/89, AND BENEFITS EXHAUSTED DATE IS OUTSIDE THE STATEMENT COVERS PERIOD DATES. OR CLAIMS WITH DATES OF SERVICE BETWEEN 01/01/1989 AND 12/31/1989 NON-PSYCH- IATRIC HOSPITAL BILLS THE BENEFIT EXHAUST DATE IS GREATER THAN 12/31/1988 OR PRIOR TO 01/01/1990. FOR SNF AND PSYCHIATRIC BILLS THE EDIT REMAINS THE SAME. E28#1 OCCURRENCE CODE MUST BE BLANK OR A 2 CHARACTER CODE OF 01-99 OR A0-Z9. THE ASSOCIATED DATE MUST BE VALID AND NOT AFTER THE THRU DATE OF THE CLAIM. OCCURRENCE CODES A3, 21, 22, 26, 32 AND 42 MUST BE WITHIN THE FROM AND THRU M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 056 CODE EXTERNAL NARRATIVE E28#1 DATES OF THE CLAIM. . CORRECT AND RESUBMIT IF APPROPRIATE E28#2 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E28#3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN --HOSPITAL BILL: DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATE THAN 12/31/88. HOSPITAL BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89: PSYCH- IATRIC HOSPITAL EDIT REMAINS THE SAME. E28#4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANNOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF THE ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLIN DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. E28#5 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E28#6 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3, OR C3). E28#7 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 057 CODE EXTERNAL NARRATIVE E28#7 HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSUARNCE AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCH- IATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88 , UNLESS THE PATIENT STATUS CODES IS 30 (STILL PATIENT) IN WHICH CASEIT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAY- MENT BEGAN MUST BE LATER THAN 12/31/89. E28#8 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - HOSPITAL/SNF: DATE ACTIVE CARE ENDED - THIS DATE IS OUTSIDE THE STATEMENT COVERS PERIOD DATES. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE IS 1 THROUGH 0, WITH A 0 REPRESENTING THE 10TH CODE. THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS IS EQUAL TO C, N OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. E28#9 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. E28AD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28AE **TO CORRECT THE CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28AF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28AM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 058 CODE EXTERNAL NARRATIVE E28AM - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28AO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28AP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28A1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28A8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28BD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 059 CODE EXTERNAL NARRATIVE E28BD PUB 100-4, CHAPTER 25, SECTION 60. E28BE **TO CORRECT THE CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28BF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28BM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28BO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28BP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28B1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28B8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 060 CODE EXTERNAL NARRATIVE E28B8 CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28CD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28CE **TO CORRECT THE CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28CF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28CM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28CO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28CP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 061 CODE EXTERNAL NARRATIVE E28C1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28C8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28DD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28DE **TO CORRECT THE CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28DF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28DM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 062 CODE EXTERNAL NARRATIVE E28DM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28DO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28DP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28D1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28D8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28ED **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28EE **TO CORRECT THE CLAIM** M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 063 CODE EXTERNAL NARRATIVE E28EE REMOVE THE INCORRECT OCCURRENCE CODE AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28EF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28EM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28EO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28EP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28E1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28E8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 064 CODE EXTERNAL NARRATIVE E28E8 -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28FD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28FF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28FM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28FO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28FP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28F1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 065 CODE EXTERNAL NARRATIVE E28F1 PUB 100-4, CHAPTER 25, SECTION 60. E28F8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28GD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28GF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28GM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28GO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28GP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 066 CODE EXTERNAL NARRATIVE E28G1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28G8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28HD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28HF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28HM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28HO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 067 CODE EXTERNAL NARRATIVE E28HO INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28HP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28H1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28H8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28ID **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28IF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28IM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 068 CODE EXTERNAL NARRATIVE E28IM - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28IO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28IP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28I1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28I8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28JD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 069 CODE EXTERNAL NARRATIVE E28JF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28JM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28JO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28JP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28J1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28J8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 070 CODE EXTERNAL NARRATIVE E28KD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28KF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28KM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28KO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28KP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28K1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28K8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 071 CODE EXTERNAL NARRATIVE E28K8 CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28LD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28LF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28LM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28LO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28LP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28L1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 072 CODE EXTERNAL NARRATIVE E28L1 CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28L8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28MD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28MF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28MM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28MO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28MP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 073 CODE EXTERNAL NARRATIVE E28MP - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28M1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28M8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28ND **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28NF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28NM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28NO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 074 CODE EXTERNAL NARRATIVE E28NO - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28NP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28N1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28N8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28OD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28OF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 075 CODE EXTERNAL NARRATIVE E28OM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28OO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28OP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28O1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28O8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28PD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 076 CODE EXTERNAL NARRATIVE E28PD HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28PF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28PM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28PO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28PP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28P1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28P8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 077 CODE EXTERNAL NARRATIVE E28P8 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28QD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28QF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28QM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28QO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28QP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28Q1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 078 CODE EXTERNAL NARRATIVE E28Q8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28RD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28RF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28RM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28RO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28RP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28R1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 079 CODE EXTERNAL NARRATIVE E28R1 NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28R8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28SD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28SF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28SM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28SO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 080 CODE EXTERNAL NARRATIVE E28SP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28S1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28S8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28TD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28TF FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E28TM FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 081 CODE EXTERNAL NARRATIVE E28TM CLAIM. E28TO FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E28TP FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28T1 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28T8 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28UD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28VD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 082 CODE EXTERNAL NARRATIVE E28VD ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28WD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28XD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28XL **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28YD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E28ZD **TO CORRECT THE CLAIM** UPDATE THE OCCURRENCE CODE ON PAGE 1 TO EQUAL THE THRU DATE OF THE 70 OCCURR- ENCE CODE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E280A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E280B DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3 IS GREATER THAN THE THE FROM DATE. **TO CORRECT YOUR CLAIM** UPDATE THE OCCURRENCE CODE A3, B3 OR C3 ON PAGE 1 SO IT IS NOT GREATER THAN M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 083 CODE EXTERNAL NARRATIVE E280B THE FROM DATE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E280C THE DATE BENEFITS EXHAUSTED IS SHOWN FOR OTHER THAN AN INPATIENT ANCILLARY CLAIM (12X OR 22X). CORRECT AND RESUBMIT. E280D AN OCCURRENCE CODE A3, B3, OR C3 IS PRESENT ON A PPS CLAIM WITH OCCURRENCE SPAN CODE 70 WITH NO CONDITION CODE 60/61 OR THE OCCURRENCE CODE A3, B3 OR C3 DATE IS NOT EQUAL TO THE THRU DATE OF THE OCCURRENCE SPAN CODE 70. - FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E280E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. E280F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E280J FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (RESPITE CARE BILLS WITH FROM DATE AFTER 12/31/90) BENEFICIARY ELIGIBILITY DATE (OCCURRENCE CODE 47) IS GREATER THAN FIRST SERVICE DATE. E280K FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (HOME IV BILL WITH FROM DATE AFTER 12/31/90 DATE DISCHARGED ON A CONTINUOUS COURSE OF IV THERAPY (OCCURRENCE CODE 39) IS GREATER THAN FIRST SERVICE DATE. E280L **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E280M OCCURRENCE CODE 42 DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. PLEASE CORRECT AND RESUBMIT IF APPROPRIATE. E280N AN INPATIENT OR SNF CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS PRIMARY BUT THE OCCURRENCE CODE IS NOT AN A3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS SECONDARY BUT THE OCCURRENCE CODE IS NOT A B3 OR M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 084 CODE EXTERNAL NARRATIVE E280N THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS TERTIARY BUT THE OCCURRENCE CODE IS NOT A C3. **TO CORRECT YOUR CLAIM** GO TO CLAIM PAGE 1 AND CORRECT THE OCCURRENCE CODE. YOU WILL NEED TO EITHER CORRECT THE A3, B3, OR C3 OCCUR CODE OR REMOVE THE CODE. **FOR MORE INFORMATION, GO TO: HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25. E280O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E280P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E2800 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - 1) INPATIENT CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE. 2) SNF CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE OR THE DATES OF SERVICE OVERLAP A CATASTROPHIC PERIOD, AND THE THROUGH DATE IS GREATER THAN 010189 AND THE BENEFIT EXHAUST DATE IS IN 1989. E2801 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2802 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/3/189: DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE AS THIS ITEM APPLIES ONLY TO HOSPITAL BILLS. HOSPITAL/SNF: BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE ON SNF BILL AND NON- M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 085 CODE EXTERNAL NARRATIVE E2802 PSYCHIATRIC HOSPITAL BILLS. GUARANTEE OF PAYMENT ONLY APPLIES TO PSYCH HOSPITALS. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON-CODE) RE- FLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE IS 1 THROUGH 0, WITH 0 REPRESENTING THE 10TH CODE. E2803 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN -- DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE OF GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATERTHAN 12/31/88. E2804 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. E2805 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E2806 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3 OR C3). E2807 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSURANCE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 086 CODE EXTERNAL NARRATIVE E2807 AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS1 AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88, UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE IT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAYMENT BEGAN MUST BE LATER THAN 12/31/89. E2808 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. E2809 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. E281A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E281B DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3 IS GREATER THAN THE THE FROM DATE. **TO CORRECT YOUR CLAIM** UPDATE THE OCCURRENCE CODE A3, B3 OR C3 ON PAGE 1 SO IT IS NOT GREATER THAN THE FROM DATE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E281C THE DATE BENEFITS EXHAUSTED IS SHOWN FOR OTHER THAN AN INPATIENT ANCILLARY CLAIM (12X OR 22X). CORRECT AND RESUBMIT. E281D FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E281E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. E281F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E281J FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (RESPITE CARE BILLS WITH FROM DATE AFTER 12/31/90) BENEFICIARY ELIGIBILITY DATE (OCCURRENCE CODE 47) IS GREATER THAN FIRST SERVICE DATE. E281K FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 087 CODE EXTERNAL NARRATIVE E281K - OUTPATIENT: (HOME IV BILL WITH FROM DATE AFTER 12/31/90 DATE DISCHARGED ON A CONTINUOUS COURSE OF IV THERAPY (OCCURRENCE CODE 39) IS GREATER THAN FIRST SERVICE DATE. E281L **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E281M FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E281N AN INPATIENT OR SNF CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS PRIMARY BUT THE OCCURRENCE CODE IS NOT AN A3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS SECONDARY BUT THE OCCURRENCE CODE IS NOT A B3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS TERTIARY BUT THE OCCURRENCE CODE IS NOT A C3. **TO CORRECT YOUR CLAIM** GO TO CLAIM PAGE 1 AND CORRECT THE OCCURRENCE CODE. YOU WILL NEED TO EITHER CORRECT THE A3, B3, OR C3 OCCUR CODE OR REMOVE THE CODE. **FOR MORE INFORMATION, GO TO: HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25. E281O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E281P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 088 CODE EXTERNAL NARRATIVE E2810 INPATIENT CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE. SNF CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE OR THE DATES OF SERVICE OVERLAP A CATASTROPHIC PERIOD, AND THE THROUGH DATE IS GREATER THAN 010189 AND THE BENEFIT EXHAUST DATE IS IN 1989. **TO CORRECT THE CLAIM** UPDATE THE DATE ASSOCIATED WITH OCCURRENCE CODE A3 OR REMOVE THE A3 OCCURR- ENCE CODE AND DATE ON PAGE 1 AND F9. E2811 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2812 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/3/189: DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE AS THIS ITEM APPLIES ONLY TO HOSPITAL BILLS. HOSPITAL/SNF: BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE ON SNF BILL AND NON- PSYCHIATRIC HOSPITAL BILLS. GUARANTEE OF PAYMENT ONLY APPLIES TO PSYCH HOSPITALS. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON-CODE) RE- FLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE IS 1 THROUGH 0, WITH 0 REPRESENTING THE 10TH CODE. E2813 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN -- DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE OF GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATERTHAN 12/31/88. E2814 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 089 CODE EXTERNAL NARRATIVE E2814 - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. E2815 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E2816 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3 OR C3). E2817 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSURANCE AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS1 AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88, UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE IT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAYMENT BEGAN MUST BE LATER THAN 12/31/89. E2818 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 090 CODE EXTERNAL NARRATIVE E2818 -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2819 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. E282A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E282B DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3 IS GREATER THAN THE THE FROM DATE. **TO CORRECT YOUR CLAIM** UPDATE THE OCCURRENCE CODE A3, B3 OR C3 ON PAGE 1 SO IT IS NOT GREATER THAN THE FROM DATE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E282C THE DATE BENEFITS EXHAUSTED IS SHOWN FOR OTHER THAN AN INPATIENT ANCILLARY CLAIM (12X OR 22X). CORRECT AND RESUBMIT. E282D FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E282E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. E282F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E282J FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (RESPITE CARE BILLS WITH FROM DATE AFTER 12/31/90) BENEFICIARY ELIGIBILITY DATE (OCCURRENCE CODE 47) IS GREATER THAN FIRST SERVICE DATE. E282K FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (HOME IV BILL WITH FROM DATE AFTER 12/31/90 DATE DISCHARGED ON A CONTINUOUS COURSE OF IV THERAPY (OCCURRENCE CODE 39) IS GREATER THAN FIRST SERVICE DATE. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 091 CODE EXTERNAL NARRATIVE E282L **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E282M FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E282N AN INPATIENT OR SNF CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS PRIMARY BUT THE OCCURRENCE CODE IS NOT AN A3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS SECONDARY BUT THE OCCURRENCE CODE IS NOT A B3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS TERTIARY BUT THE OCCURRENCE CODE IS NOT A C3. **TO CORRECT YOUR CLAIM** GO TO CLAIM PAGE 1 AND CORRECT THE OCCURRENCE CODE. YOU WILL NEED TO EITHER CORRECT THE A3, B3, OR C3 OCCUR CODE OR REMOVE THE CODE. **FOR MORE INFORMATION, GO TO: HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25. E282O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E282P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E2820 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - 1) INPATIENT CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 092 CODE EXTERNAL NARRATIVE E2820 BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE. 2) SNF CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE OR THE DATES OF SERVICE OVERLAP A CATASTROPHIC PERIOD, AND THE THROUGH DATE IS GREATER THAN 010189 AND THE BENEFIT EXHAUST DATE IS IN 1989. E2821 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2822 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/3/189: DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE AS THIS ITEM APPLIES ONLY TO HOSPITAL BILLS. HOSPITAL/SNF: BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE ON SNF BILL AND NON- PSYCHIATRIC HOSPITAL BILLS. GUARANTEE OF PAYMENT ONLY APPLIES TO PSYCH HOSPITALS. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON-CODE) RE- FLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE IS 1 THROUGH 0, WITH 0 REPRESENTING THE 10TH CODE. E2823 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN -- DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE OF GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATERTHAN 12/31/88. E2824 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 093 CODE EXTERNAL NARRATIVE E2825 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E2826 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3 OR C3). E2827 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSURANCE AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS1 AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88, UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE IT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAYMENT BEGAN MUST BE LATER THAN 12/31/89. E2828 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 094 CODE EXTERNAL NARRATIVE E2829 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. E283A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E283B DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3 IS GREATER THAN THE THE FROM DATE. **TO CORRECT YOUR CLAIM** UPDATE THE OCCURRENCE CODE A3, B3 OR C3 ON PAGE 1 SO IT IS NOT GREATER THAN THE FROM DATE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E283C THE DATE BENEFITS EXHAUSTED IS SHOWN FOR OTHER THAN AN INPATIENT ANCILLARY CLAIM (12X OR 22X). CORRECT AND RESUBMIT. E283D FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E283E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. E283F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E283J FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (RESPITE CARE BILLS WITH FROM DATE AFTER 12/31/90) BENEFICIARY ELIGIBILITY DATE (OCCURRENCE