1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 001 0 CODE EXTERNAL NARRATIVE AHIC# FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. APR03 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. A0001 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. A0010 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. A9990 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. 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. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 002 0 CODE EXTERNAL NARRATIVE B02U2 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B02U3 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B9980 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. B9981 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. 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. CT002 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT003 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT004 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT005 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT008 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT010 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT012 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT013 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT014 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT015 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. CT016 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. CT017 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. CT018 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 003 0 CODE EXTERNAL NARRATIVE CT018 REASON CODE REQUIRING CORRECTION IS PRESENT. CT020 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. CT023 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. CWFB0 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. CWFB1 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. CWFB2 STATUS LOCATION ON REASON CODE FILE IS INCONSISTENT WITH CWF REJECT RESPONSE. CLAIM SYSTEMATICALLY SET TO STATUS LOCATION S M0500 FOR FURTHER EVALUATION. CWFRC STATUS LOCATION ON REASON CODE FILE IS INCONSISTENT WITH CWF REJECT RESPONSE. CLAIM SYSTEMATICALLY SET TO STATUS LOCATION S M0500 FOR FURTHER EVALUATION. C0042 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C0043 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C524P FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C524Q FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7010 THE EDITED INPATIENT OR OUTPATIENT CLAIM HAS FROM/THRU DATES WHICH OVERLAP A HOSPICE ELECTION PERIOD AND IS NOT INDICATED AS TREATMENT OF A NON-TERMINAL CONDITION (CONDITION CODE 07). C7020 OUTPATIENT CLAIM WITH TOB 12X AND FROM AND THRU DATES EQUAL POSTED 73X SERVICE DATES AND TO SPAN CODE 72 FROM AND THRU DATES AND DATES OF SERVICE ARE NOT EQUAL TO SPAN 74 DATES OF SERVICE C7030 THE SERVICE DATES ON THE OUTPATIENT CLAIM OVERLAP A HOSPICE CLAIM WITH THE SAME DIAGNOSIS. THEREFORE, NO MEDICARE PAYMENT CAN BE MADE. C7040 THE SERVICE DATES ON THE SKILLED NURSING FACILITY CLAIM OVERLAP A HOSPICE CLAIM WITH THE SAME DIAGNOSIS. THEREFORE, NO MEDICARE PAYMENT CAN BE MADE. C7050 THE DATES OF SERVICE (OR, IF PRESENT, OCCURRENCE SPAN CODE 72 DATES) ON THIS PART B CLAIM ARE EQUAL TO OR OVERLAP THE DATES OF SERVICE ON A HOSPITAL INPATIENT OR SNF CLAIM AND THE PROVIDER NUMBERS ARE THE SAME. