M E D I C A R E P A R T A CURRENT DATE: 07/31/08 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: 07/31/08 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: 07/31/08 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: 07/31/08 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: 07/31/08 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: 07/31/08 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: 07/31/08 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: 07/31/08 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: 07/31/08 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: 07/31/08 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', '048X', '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 LES 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 OUTPAT- IENT HISTORY FROM DATE OR IF PRESENT, THE OCCURRENCE SPAN CODE '72' FROM DATE IS GREATER THAN 12/31/90 *********** WHEN THE INCOMING INPATIENT CLAIM IS BILL TYPE OF '11X' OR '41X', AND THE OUT M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 011 CODE EXTERNAL NARRATIVE C7113 PATIENT 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', '048X', '061X', '073X', '074X', '092X', '0254', '0255', -F6- '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 DATE, OR IF PRESENT, THE OCCURRENCE SPAN CODE 72 THRU DATE, AND THE OUTPAT- M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 012 CODE EXTERNAL NARRATIVE C7120 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: 07/31/08 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 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 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. M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 014 CODE EXTERNAL NARRATIVE C7247 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). 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. M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 015 CODE EXTERNAL NARRATIVE 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 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 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'). . 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 016 CODE EXTERNAL NARRATIVE C7268 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 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 017 CODE EXTERNAL NARRATIVE C7275 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 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 018 CODE EXTERNAL NARRATIVE C7279 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. - 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 019 CODE EXTERNAL NARRATIVE C7285 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** -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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 020 CODE EXTERNAL NARRATIVE 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. - 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. M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 021 CODE EXTERNAL NARRATIVE C7294 ******* 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 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 022 CODE EXTERNAL NARRATIVE C7531 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. **** 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. M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 023 CODE EXTERNAL NARRATIVE C7550 . 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 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 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). M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 024 CODE EXTERNAL NARRATIVE 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. . 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 025 CODE EXTERNAL NARRATIVE 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 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 026 CODE EXTERNAL NARRATIVE 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 . 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. . M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 027 CODE EXTERNAL NARRATIVE DT012 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 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 028 CODE EXTERNAL NARRATIVE 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 . 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. . M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 029 CODE EXTERNAL NARRATIVE D0106 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 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 030 CODE EXTERNAL NARRATIVE 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. 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 031 CODE EXTERNAL NARRATIVE 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 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. . M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 032 CODE EXTERNAL NARRATIVE D7555 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. . 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. M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 033 CODE EXTERNAL NARRATIVE D7613 . 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. . 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 034 CODE EXTERNAL NARRATIVE 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 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 M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 035 CODE EXTERNAL NARRATIVE D7635 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 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. M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 036 CODE EXTERNAL NARRATIVE D7645 . 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. . 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. . M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 037 CODE EXTERNAL NARRATIVE D7663 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 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. M E D I C A R E P A R T A CURRENT DATE: 07/31/08 REQUESTED BY: DMS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 038 CODE EXTERNAL NARRATIVE D9990 . 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