CODE 47) IS GREATER THAN FIRST SERVICE DATE. E283K FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (HOME IV BILL WITH FROM DATE AFTER 12/31/90 DATE DISCHARGED ON A CONTINUOUS COURSE OF IV THERAPY (OCCURRENCE CODE 39) IS GREATER THAN FIRST SERVICE DATE. E283L **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 095 CODE EXTERNAL NARRATIVE E283M FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E283N AN INPATIENT OR SNF CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS PRIMARY BUT THE OCCURRENCE CODE IS NOT AN A3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS SECONDARY BUT THE OCCURRENCE CODE IS NOT A B3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS TERTIARY BUT THE OCCURRENCE CODE IS NOT A C3. **TO CORRECT YOUR CLAIM** GO TO CLAIM PAGE 1 AND CORRECT THE OCCURRENCE CODE. YOU WILL NEED TO EITHER CORRECT THE A3, B3, OR C3 OCCUR CODE OR REMOVE THE CODE. **FOR MORE INFORMATION, GO TO: HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25. E283O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E283P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E2830 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - 1) INPATIENT CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE. 2) SNF CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE OR THE DATES OF SERVICE OVERLAP A CATASTROPHIC PERIOD, AND THE THROUGH DATE IS GREATER THAN 010189 AND THE BENEFIT EXHAUST DATE IS IN 1989. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 096 CODE EXTERNAL NARRATIVE E2831 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2832 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/3/189: DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE AS THIS ITEM APPLIES ONLY TO HOSPITAL BILLS. HOSPITAL/SNF: BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE ON SNF BILL AND NON- PSYCHIATRIC HOSPITAL BILLS. GUARANTEE OF PAYMENT ONLY APPLIES TO PSYCH HOSPITALS. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON-CODE) RE- FLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE IS 1 THROUGH 0, WITH 0 REPRESENTING THE 10TH CODE. E2833 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN -- DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE OF GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATERTHAN 12/31/88. E2834 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. E2835 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 097 CODE EXTERNAL NARRATIVE E2835 COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E2836 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3 OR C3). E2837 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSURANCE AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS1 AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88, UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE IT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAYMENT BEGAN MUST BE LATER THAN 12/31/89. E2838 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2839 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. E284A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 098 CODE EXTERNAL NARRATIVE E284A - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 'UTILIZATION DAYS' ARE GREATER THAN THE NUMBER OF DAYS FROM THE 'FROM DATE' THROUGH THE 'DATE BENEFITS EXHAUSTED' AND ON A HOSPITAL BILL, 'DATE GUARANTEE OF PAYMENT BEGAN' IS NOT PRESENT. FOR HOSPITAL CLAIMS THAT SPAN 88-89, THE EDIT WILL ONLY APPLY TO FIRST-YEAR DAYS (UP TO 12/31/88). "FIRST YEAR UTILIZATION DAYS' ARE GREATER THAN THE NUMBER OF DAYS FROM THE 'FROM DATE' THROUGH THE 'BENEFITS EXHAUSTED DATE'. E284B DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3 IS GREATER THAN THE THE FROM DATE. **TO CORRECT YOUR CLAIM** UPDATE THE OCCURRENCE CODE A3, B3 OR C3 ON PAGE 1 SO IT IS NOT GREATER THAN THE FROM DATE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E284C THE DATE BENEFITS EXHAUSTED IS SHOWN FOR OTHER THAN AN INPATIENT ANCILLARY CLAIM (12X OR 22X). CORRECT AND RESUBMIT. E284D FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E284E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. E284F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E284J FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (RESPITE CARE BILLS WITH FROM DATE AFTER 12/31/90) BENEFICIARY ELIGIBILITY DATE (OCCURRENCE CODE 47) IS GREATER THAN FIRST SERVICE DATE. E284K FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (HOME IV BILL WITH FROM DATE AFTER 12/31/90 DATE DISCHARGED ON A CONTINUOUS COURSE OF IV THERAPY (OCCURRENCE CODE 39) IS GREATER THAN FIRST SERVICE DATE. E284L **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 099 CODE EXTERNAL NARRATIVE E284L PUB 100-4, CHAPTER 25, SECTION 60. E284M FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E284N AN INPATIENT OR SNF CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS PRIMARY BUT THE OCCURRENCE CODE IS NOT AN A3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS SECONDARY BUT THE OCCURRENCE CODE IS NOT A B3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS TERTIARY BUT THE OCCURRENCE CODE IS NOT A C3. **TO CORRECT YOUR CLAIM** GO TO CLAIM PAGE 1 AND CORRECT THE OCCURRENCE CODE. YOU WILL NEED TO EITHER CORRECT THE A3, B3, OR C3 OCCUR CODE OR REMOVE THE CODE. **FOR MORE INFORMATION, GO TO: HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25. E284O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E284P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E2840 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - 1) INPATIENT CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE. 2) SNF CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE OR THE DATES OF M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 100 CODE EXTERNAL NARRATIVE E2840 SERVICE OVERLAP A CATASTROPHIC PERIOD, AND THE THROUGH DATE IS GREATER THAN 010189 AND THE BENEFIT EXHAUST DATE IS IN 1989. E2841 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2842 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/3/189: DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE AS THIS ITEM APPLIES ONLY TO HOSPITAL BILLS. HOSPITAL/SNF: BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE ON SNF BILL AND NON- PSYCHIATRIC HOSPITAL BILLS. GUARANTEE OF PAYMENT ONLY APPLIES TO PSYCH HOSPITALS. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON-CODE) RE- FLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE IS 1 THROUGH 0, WITH 0 REPRESENTING THE 10TH CODE. E2843 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN -- DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE OF GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATERTHAN 12/31/88. E2844 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. E2845 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 101 CODE EXTERNAL NARRATIVE E2845 GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E2846 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3 OR C3). E2847 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSURANCE AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS1 AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88, UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE IT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAYMENT BEGAN MUST BE LATER THAN 12/31/89. E2848 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2849 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 102 CODE EXTERNAL NARRATIVE E285A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E285B DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3 IS GREATER THAN THE THE FROM DATE. **TO CORRECT YOUR CLAIM** UPDATE THE OCCURRENCE CODE A3, B3 OR C3 ON PAGE 1 SO IT IS NOT GREATER THAN THE FROM DATE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E285C THE DATE BENEFITS EXHAUSTED IS SHOWN FOR OTHER THAN AN INPATIENT ANCILLARY CLAIM (12X OR 22X). CORRECT AND RESUBMIT. E285D FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E285E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. E285F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E285J FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (RESPITE CARE BILLS WITH FROM DATE AFTER 12/31/90) BENEFICIARY ELIGIBILITY DATE (OCCURRENCE CODE 47) IS GREATER THAN FIRST SERVICE DATE. E285K FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (HOME IV BILL WITH FROM DATE AFTER 12/31/90 DATE DISCHARGED ON A CONTINUOUS COURSE OF IV THERAPY (OCCURRENCE CODE 39) IS GREATER THAN FIRST SERVICE DATE. E285L **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E285M FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 103 CODE EXTERNAL NARRATIVE