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 004 0 CODE EXTERNAL NARRATIVE C7055 OUTPATIENT SERVICES ENTERED WITH BILL TYPES 13X, 14X, OR 83X ON THE INCOMING CLAIM OR ASSOCIATED HISTORY CLAIM ARE BEING BILLED WITH THE FROM/THRU DATES EQUAL TO, WITHIN, OR OVERLAPPING THE FROM/THRU DATES AND SAME PROVIDER NUMBER AS AN AMBULATORY SURGERY CLAIM (ASC). C7060 THE SERVICE DATES ON THE OUTPATIENT CLAIM DUPLICATE A PREVIOUS OUTPATIENT CLAIM FOR THE SAME PROVIDER NUMBER, REVENUE CODE AND TOTAL CHARGES. THEREFORE, NO MEDICARE PAYMENT CAN BE MADE. C7070 THE LAST SERVICE DATE ON THE OUTPATIENT CLAIM DUPLICATES AN INPATIENT ADMISSION DATE FOR THE SAME PROVIDER NUMBER. THEREFORE, NO MEDICARE PAYMENT CAN BE MADE. C7080 THE DATES OF SERVICE ON THIS OUTPATIENT CLAIM ARE EQUAL TO OR OVERLAP THE DATES OF SERVICE ON AN INPATIENT CLAIM AND THE PROVIDER NUMBERS ARE DIFFERENT PLEASE CORRECT YOUR CLAIM AND RESUBMIT, IF NECESSARY. C7090 PART B NONPHYSICIAN SERVICE DATES OVERLAP INPATIENT STAY DATES. NO MEDICARE PAYMENT CAN BE MADE. C7108 OUTPATIENT CLAIM WITH FROM/THRU DATES OF SERVICE OR IF PRESENT OCCURRENCE SPAN CODE '72' DATES EQUAL OR OVERLAP OUTPATIENT FROM/THRU OR IF PRESENT OCCURRENCE SPAN CODE '72' DATES. 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. C7111 INPATIENT PPS CLAIM WITH THRU DATE EQUAL TO INPATIENT PPS FROM DATE. THE INCOMING INPATIENT CLAIM IS A BILL TYPE OF 11X, AND THE PATIENT STATUS IS A 01, 05, 07, 65, 71 OR 72; HISTORY INPATIENT BILL TYPE IS 11X, AND THE INCOMING CLAIM THRU DATE IS EQUAL TO THE HISTORY CLAIM FROM DATE C7112 AN INPATIENT CLAIM WAS SUBMITTED AGAINST A PAID OUTPATIENT CLAIM WHOSE SERVICE DATE IS ONE DAY PRIOR TO OR THE SAME DAY AS THE INPATIENT DATE OF ADMISSION. A BILL TYPE XX8 SHOULD BE SUBMITTED TO CANCEL THE PAID OUTPATIENT CLAIM. AS SOON AS THE CANSELLATION APPEARS ON YOUR REMITTANCE ADVICE, YOU SHOULD ADD THE OUTPATIENT SERVICES TO THE INPATIENT BILL AND RESUBMIT A BILL TYPE 111. ANY PART BE DEDUCTIBLE AND/OR COINSURANCE COLLECTED FROM THE BENEFICIARY MUST BE REFUNDED. C7113 AN INPATIENT CLAIM WITH THE ADMISSION DATE LESS THAN FOUR DAYS FROM THE 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 005 0 CODE EXTERNAL NARRATIVE C7113 OUTPATIENT HISTORY THRU DATE OR IF PRESENT THE OCCURRENCE SPAN CODE 72 DATE, AND THE OUTPATIENT CLAIM IS FOR DIAGNOSTIC SERVICES ONLY. PLEASE SUBMIT A CANCEL FOR THE OUTPATIENT CLAIM AND RESUBMIT WITH DIAGNOSTIC SERVICES ON I/P CLAIM C7114 THIS OUTPATIENT CLAIM CONTAINS THERAPEUTIC SERVICES AGAINST A POSTED INPATIENT HISTORY CLAIM WITH THE THRU DATE GREATER THAN THE INPATIENT ADMISSION DATE, MINUS FOUR DAYS, OR IS EQUAL TO THE ADMISSION DATE. C7114 IS RECEIVED WHEN: THE OUTPATIENT FROM DATE (OR IF PRESENT, OCCURRENCE SPAN CODE 72 FROM DATE) IS GREATER THAN '90365', AND THE OUTPATIENT THRU DATE (OR IF PRESENT, OCCURRENCE SPAN CODE 72 THRU DATE) IS EQUAL TO, OR WITHIN THREE DAYS PRIOR TO A HISTORY INPATIENT ADMISSION DATE THAT HAS A BILL TYPE 11X OR 41X, AND THE PROVIDERS ARE THE SAME AND AN OUTPATIENT REVENUE CODE IS EQUAL TO: 0250, 0251, 0252, 0256, 0257, 0258, 0259, 026X, 027X, 028X, 033X, 0340, 0342, 0349, 036X, 0370, 0374, 0379, 041X, 042X, 043X, 044X, 045X, 0472, 049X, 051X, 052X, 053X, 055X, 056X, 0623, 063X, 070X, 071X, 072X, 075X, 076X, 079X, 090X, 091X, 094X, AND THE DIAGNOSIS ON BOTH CLAIMS ARE EQUAL OR C7115 THIS INCOMING INPATIENT CLAIM ADMISSION DATE IS LESS THAN 4 DAYS FROM AN ALREADY PROCESSED OUTPATIENT CLAIM'S THRU DATE (OR, IF PRESENT, OCCURRENCE SPAN CODE 72 THRU DATE), A THERAPEUTIC REVENUE CODE IS PRESENT ON THE OUTPATIENT CLAIM AND THE DIAGNOSIS CODES ON THE CLAIMS ARE EQUAL. OR WHEN INCOMING BILL TYPE IS '11X' OR '41X', AND THE OUTPATIENT THRU DATE (OR IF PRESENT, OCCURRENCE SPAN CODE '72' THRU DATE) IS EQUAL TO THE INPATIENT ADMISSION DATE OR ONE OF THE THREE DAYS PRIOR TO THE ADMISSION DATE, AND IF THE PROVIDER NUMBERS ARE EQUAL, AND IF REVENUE CODE IS EQUAL TO: '0250', '0251', '0252', '0256', '0257', '0258', '0259', '026X', '027X', '028X', '033X', '0340', '0342', '0349', '036X', '0370', '0374', '0379', '041X', '042X', '043X', '044X', '045X', '0472', '049X', '051X', '052X', '053X', '055X', '056X', '0623', '063X', '070X', '071X', '072X', '075X', '076X', '079X', '090X', '091X', '094X', AND IF THE DIAGNOSIS ON THE INCOMING CLAIM AND HISTORY CLAIM ARE EQUAL, THE EDIT WILL SET C7119 THIS OUTPATIENT CLAIM THRU DATE OR, IF PRESENT, OCCURRENCE SPAN CODE 72 THRU DATE, IS EQUAL TO OR ONE DAY PRIOR TO THE ADMISSION DATE ON A NON-PPS (CC 65) INPATIENT HISTORY CLAIM, AND ONE OR MORE DIAGNOSTIC REVENUE CODES ARE PRESENT ON THE OUTPATIENT CLAIM. C7120 AN INPATIENT CLAIM WITH CONDITION CODE 65 PRESENT WITH AND ADMISSION DATE, OR THE ADMISSION DATE MINUS ONE DAY, EQUAL TO THE OUTPATIENT HISTORY THRU DATE, 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 006 0 CODE EXTERNAL NARRATIVE C7120 OR THE OCCURRENCE SPAN CODE 72 THRU DATE, AND THE OUTPATIENT HISTORY CLAIM HAS ONE OR MORE DIAGNOSTIC REVENUE CODES PRESENT. C7121 AN OUTPATIENT CLAIM WITH THE THRU DATE (OR IF PRESENT, OCCURRENCE SPAN CODE '72' DATE) EQUAL TO THE INPATIENT ADMISSION DATE OR THE INPATIENT ADMISSION DATE MINUS ONE DAY, AND ONE OR MORE THERAPEUTIC REVENUE CODES ARE ON THE OUTPATIENT CLAIM, AND THE INPATIENT HISTORY CLAIM HAS A CONDITION CODE OF '65'. C7122 AN INPATIENT CLAIM WITH CONDITION CODE '65' PRESENT WITH THE ADMISSION DATE, OR THE ADMISSION DATE MINUS ONE DAY, EQUAL TO THE OUTPATIENT HISTORY THRU DATE (OR IF PRESENT, OCCURRENCE SPAN CODE '72' THRU DATE), AND THE OUTPATIENT HISTORY CLAIM HAS ONE OR MORE THERAPEUTIC REVENUE CODES PRESENT. C7171 AN INPATIENT CLAIM WITH CONDITION CODE '65' PRESENT WITH THE ADMISSION DATE, OR THE ADMISSION DATE MINUS ONE DAY, EQUAL TO THE OUTPATIENT HISTORY THRU DATE (OR IF PRESENT, OCCURRENCE SPAN CODE '72' THRU DATE), AND THE OUTPATIENT HISTORY CLAIM HAS ONE OR MORE THERAPEUTIC REVENUE CODES PRESENT. C7172 AN OUTPATIENT OR PART B CLAIM HAS PREVIOUSLY BEEN SUBMITTED FOR A SCREENING PAP SMEAR. C7220 DISPOSITION CR TRAILER 08 AND 13 RECEIVED. SURG900 FILE SHOWS PRIOR EYEWEAR CLAIM PROCESSED. C7230 DISPOSITION CR TRAILER 08 AND 13 RECEIVED. MULTIPLE