E285M THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E285N AN INPATIENT OR SNF CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS PRIMARY BUT THE OCCURRENCE CODE IS NOT AN A3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS SECONDARY BUT THE OCCURRENCE CODE IS NOT A B3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS TERTIARY BUT THE OCCURRENCE CODE IS NOT A C3. **TO CORRECT YOUR CLAIM** GO TO CLAIM PAGE 1 AND CORRECT THE OCCURRENCE CODE. YOU WILL NEED TO EITHER CORRECT THE A3, B3, OR C3 OCCUR CODE OR REMOVE THE CODE. **FOR MORE INFORMATION, GO TO: HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25. E285O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E285P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E2850 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - 1) INPATIENT CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE. 2) SNF CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE OR THE DATES OF SERVICE OVERLAP A CATASTROPHIC PERIOD, AND THE THROUGH DATE IS GREATER THAN 010189 AND THE BENEFIT EXHAUST DATE IS IN 1989. E2851 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 104 CODE EXTERNAL NARRATIVE E2851 SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2852 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/3/189: DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE AS THIS ITEM APPLIES ONLY TO HOSPITAL BILLS. HOSPITAL/SNF: BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE ON SNF BILL AND NON- PSYCHIATRIC HOSPITAL BILLS. GUARANTEE OF PAYMENT ONLY APPLIES TO PSYCH HOSPITALS. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON-CODE) RE- FLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE IS 1 THROUGH 0, WITH 0 REPRESENTING THE 10TH CODE. E2853 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN -- DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE OF GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATERTHAN 12/31/88. E2854 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. E2855 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 105 CODE EXTERNAL NARRATIVE E2855 FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E2856 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3 OR C3). E2857 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSURANCE AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS1 AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88, UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE IT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAYMENT BEGAN MUST BE LATER THAN 12/31/89. E2858 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2859 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. E286A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E286B DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3 IS GREATER THAN THE THE FROM DATE. **TO CORRECT YOUR CLAIM** M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 106 CODE EXTERNAL NARRATIVE E286B UPDATE THE OCCURRENCE CODE A3, B3 OR C3 ON PAGE 1 SO IT IS NOT GREATER THAN THE FROM DATE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E286C THE DATE BENEFITS EXHAUSTED IS SHOWN FOR OTHER THAN AN INPATIENT ANCILLARY CLAIM (12X OR 22X). CORRECT AND RESUBMIT. E286D FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E286E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. E286F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E286J FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (RESPITE CARE BILLS WITH FROM DATE AFTER 12/31/90) BENEFICIARY ELIGIBILITY DATE (OCCURRENCE CODE 47) IS GREATER THAN FIRST SERVICE DATE. E286K FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (HOME IV BILL WITH FROM DATE AFTER 12/31/90 DATE DISCHARGED ON A CONTINUOUS COURSE OF IV THERAPY (OCCURRENCE CODE 39) IS GREATER THAN FIRST SERVICE DATE. E286L **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E286M FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E286N AN INPATIENT OR SNF CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS PRIMARY BUT THE OCCURRENCE CODE IS NOT AN A3 M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 107 CODE EXTERNAL NARRATIVE E286N OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS SECONDARY BUT THE OCCURRENCE CODE IS NOT A B3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS TERTIARY BUT THE OCCURRENCE CODE IS NOT A C3. **TO CORRECT YOUR CLAIM** GO TO CLAIM PAGE 1 AND CORRECT THE OCCURRENCE CODE. YOU WILL NEED TO EITHER CORRECT THE A3, B3, OR C3 OCCUR CODE OR REMOVE THE CODE. **FOR MORE INFORMATION, GO TO: HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25. E286O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E286P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E2860 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - 1) INPATIENT CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE. 2) SNF CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE OR THE DATES OF SERVICE OVERLAP A CATASTROPHIC PERIOD, AND THE THROUGH DATE IS GREATER THAN 010189 AND THE BENEFIT EXHAUST DATE IS IN 1989. E2861 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 108 CODE EXTERNAL NARRATIVE E2862 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/3/189: DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE AS THIS ITEM APPLIES ONLY TO HOSPITAL BILLS. HOSPITAL/SNF: BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE ON SNF BILL AND NON- PSYCHIATRIC HOSPITAL BILLS. GUARANTEE OF PAYMENT ONLY APPLIES TO PSYCH HOSPITALS. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON-CODE) RE- FLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE IS 1 THROUGH 0, WITH 0 REPRESENTING THE 10TH CODE. E2863 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN -- DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE OF GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATERTHAN 12/31/88. E2864 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. E2865 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E2866 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 109 CODE EXTERNAL NARRATIVE E2866 CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3 OR C3). E2867 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSURANCE AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS1 AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88, UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE IT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAYMENT BEGAN MUST BE LATER THAN 12/31/89. E2868 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2869 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. E287A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E287B DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3 IS GREATER THAN THE THE FROM DATE. **TO CORRECT YOUR CLAIM** UPDATE THE OCCURRENCE CODE A3, B3 OR C3 ON PAGE 1 SO IT IS NOT GREATER THAN THE FROM DATE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 110 CODE EXTERNAL NARRATIVE E287C THE DATE BENEFITS EXHAUSTED IS SHOWN FOR OTHER THAN AN INPATIENT ANCILLARY CLAIM (12X OR 22X). CORRECT AND RESUBMIT. E287D FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E287E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. E287F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E287J FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (RESPITE CARE BILLS WITH FROM DATE AFTER 12/31/90) BENEFICIARY ELIGIBILITY DATE (OCCURRENCE CODE 47) IS GREATER THAN FIRST SERVICE DATE. E287K FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (HOME IV BILL WITH FROM DATE AFTER 12/31/90 DATE DISCHARGED ON A CONTINUOUS COURSE OF IV THERAPY (OCCURRENCE CODE 39) IS GREATER THAN FIRST SERVICE DATE. E287L **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E287M FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E287N AN INPATIENT OR SNF CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS PRIMARY BUT THE OCCURRENCE CODE IS NOT AN A3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS SECONDARY BUT THE OCCURRENCE CODE IS NOT A B3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS TERTIARY BUT THE OCCURRENCE CODE IS NOT A C3. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 111 CODE EXTERNAL NARRATIVE E287N **TO CORRECT YOUR CLAIM** GO TO CLAIM PAGE 1 AND CORRECT THE OCCURRENCE CODE. YOU WILL NEED TO EITHER CORRECT THE A3, B3, OR C3 OCCUR CODE OR REMOVE THE CODE. **FOR MORE INFORMATION, GO TO: HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25. E287O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E287P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E2870 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - 1) INPATIENT CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE. 2) SNF CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE OR THE DATES OF SERVICE OVERLAP A CATASTROPHIC PERIOD, AND THE THROUGH DATE IS GREATER THAN 010189 AND THE BENEFIT EXHAUST DATE IS IN 1989. E2871 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2872 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/3/189: DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE AS THIS ITEM APPLIES ONLY TO HOSPITAL BILLS. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 112 CODE EXTERNAL NARRATIVE E2872 HOSPITAL/SNF: BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE ON SNF BILL AND NON- PSYCHIATRIC HOSPITAL BILLS. GUARANTEE OF PAYMENT ONLY APPLIES TO PSYCH HOSPITALS. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON-CODE) RE- FLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE IS 1 THROUGH 0, WITH 0 REPRESENTING THE 10TH CODE. E2873 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN -- DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE OF GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATERTHAN 12/31/88. E2874 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. E2875 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E2876 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3 OR C3). E2877 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 113 CODE EXTERNAL NARRATIVE E2877 HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSURANCE AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS1 AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88, UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE IT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAYMENT BEGAN MUST BE LATER THAN 12/31/89. E2878 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2879 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. E288A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E288B DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3 IS GREATER THAN THE THE FROM DATE. **TO CORRECT YOUR CLAIM** UPDATE THE OCCURRENCE CODE A3, B3 OR C3 ON PAGE 1 SO IT IS NOT GREATER THAN THE FROM DATE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E288C THE DATE BENEFITS EXHAUSTED IS SHOWN FOR OTHER THAN AN INPATIENT ANCILLARY CLAIM (12X OR 22X). CORRECT AND RESUBMIT. E288D FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E288E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 114 CODE EXTERNAL NARRATIVE E288F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. E288J FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (RESPITE CARE BILLS WITH FROM DATE AFTER 12/31/90) BENEFICIARY ELIGIBILITY DATE (OCCURRENCE CODE 47) IS GREATER THAN FIRST SERVICE DATE. E288K FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (HOME IV BILL WITH FROM DATE AFTER 12/31/90 DATE DISCHARGED ON A CONTINUOUS COURSE OF IV THERAPY (OCCURRENCE CODE 39) IS GREATER THAN FIRST SERVICE DATE. E288L **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E288M FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E288N AN INPATIENT OR SNF CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS PRIMARY BUT THE OCCURRENCE CODE IS NOT AN A3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS SECONDARY BUT THE OCCURRENCE CODE IS NOT A B3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS TERTIARY BUT THE OCCURRENCE CODE IS NOT A C3. **TO CORRECT YOUR CLAIM** GO TO CLAIM PAGE 1 AND CORRECT THE OCCURRENCE CODE. YOU WILL NEED TO EITHER CORRECT THE A3, B3, OR C3 OCCUR CODE OR REMOVE THE CODE. **FOR MORE INFORMATION, GO TO: HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 115 CODE EXTERNAL NARRATIVE E288O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E288P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E2880 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - 1) INPATIENT CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE. 2) SNF CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE OR THE DATES OF SERVICE OVERLAP A CATASTROPHIC PERIOD, AND THE THROUGH DATE IS GREATER THAN 010189 AND THE BENEFIT EXHAUST DATE IS IN 1989. E2881 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2882 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/3/189: DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE AS THIS ITEM APPLIES ONLY TO HOSPITAL BILLS. HOSPITAL/SNF: BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE ON SNF BILL AND NON- PSYCHIATRIC HOSPITAL BILLS. GUARANTEE OF PAYMENT ONLY APPLIES TO PSYCH HOSPITALS. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON-CODE) RE- FLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 116 CODE EXTERNAL NARRATIVE E2882 IS 1 THROUGH 0, WITH 0 REPRESENTING THE 10TH CODE. E2883 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN -- DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE OF GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATERTHAN 12/31/88. E2884 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. E2885 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E2886 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3 OR C3). E2887 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSURANCE AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 117 CODE EXTERNAL NARRATIVE E2887 PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS1 AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88, UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE IT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAYMENT BEGAN MUST BE LATER THAN 12/31/89. E2888 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2889 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. E289A FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E289B DATES BENEFITS EXHAUSTED (OCCURRENCE CODES A3, B3 OR C3 IS GREATER THAN THE THE FROM DATE. **TO CORRECT YOUR CLAIM** UPDATE THE OCCURRENCE CODE A3, B3 OR C3 ON PAGE 1 SO IT IS NOT GREATER THAN THE FROM DATE AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E289C THE DATE BENEFITS EXHAUSTED IS SHOWN FOR OTHER THAN AN INPATIENT ANCILLARY CLAIM (12X OR 22X). CORRECT AND RESUBMIT. E289D FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. E289E MORE THAN ONE BENEFITS EXHAUST DATE IS ON THE CLAIM; CORRECT AND RESUBMIT. E289F FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - A COMPLETELY NON-COVERED SNF CLAIM (NON-PAY CODE 'B', 'C', 'N', OR 'W' IS PRESENT) CONTAINS AN OCCURRENCE CODE 22 THAT IS WITH THE FROM AND THRU DATES. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 118 CODE EXTERNAL NARRATIVE E289J FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - OUTPATIENT: (RESPITE CARE BILLS WITH FROM DATE AFTER 12/31/90) BENEFICIARY ELIGIBILITY DATE (OCCURRENCE CODE 47) IS GREATER THAN FIRST SERVICE DATE. E289K FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E289L **TO CORRECT YOUR CLAIM** REMOVE THE INCORRECT OCCURRENCE CODE 20 FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E289M FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - REASON CODE IS NOT CURRENTLY USED. - THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E289N AN INPATIENT OR SNF CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS PRIMARY BUT THE OCCURRENCE CODE IS NOT AN A3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS SECONDARY BUT THE OCCURRENCE CODE IS NOT A B3 OR THE CLAIM INDICATES THAT BENEFITS ARE EXHAUSTED AND MEDICARE IS TERTIARY BUT THE OCCURRENCE CODE IS NOT A C3. **TO CORRECT YOUR CLAIM** GO TO CLAIM PAGE 1 AND CORRECT THE OCCURRENCE CODE. YOU WILL NEED TO EITHER CORRECT THE A3, B3, OR C3 OCCUR CODE OR REMOVE THE CODE. **FOR MORE INFORMATION, GO TO: HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25. E289O FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. - INVALID OR MISSING OCCURRENCE CODE '23' OR '42' DATE. E289P FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - REASON CODE NOT CURRENTLY USED. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 119 CODE EXTERNAL NARRATIVE E289P - OCCURRENCE CODE '23' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E2890 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - 1) INPATIENT CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE. 2) SNF CLAIM: THE DATES OF SERVICE DO NOT OVERLAP A CATASTROPHIC PERIOD, THEREFORE THE BENEFIT EXHAUST DATE MUST BE WITHIN THE DATES OF SERVICE OR THE DATES OF SERVICE OVERLAP A CATASTROPHIC PERIOD, AND THE THROUGH DATE IS GREATER THAN 010189 AND THE BENEFIT EXHAUST DATE IS IN 1989. E2891 HOSPITAL/SNF/OP: THE DATE ASSOCIATED WITH THE INDICATED OCCURRENCE CODE IS IMPOSSIBLE, INCOMPLETE OR MISSING. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON CODE) REFLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED." **TO CORRECT YOUR CLAIM** CORRECT AND/OR UPDATE THE OCCURRENCE CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2892 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/3/189: DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE AS THIS ITEM APPLIES ONLY TO HOSPITAL BILLS. HOSPITAL/SNF: BILLS WITH DATES OF SERVICE BETWEEN 01/01/89 AND 12/31/89, DATE GUARANTEE OF PAYMENT BEGAN -- ENTRY IS INAPPROPRIATE ON SNF BILL AND NON- PSYCHIATRIC HOSPITAL BILLS. GUARANTEE OF PAYMENT ONLY APPLIES TO PSYCH HOSPITALS. NOTE: THE FOURTH DIGIT OF THE RETURN CODE (REASON-CODE) RE- FLECTS THE SEQUENCE IN WHICH THE CODE OCCURRED. THE SEQUENCE IS 1 THROUGH 0, WITH 0 REPRESENTING THE 10TH CODE. E2893 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89, DATE OF GUARANTEE OF PAYMENT BEGAN -- DATE IS EARLIER THAN THE ADMISSION DATE OR LATER THAN THE STATEMENT COVERS THRU DATE. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE OF GUARANTEE OF PAYMENT BEGAN IS EARLIER THAN THE ADMISSION DATE OR LATERTHAN 12/31/88. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 120 CODE EXTERNAL NARRATIVE E2894 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- DATE GUARANTEE OF PAYMENT BEGAN: UTILIZATION DAYS CANOT EXCEED 12 DAYS BEYOND THE ADMISSION DATE, IF ADMISSION DATE AND THE STATEMENT COVERS PERIOD FROM DATE ARE THE SAME, UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. E2895 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND 12/31/89: IF THE GUARANTEE OF PAYMENT DATE IS SHOWN AND THE ADMISSION DATE AND FROM DATE ARE NOT EQUAL, UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THROUGH 1/2, IN WHICH CASE 13 DAYS CANNOT BE EXCEEDED. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE 1988 UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2, IN WHICH CASE THE 13 DAYS CANNOT BE EXCEEDED. FOR NON-PSYCHIATRIC HOSPITALS THAT SPAN 89-90, THE GUARANTEE OF PAYMENT DATE MUST BE LATER THAN 12/31/89 AND THE UTILIZATION DAYS CANNOT EXCEED 12 DAYS UNLESS THE BILLING DATES COVER THE PERIOD 12/24 THRU 1/2. E2896 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CLAIMS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89 THE 'DATE GUARANTEE OF PAYMENT BEGAN' IS EARLIER THAN THE 'DATE BENEFITS EXHAUSTED' (OCCURRENCE CODE A3, B3 OR C3). E2897 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED. - HOSPITAL BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89- THE DATE GUARANTEE OF PAYMENT BEGAN PLUS UTILIZATION DAYS (LESS COINSURANCE AND NONUTILIZATION DAYS) CANNOT EXCEED THE STATEMENT COVERS PERIOD THRU DATE UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE THE THRU DATE CANNOT BE EXCEEDED BY MORE THAN 1 DAY. FOR HOSPITAL BILLS (NON-PSYCHIATRIC) THAT SPAN 88-89, THE DATE GUARANTEE OF PAYMENT BEGAN PLUS FIRST YEAR (88) UTILIZATION DAYS (LESS COINS1 AND NON-UTIL FOR 88) CANNOT EXCEED 12/31/88, UNLESS THE PATIENT STATUS CODE IS 30 (STILL PATIENT) IN WHICH CASE IT CAN'T BE EXCEEDED BY MORE THAN 1 DAY. FOR 89-90, THE DATE GUARANTEE OF PAYMENT BEGAN MUST BE LATER THAN 12/31/89. E2898 THE OCCURRENCE CODE 22 DATE MUST BE WITHIN THE STATEMENT COVERS PERIOD FOR ALL SNF TOB'S (18X, 21X, 28X OR 51X) UNLESS THE NON-PAYMENT CODE IS EQUAL TO C, N, OR W THEN THE DATE CAN BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. **TO CORRECT YOUR CLAIM** M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 121 CODE EXTERNAL NARRATIVE E2898 -CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE W/IN THE STATMENT COVERS PERIOD. -IF THE NON-PAYMENT CODE IS EQUAL TO C, N OR W, CORRECT OCCURRENCE CODE 22 ON PAGE 1 TO BE PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THRU DATE. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E2899 UTILIZATION DAYS EXCEED THE NUMBER OF UTILIZATION DAYS CALCULATED FROM THE STATEMENT COVERS FROM DATE TO THE OCCURRENCE CODE 22 DATE. . CORRECT AND RESUBMIT IF APPROPRIATE. E33#1 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E33#2 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E33#3 THE QUALIFYING STAY REQUIREMENT IS NOT MET (TWO-DAY STAY REQUIREMENT WHEN THE PRIOR STAY WAS IN AN RPCH; THREE-DAY STAY REQUIREMENT FOR ALL OTHER PRIOR STAYS). E33#4 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 122 CODE EXTERNAL NARRATIVE E33#4 HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E33#5 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E33#6 SCREENING SERVICES BILLED MULTIPLE TIMES ON THE SAME CLAIM. -FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E33#7 SCREENING SERVICE BILLED MULTIPLE TIMES ON SAME CLAIM. E33A1 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E33X6 SCREENING SERVICE BILLED MULTIPLE TIMES ON THE SAME CLAIM. E33X7 SCREENING SERVICE BILLED MULTIPLE TIMES ON SAME CLAIM. E3301 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3302 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 123 CODE EXTERNAL NARRATIVE E3302 ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3303 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OCCURRENCE SPAN 70 (QUALIFYING STAY) LESS THAN 3 DAYS. . REASON CODE NOT CURRENTLY USED E3304 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3305 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3311 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 124 CODE EXTERNAL NARRATIVE E3311 PUB 100-4, CHAPTER 25, SECTION 60. E3312 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3313 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OCCURRENCE SPAN 70 (QUALIFYING STAY) LESS THAN 3 DAYS. . REASON CODE NOT CURRENTLY USED E3314 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3315 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3321 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 125 CODE EXTERNAL NARRATIVE E3321 REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3322 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3323 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OCCURRENCE SPAN 70 (QUALIFYING STAY) LESS THAN 3 DAYS. . REASON CODE NOT CURRENTLY USED E3324 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3325 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3331 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 126 CODE EXTERNAL NARRATIVE E3331 EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3332 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3333 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OCCURRENCE SPAN 70 (QUALIFYING STAY) LESS THAN 3 DAYS. . REASON CODE NOT CURRENTLY USED E3334 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3335 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 127 CODE EXTERNAL NARRATIVE E3341 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3342 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3343 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OCCURRENCE SPAN 70 (QUALIFYING STAY) LESS THAN 3 DAYS. . REASON CODE NOT CURRENTLY USED E3344 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3345 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 128 CODE EXTERNAL NARRATIVE E3345 HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3351 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3352 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3353 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OCCURRENCE SPAN 70 (QUALIFYING STAY) LESS THAN 3 DAYS. . REASON CODE NOT CURRENTLY USED E3354 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3355 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 129 CODE EXTERNAL NARRATIVE E3355 **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3361 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3362 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3363 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OCCURRENCE SPAN 70 (QUALIFYING STAY) LESS THAN 3 DAYS. . REASON CODE NOT CURRENTLY USED E3364 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3365 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 130 CODE EXTERNAL NARRATIVE E3365 OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3371 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3372 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3373 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OCCURRENCE SPAN 70 (QUALIFYING STAY) LESS THAN 3 DAYS. . REASON CODE NOT CURRENTLY USED E3374 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 131 CODE EXTERNAL NARRATIVE E3374 PUB 100-4, CHAPTER 25, SECTION 60. E3375 