EYEWEAR COVERAGE IS LIMITED. C7240 AN OUTPATIENT OR PART B CLAIM FOR INFLUENZA HAS ALREADY BEEN PAID FOR THIS DATE OF SERVICE. C7241 THERE IS A CLAIM POSTED TO HISTORY FOR THE SAME PROSTHETICS/ORTHOTICS ITEM WITH THE SAME DATE OF SERVICE. C7242 AN INCOMING OUTPATIENT CLAIM WITH REVENUE CODE 623 HAS THE SAME DATE OF SERVICE AND THE SAME HCPCS CODE AS A PAID DME CLAIM OR PAID OUTPATIENT CLAIM ON THE HISTORY FILE. C7243 AN INCOMING OUTPATIENT CLAIM WITH A LAB REVENUE CODE ( 300-319 ) HAS THE SAME DATE OF SERVICE AND THE SAME HCPCS CODE AS A PART B OR OUTPATIENT CLAIM HISTORY. C7245 ANTIEMETIC DRUG HCPCS CODE NOT BILLED IN CONJUNCTION 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 007 0 CODE EXTERNAL NARRATIVE C7245 WITH ORAL ANTICANCER DRUG, OR DUPLICATE ANTIEMETIC DRUG CLAIM. NOTE: THE PHYSICIAN/SUPPLIER MAY HAVE ALSO FILED FOR PAYMENT OF THESE SERVICES. C7246 ANTIEMETIC DRUG HCPCS CODE NOT BILLED IN CONJUNCTION WITH ORAL ANTICANCER DRUG, OR DUPLICATE ANTIEMETIC DRUG CLAIM. NOTE: THE PHYSICIAN/SUPPLIER MAY HAVE ALSO FILED FOR PAYMENT OF THESE SERVICES. C7247 DUPLICATE BILLING FOR ORAL ANTI-EMETIC DRUG WHICH IS CONSIDERED A FULL THERAPEUTIC REPLACEMENT FOR INTRAVENOUS DRUG FORMS AS A PART OF A CANCER CHEMOTHERAPEUTIC REGIMEN. C7248 INCOMING OR HISTORY OUTPATIENT CLAIMS WITH HCPC CODE '97504' AND '97116' CANNOT BE BILLED ON THE SAME DAY. THE EDIT IS BYPASSED WHEN: THE INCOMING OUTPATIENT CLAIM HAS AN ACTION CODE OF '7', OR THE INCOMING OUTPATIENT CLAIMS HAS AN ACTION CODE OF '4', OR THE INCOMING OR HISTORY CLAIM HAS A 'N' OR 'B' NON-PAYMENT, OR THE INCOMING OR HISTORY CLAIM HAS THE TOTAL CHARGES EQUAL THE NON-COVERED CHARGES FOR THE DETAIL LINE, OR IF THE HISTORY CLAIM HAS A CANCEL DATE, OR IF THE INCOMING OR HISTORY CLAIM HAS A MODIFIER '59'. C7249 THE DATES OF SERVICE ON THIS CLAIM FALL WITHIN AN INTERRUPTED STAY REPORTED ON A PROCESSED IRF PPS CLAIM. C7250 THE DATES OF SERVICE ON THIS CLAIM FALL WITHIN AN INTERRUPTED STAY REPORTED ON A PROCESSED IRF PPS CLAIM. C7251 THIS OUTPATIENT CLAIM CONTAINS THERAPY HCPC CODE(S) AND THE SERVICE DATES ARE WITHIN THE ADMISSION AND DISCHARGE DATES OF AN INPATIENT SNF CLAIM. . OR . THERE IS AN I/P SNF CLAIM WITH DOS PRIOR TO THIS CLAIM AND THE PATIENT STATUS IS 30. YOU NEED TO SUBMIT THE SNF PART A CLAIM PRIOR TO SUBMITTING THE SNF PART B CLAIM. C7252 THIS OUTPATIENT CLAIM WAS SUBMITTED WITH A NON-THERAPY SERVICE AND THE DETAIL LINE ITEM DATES OF SERVICE (OR IN THE ABSENCE OF A DETAIL LINE TIEM DOS, USE THE FROM AND THRU DATE) ARE WITHIN THE ADMIT AND DISCHARGE DATE OF A SNF INPATIENT PART A CLAIM (21X). 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 008 0 CODE EXTERNAL NARRATIVE C7253 AN OUTPATIENT CLAIM (23X) WAS SUBMITTED WITH THE REVENUE CODE '54X', MODIFIER CODE(S) (IF PRESENT), AND DATES OF SERVICE EQUAL TO A PART B CLAIM WITH HCPCS CODE(S) (A0380, A0390, A0425-A0436, AND A0999) AND MODIFIER CODE(S). C7254 AN OUTPATIENT CLAIM WAS SUBMITTED WITH THE SAME HCPCS CODE (S), MODIFIER CODE(S) (IF PRESENT), AND DETAIL LINE ITEM DATE OF SERVICE AS A SNF INPATIENT PART B CLAIM (22X). C7255 A SNF INPATIENT PART B CLAIM (22X) WAS SUBMITTED WITH THE SAME HCPCS CODE(S), MODIFIER CODE(S) (IF PRESENT), AND DETAIL LINE ITEM DATE OF SERVICE AS AN OUTPATIENT CLAIM WITH THE SAME HCPC CODE(S) AND MODIFIER(S). C7256 AN OUTPATIENT CLAIM (12X, 13X, 14X, 23X, 34X, 74X, 75X, 83X, OR 85X) IS SUBMITTED WITH THE SAME HCPCS CODE (S) AND MODIFIER CODE (S) IF PRESENT, AND THE DETAIL LINE ITEM DATE OF SERVICE IS EQUAL TO AN DMERC OR PART B CLAIM WITH THE SAME HCPCS CODE (S) AND MODIFIER CODE (S) AND THE DETAL LINE ITEM DATE OF SERVICE. C7257 A SNF INPATIENT PART B CLAIM (22X) WAS SUBMITTED WITH THE SAME HCPCS CODE(S), MODIFIER CODE(S) (IF PRESENT), AND DETAIL LINE ITEM DATE OF SERVICE AS A DMERC OR PART B CLAIM. C7262 A CLAIM HAS BEEN FILED WITH A FLU OR PNEUMOCOCCAL SERVICE THAT IS A DUPLICATE OF A PREVIOUSLY FILED CLAIM C7265 A CLAIM HAS BEEN FILED WITH A FLU OR PNEUMOCOCCAL SERVICE THAT IS A DUPLICATE OF A PREVIOUSLY FILED CLAIM NOTE: POSSIBLE DUPLICATE DUE TO PHYSICIAN OR PART B CLAIM PAID BY CARRIER. C7266 HCPC CODE 11055, 11056, 11057, 11719, 11720, OR 11721 HAS BEEN PAID WITHIN 6 MONTHS OF G0245, G0246, OR G0247. PLEASE CORRECT AND RESUBMIT. 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' OR 'R') -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'). 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 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 009 0 CODE EXTERNAL NARRATIVE C7268 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 EQUAL OR LESS THAN '45' DAYS C7270 INPATIENT PPS HOSPITALS-REPEAT ADMISSIONS . WHEN A PATIENT IS DISCHARGED/TRANSFERRED FROM AN ACUTE CARE PPS HOSPITAL AND IS READMITTED TO THE SAME HOSPITAL ON THE SAME DAY FOR SYMPTOMS RELATED TO, OR FOR THE EVALUATION AND MANAGEMENT OF, THE PRIOR STAY'S MEDICAL CONDITION, BOTH STAYS SHOULD BE BILLED ON A SINGLE CLAIM*. IF THE READMIT IS UNRELATED TO, AND/OR NOT FOR THE EVALUATION AND MANAGEMENT OF, THE PRIOR STAY'S MEDICAL CONDITION, THE STAYS SHOULD BE BILLED AS TWO SEPARATE CLAIMS AND THE CLAIM REFLECTING THE SECOND ADMIT SHOULD BE BILLED WITH CONDITION CODE B4. . NOTES: SERVICES RENDERED BY OTHER ENTITES DURING A COMBINED STAY MUST BE PAID BY THE ACUTE CARE PPS HOSPITAL. THE ACUTE CARE PPS HOSPITAL IS RESPONSIBLE FOR THE OTHER ENTITY'S SERVICES PER COMMON MEDICARE PRACTICE. - MEDICARE DOES NOT REIMBURSE OTHER ENTITIES FOR SERVICES PERFORMED DURING TWO INPATIENT ACUTE CARE PPS STAYS THAT ARE COMBINED ONTO A SINGLE CLAIM. HOWEVER, THE OTHER ENTITY'S SERVICES MAY BE CONSIDERED AND BILLED AS COVERED SERVICES, WHEN APPROPRIATE, BY THE ACUTE CARE PPS HOSPITAL. . (REFERENCES: CR 3389 DATED 07/30/04, HOSPITAL IOM, CHAPTER 3, SECTION 40.2.5) C7271 INPATIENT PPS HOSPITALS-REPEAT ADMISSIONS . WHEN A PATIENT IS DISCHARGED/TRANSFERRED FROM AN ACUTE CARE PPS HOSPITAL AND IS READMITTED TO THE SAME HOSPITAL ON THE SAME DAY FOR SYMPTOMS RELATED TO, OR FOR THE EVALUATION AND MANAGEMENT OF, THE PRIOR STAY'S MEDICAL CONDITION, BOTH STAYS SHOULD BE BILLED ON A SINGLE CLAIM*. IF THE READMIT IS UNRELATED TO, AND/OR NOT FOR THE EVALUATION AND MANAGEMENT OF, THE PRIOR STAY'S MEDICAL CONDITION, THE STAYS SHOULD BE BILLED AS TWO SEPARATE CLAIMS AND THE CLAIM REFLECTING THE SECOND ADMIT SHOULD BE BILLED WITH CONDITION CODE B4. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 010 0 CODE EXTERNAL NARRATIVE C7271 . NOTES: SERVICES RENDERED BY OTHER ENTITES DURING A COMBINED STAY MUST BE PAID BY THE ACUTE CARE PPS HOSPITAL. THE ACUTE CARE PPS HOSPITAL IS RESPONSIBLE FOR THE OTHER ENTITY'S SERVICES PER COMMON MEDICARE PRACTICE. - MEDICARE DOES NOT REIMBURSE OTHER ENTITIES FOR SERVICES PERFORMED DURING TWO INPATIENT ACUTE CARE PPS STAYS THAT ARE COMBINED ONTO A SINGLE CLAIM. HOWEVER, THE OTHER ENTITY'S SERVICES MAY BE CONSIDERED AND BILLED AS COVERED SERVICES, WHEN APPROPRIATE, BY THE ACUTE CARE PPS HOSPITAL. . (REFERENCES: CR 3389 DATED 07/30/04, HOSPITAL IOM, CHAPTER 3, SECTION 40.2.5) C7272 INPATIENT PPS CLAIM WITH INCORRECT PATIENT STATUS DUE TO TRANSFER TO ANOTHER FACILITY. C7273 A RAP HAS THE INCORRECT HIPPS CODE AND AN INPATIENT CLAIM IS IN HISTORY WITHIN 14 DAYS OF THE START OF HOME HEALTH CARE. C7274 A RAP HAS THE INCORRECT HIPPS CODE AND AN INPATIENT CLAIM IS IN HISTORY WITHIN 14 DAYS OF THE START OF HOME HEALTH CARE. C7275 THE DETAIL LINE ITEM DATE OF SERVICE IS WITHIN THE ADMISSION 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. C7276 FOR AN OUTPATIENT CLAIM (43X) THE DETAIL LINE ITEM DATE OF SERVICE EQUALS THE DETAIL FROM AND THRU DATE IF A DMERC CLAIM AND THE SAME HCPCS CODE(S) DME IS PRESENT. OR FOR A DMERC CLAIM (HUDC) THE DETAIL FROM AND THRU DATE EQUALS THE DETAIL LINE ITEM DATE OF SERVICE AND THE SAME HCPCS CODE(S) DME SERVICE IS PRESENT. C7277 FOR AN OUTPATIENT CLAIM (43X) THE DETAIL LINE ITEM DATE OF SERVICE EQUALS THE DETAIL FROM AND THRU DATE IF A DMERC CLAIM AND THE SAME HCPCS CODE(S) DME IS PRESENT. OR FOR A DMERC CLAIM (HUDC) THE DETAIL FROM AND THRU DATE EQUALS THE DETAIL LINE ITEM DATE OF SERVICE AND THE SAME HCPCS CODE(S) DME SERVICE IS PRESENT. C7278 INPATIENT LTCH, IRF, OR IPF RECORD WITH ADMIT DATE LESS THAN 3 DAYS FROM THE DISCHARGE DATE FROM THE SAME LTCH, IRF, OR IPF C7279 OUTPATIENT CLAIM IS WITHIN AN LTCH CLAIM AND WITHIN THE 3 DAY INTERRUPTED STAY. THEREFORE, THE LTCH IS RESPONSIBLE FOR PAYING THE OUTPATIENT SERVICES 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 011 0 CODE EXTERNAL NARRATIVE C7279 DURING THE INTERRUPTION. C7280 INPATIENT ACUTE CARE HOSPITAL CLAIM IS WITHIN AN LTCH CLAIM AND THE INTERRUPTED STAY IS WITHIN 3 DAYS. THEREFORE, THE LTCH IS RESPONSIBLE FOR PAYING THE ACUTE CARE HOSPITAL FOR THE PATIENT'S STAY "UNDER ARRANGEMENTS". C7281 FOR AN OUTPATIENT CLAIM (34X) THE DETAIL LINE ITEM DATE OF SERVICE IS WITHIN OR EQUALS A RNHCI CLAIM (41X) AND THE PROVIDER NUMBERS ARE THE SAME. OR FOR AN OUTPATIENT CLAIM (43X) AND THE DETAIL LINE ITEM DATE OF SERVICE IS NOT PRESENT THE FROM/THRU DATE IS WITHIN OR OVERLAPS A RNHCI CLAIM (41X) AND THE PROVIDER NUMBERS ARE THE SAME. C7283 FOR AN OUTPATIENT CLAIM (34X) THE DETAIL LINE ITEM DATE OF SERVICE IS WITHIN OR EQUALS A RNHCI CLAIM (41X) AND THE PROVIDER NUMBERS ARE THE SAME. OR FOR AN OUTPATIENT CLAIM (43X) AND THE DETAIL LINE ITEM DATE OF SERVICE IS NOT PRESENT THE FROM/THRU DATE IS WITHIN OR OVERLAPS A RNHCI CLAIM (41X) AND THE PROVIDER NUMBERS ARE THE SAME. C7284 FOR AN OUTPATIENT CLAIM (34X) THE DETAIL LINE ITEM DATE OF SERVICE IS WITHIN OR