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3381 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3382 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3383 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OCCURRENCE SPAN 70 (QUALIFYING STAY) LESS THAN 3 DAYS. . REASON CODE NOT CURRENTLY USED E3384 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 132 CODE EXTERNAL NARRATIVE E3384 CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3385 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3391 BILLS WITH DATE OF SERVICE PRIOR TO 01/01/89, OR AFTER 12/31/89: A SPAN CODE 'FROM' OR 'THRU' DATE IS AN INVALID OR INCONSISTENT DATE ENTRY. THIS EDIT FOR SNF CLAIMS APPLIES TO THE SPAN CODE 70 FOR QUALIFYING STAY DATES. THIS EDIT FOR HOSPITAL CLAIMS APPLIES TO SPAN CODE 70, 74, 76, 77 AND 79 FOR NON- COVERED DATES. **TO CORRECT YOUR CLAIM** REMOVE OR CORRECT OCCURRENCE SPAN CODES 70, 74, 76, 77 OR 79 ON PAGE 1 AND F9 -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3392 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS THE SAME AS, OR PRIOR TO, THE FROM DATE. NOTE:THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE QUALIFYING HOSPITAL STAY OCCURRENCE CODE ON PAGE 1 (IT CAN NOT BE THE SAME AS YOUR DATE OF SERVICE) AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3393 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. - OCCURRENCE SPAN 70 (QUALIFYING STAY) LESS THAN 3 DAYS. . REASON CODE NOT CURRENTLY USED E3394 SNF BILLS WITH DATES OF SERVICE PRIOR TO 01/01/89 AND AFTER 12/31/89-QUALIFY- ING STAY DATES: THE THRU DATE IS LATER THAN THE DATE OF CURRENT ADMISSION. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 133 CODE EXTERNAL NARRATIVE E3394 NOTE: THE FOURTH DIGIT OF THE ERROR CODE (REASON CODE) REPRESENTS THE LOCATION OF THE OCCURRENCE SPAN CODE THAT FAILED A CMS EDIT. **TO CORRECT YOUR CLAIM** CORRECT THE OCCURRENCE SPAN CODE DATE ON PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3395 THE OCCURRENCE SPAN CODE 70 FROM DATE IS EQUAL TO THE FROM DATE OF THE CLAIM AND IT IS NOT A PPS TRANSITION BILL, OR THE CLAIM FROM AND THROUGH DATES FALL WITHIN A PERIOD OF CATASTROPHIC COVERAGE, OR OCCURRENCE SPAN CODE 70 IS PRESENT ON A NON-PPS BILL. **TO CORRECT YOUR CLAIM** -REMOVE OCCURRENCE SPAN CODE 70 AND DATE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E35#1 CONDITION CODES '60/61/66' CANNOT BE PRESENT ON A NON-PPS CLAIM OR THERE IS MORE THAN ONE PPS CONDITION CODE PRESENT OR; CONDITION CODE '65' IS PRESENT ON A PPS CLAIM. **TO CORRECT YOUR CLAIM** REMOVE THE 60, 61, 65 AND/OR 66 CONDITION CODES FROM THE NON-PPS CLAIM ON PAGE 1 OR REMOVE THE DUPLICATE PPS CONDITON CODE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E35#2 HOSPITAL CLAIM WITH A STATEMENT COVERS THROUGH DATE PRIOR TO 100191 WITH EITHER CONDITION CODE 60 (LENGTH OF STAY OUTLIER) OR 61 (COST OUTLIER) PRESENT AND A VALUE COEDE 17 NOT PRESENT. **TO CORRECT YOUR CLAIM** -REMOVE THE 60 OR 61 CONDITION CODE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E35#3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35#4 FOR FISCAL INTERMEDIARY USE ONLY; NO PROVIDER ACTION NEEDED. - CONDITION CODE '69' IS INVALID ON TYPE OF OTHER THAN 11X. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 134 CODE EXTERNAL NARRATIVE E35#4 - REASON CODE NOT CURRENTLY USED E35A3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35A4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35B3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35B4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35C3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35C4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35D3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35D4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 135 CODE EXTERNAL NARRATIVE E35D4 REASON CODE NOT CURRENLTLY USED E35E3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35E4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35F3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35F4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35G3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35G4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35H3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35H4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 136 CODE EXTERNAL NARRATIVE E35I3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35I4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35J3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35J4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35K3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35K4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35L3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35L4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 137 CODE EXTERNAL NARRATIVE E35M3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35M4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35N3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35N4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35O3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35O4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35P3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35P4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35Q3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 138 CODE EXTERNAL NARRATIVE E35Q3 - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35Q4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35R3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35R4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35S3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35S4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E35T3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E35T4 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E3501 CONDITION CODES '60/61/66' CANNOT BE PRESENT ON A NON-PPS CLAIM OR THERE IS MORE THAN ONE PPS CONDITION CODE PRESENT OR; CONDITION CODE '65' IS PRESENT M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 139 CODE EXTERNAL NARRATIVE E3501 ON A PPS CLAIM. **TO CORRECT YOUR CLAIM** REMOVE THE 60, 61, 65 AND/OR 66 CONDITION CODES FROM THE NON-PPS CLAIM ON PAGE 1 OR REMOVE THE DUPLICATE PPS CONDITON CODE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3502 HOSPITAL CLAIM WITH A STATEMENT COVERS THROUGH DATE PRIOR TO 100191 WITH EITHER CONDITION CODE 60 (LENGTH OF STAY OUTLIER) OR 61 (COST OUTLIER) PRESENT AND A VALUE COEDE 17 NOT PRESENT. **TO CORRECT YOUR CLAIM** -REMOVE THE 60 OR 61 CONDITION CODE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3503 HOSPITAL CLAIM WITH A STATEMENT COVERS THROUGH DATE PRIOR TO 100191 WITH EITHER CONDITION CODE 60 (LENGTH OF STAY OUTLIER) OR 61 (COST OUTLIER) PRESENT AND A VALUE COEDE 17 NOT PRESENT. **TO CORRECT YOUR CLAIM** -REMOVE THE 60 OR 61 CONDITION CODE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3504 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E3511 CONDITION CODES '60/61/66' CANNOT BE PRESENT ON A NON-PPS CLAIM OR THERE IS MORE THAN ONE PPS CONDITION CODE PRESENT OR; CONDITION CODE '65' IS PRESENT ON A PPS CLAIM. **TO CORRECT YOUR CLAIM** REMOVE THE 60, 61, 65 AND/OR 66 CONDITION CODES FROM THE NON-PPS CLAIM ON PAGE 1 OR REMOVE THE DUPLICATE PPS CONDITON CODE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3512 HOSPITAL CLAIM WITH A STATEMENT COVERS THROUGH DATE PRIOR TO 100191 WITH EITHER CONDITION CODE 60 (LENGTH OF STAY OUTLIER) OR 61 (COST OUTLIER) PRESENT AND A VALUE COEDE 17 NOT PRESENT. M E D I C A R E P A R T A CURRENT DATE: 09/30/09 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 140 CODE EXTERNAL NARRATIVE E3512 **TO CORRECT YOUR CLAIM** -REMOVE THE 60 OR 61 CONDITION CODE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO HTTP://WWW.CMS.HHS.GOV/MANUALS/IOM/LIST.ASP#TOPOFPAGE PUB 100-4, CHAPTER 25, SECTION 60. E3513 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION REQUIRED - CONDITION CODE C3 AND/OR C7 IS PRESENT, BUT THE REQUIRED OCCURRENCE SPAN INFORMATION IS NOT PRESENT E3514 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED - CONDITION CODE '69' IS INVALID ON TYPE OF BILLS OTHER THAN 11X. - REASON CODE NOT CURRENTLY USED E3521 CONDITION CODES '60/61/66' CANNOT BE PRESENT ON A NON-PPS CLAIM OR THERE IS MORE THAN ONE PPS CONDITION CODE PRESENT OR; CONDITION CODE '65' IS PRESENT ON A PPS CLAIM. **TO CORRECT YOUR CLAIM** REMOVE THE 60, 61, 65 AND/OR 66 CONDITION CODES FROM THE NON-PPS CLAIM ON PAGE 1 OR REMOVE THE DUPLICATE PPS CONDITON CODE FROM PAGE 1 AND F9. -FOR MORE INFORMATION GO TO