EQUALS A RNHCI CLAIM (41X) AND THE PROVIDER NUMBERS ARE THE SAME. OR FOR AN OUTPATIENT CLAIM (43X) AND THE DETAIL LINE ITEM DATE OF SERVICE IS NOT PRESENT THE FROM/THRU DATE IS WITHIN OR OVERLAPS A RNHCI CLAIM (41X) AND THE PROVIDER NUMBERS ARE THE SAME. C7285 THIS REASON CODE WILL ASSIGN IF HCPCS CODES G9017, G9018, G9019, G9020, G9033 G9034, G9035, OR G9036 ARE PRESENT ON THE CLAIM AND THE BENE HAS ALREADY BEEN COVERED FOR TWO TREATMENTS OF AN INFLUENZA MEDICATION. THIS CODE WILL SENT BY CWF WHEN THE LIMIT OF TWO HAS BEEN REACHED. C7286 THIS CLAIM CONTAINS HCPC Q0496 OR Q0503 WITHOUT RP MODIFIER AND THE CLAIM DOS ARE WITHIN 6 MONTHS OF THE DISCHARGE DATE FROM A HOSPITAL STAY IN WHICH A VAD WAS IMPLANTED C7287 THIS CLAIM CONTAINS HCPC Q0496 OR Q0505 WITHOUT RP MODIFIER AND THE CLAIM DOS ARE WITHIN 6 MONTHS OF A PREVIOUSLY ALLOWED VAD UNDER PART B C7288 THIS CLAIM CONTAINS HCPC Q0480-Q0495, Q0497-Q0499, Q0505, Q0502 OR Q0504 WITHOUT RP MODIFIER AND THE CLAIM DOS ARE WITHIN 12 MONTHS OF THE DISCHARGE FROM A HOSPITAL IN WHICH A VAD WAS IMPLANTED C7289 THIS CLAIM CONTAINS HCPC Q0480-Q0495, Q0497-Q0499, Q0505, Q0502, OR Q0504 WITHOUT RP MODIFIER AND THE CLAIM DOS ARE WITHIN 12 MONTHS OF A PREVIOUSLY 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 012 0 CODE EXTERNAL NARRATIVE C7289 ALLOWED VAD UNDER PART B C729A THIS LINE CONTAINS A REVENUE CODE, HCPC CODE, MODIFIER, AND LINE ITEM DATE OF SERVICE THAT HAS ALREADY BEEN BILLED ON AN ESRD CLAIM. C729B THIS LINE TIEM DATE OF SERVICE BILLED WITH REVENUE CODE 821, 831, 841 AND/OR 851 IS EQUAL TO THE LINE ITEM DATE OF SERVICE BILLED ON A PROCESSED OUTPATIENT CLAIM. C729C THE LINE ITEM DATE OF SERVICE BILLED IS WITHIN THE ADMIT AND DISCHARGE DATES OF A PROCESSED INPATIENT CLAIM. C729H THE IRF PPS CLAIM HAS BEEN IMPROPERLY CODED AS A DISCHARGE. PLEASE VERIFY DISCHARGES STATUS, CORRECT, AND RESUBMIT. C729I THIS LINE ITEM DATE OF SERVICE BILLED IS EQUAL TO THE LINE ITEM DATE OF SERVICE OF A PROCESSED INPATIENT CLAIM. C7290 THIS LINE ITEM DATE OF SERVICE BILLED IS EQUAL TO THE LINE ITEM DATE OF SERVICE OF A PROCESSED INPATIENT CLAIM. C7291 THIS CLAIM CONTAINS HCPCS Q0480-Q0499 OR Q0501-Q0504 BUT THERE IS NOT RECORD OF A PART A STAY IN WHICH A VAD WAS IMPLANTED C7294 THIS CLAIM CONTAINS HCPCS Q0480-Q0499 OR Q0501-Q0504 BUT THERE IS NOT RECORD OF A PART A STAY IN WHICH A VAD WAS IMPLANTED C7295 THIS CLAIM CONTAINS HCPCS Q0480-Q0499 OR Q0501-Q0504 BUT THERE IS NOT RECORD OF A PART A STAY IN WHICH A VAD WAS IMPLANTED C7296 HCPC G0332 IS ONLY ALLOWED TO BE BILLED ONCE PER DAY. C7300 THIS PART B CLAIM CONTAINS HCPC CODES 99201-99205 AND THERE IS A HOSPICE CLAIM CONTAINING HCPC G0337 WHICH IS ALREADY PROCESSED AND BOTH CLAIMS CONTAIN THE SAME NPI. C7510 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7520 SNF CLAIM (INITIAL ONLY) WITH NO QUALIFYING INPATIENT SERVICE DATES. NO MEDICARE PAYMENT CAN BE MADE. IF THIS REJECT IS IN ERROR, PLEASE SUBMIT A CLAIM WITH THE CORRECTED INFORMATION. C7530 SNF CLAIM (INITIAL ONLY) WITH NO QUALIFYING INPATIENT SERVICE DATES. NO MEDICARE PAYMENT CAN BE MADE. IF THIS REJECT IS IN ERROR, PLEASE SUBMIT A CLAIM WITH THE CORRECTED INFORMATION. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 013 0 CODE EXTERNAL NARRATIVE C7531 THIS IS A CWF RETURN BECAUSE THE DISCHARGE AND ADMISSION DATES ARE THE SAME FOR A PPS HOSPITAL. THIS REQUIRES INTERMEDIARY ACTION - NO PROVIDER ACTION REQUIRED AT THIS TIME. C7532 THIS IS A CWF RETURN BECAUSE THE DISCHARGE AND ADMISSION DATES ARE THE SAME FOR A PPS HOSPITAL. THIS REQUIRES INTERMEDIARY ACTION - NO PROVIDER ACTION REQUIRED AT THIS TIME. C7533 THIS IS A CWF RETURN BECAUSE THE DISCHARGE AND ADMISSION DATES ARE THE SAME FOR A PPS HOSPITAL. THIS REQUIRES INTERMEDIARY ACTION - NO PROVIDER ACTION REQUIRED AT THIS TIME. C7534 THIS IS A CWF RETURN BECAUSE THE DISCHARGE AND ADMISSION DATES ARE THE SAME FOR A PPS HOSPITAL. THIS REQUIRES INTERMEDIARY ACTION - NO PROVIDER ACTION REQUIRED AT THIS TIME. C7535 THIS IS A CWF RETURN BECAUSE THE DISCHARGE AND ADMISSION DATES ARE THE SAME FOR A PPS HOSPITAL. THIS REQUIRES INTERMEDIARY ACTION - NO PROVIDER ACTION REQUIRED AT THIS TIME. C7537 THIS IS A CWF RETURN BECAUSE THE DISCHARGE AND ADMISSION DATES ARE THE SAME FOR A PPS HOSPITAL. THIS REQUIRES INTERMEDIARY ACTION - NO PROVIDER ACTION REQUIRED AT THIS TIME. C7540 INPATIENT CLAIM ADMISSION DATE EQUALS OUTPATIENT LAST SERVICE DATE FOR SAME PROVIDER. C7545 INPATIENT CLAIM STAY DATES OVERLAP OUTPATIENT FROM AND THROUGH DATES. C7546 INPATIENT CLAIM STAY DATES OVERLAP OUTPATIENT FROM AND THROUGH DATES. C7548 INPATIENT CLAIM STAY DATES OVERLAP OUTPATIENT FROM AND THROUGH DATES. C7550 INPATIENT CLAIM STAY DATES EQUAL OR OVERLAP PART B LINE ITEM FOR NONPHYSICIAN SERVICES. NOTE: NONPHYSICIAN SERVICES = PROVIDER SPECIALTY 41, 48, 51-65, 69, 87,88. C7555 SNF CLAIM STAY DATES OVERLAP PART B LINE ITEM FOR DME. C7560 INPATIENT MEDICAL OR PRO DENIED CLAIM STAY DATES EQUAL OR OVERLAP PART B LINE ITEM PHYSICIANS SERVICE. C7570 PART B LINE ITEM CLAIM SERVICE DATES EQUAL OR OVERLAP HOSPICE PERIOD. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 014 0 CODE EXTERNAL NARRATIVE C7580 PART B NON-PHYSICIAN SERVICE DATES OVERLAP INPATIENT STAY DATES. NO MEDICARE PAYMENT CAN BE MADE. C7585 PART B LINE ITEM DME (TYPE SERVICE A, P, I OR R - EXCLUDE PROSTHETIC DEVICES) SERVICE DATES OVERLAP SNF CLAIM. C7610 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. C7620 INPATIENT CLAIM OVERLAPS A HOSPICE PERIOD AND SERVICE DATES EQUAL OR OVERLAP HOSPICE CLAIM. C7630 OUTPATIENT CLAIM OVERLAPS HOSPICE PERIOD AND SERVICE DATES EQUAL OR OVERLAP HOSPICE CLAIM. C7701 OUTPATIENT CLAIM OVERLAPS HOSPICE PERIOD AND SERVICE DATES EQUAL OR OVERLAP HOSPICE CLAIM. C7703 THE DETAIL LINE ITEM DOS OR FROM AND THRU DATE (IF DETAIL LINE ITEM DOS IS NOT PRESENT) IS WITHIN THE START AND END DATE OF A HOME HEALTH PPS EPISODE. C8100 THE DETAIL LINE ITEM DOS OR FROM AND THRU DATE (IF DETAIL LINE ITEM DOS IS NOT PRESENT) IS WITHIN THE START AND END DATE OF A HOME HEALTH PPS EPISODE. DHIC# FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DM001 FOR INTERMEDIARY USE ONLY. NO PROVIDER ACTION IS REQUIRED. DM002 FOR INTERMEDIARY USE ONLY. NO PROVIDER ACTION IS REQUIRED. DM003 FOR INTERMEDIARY USE ONLY. NO PROVIDER ACTION IS REQUIRED. DM004 FOR INTERMEDIARY USE ONLY. NO PROVIDER ACTION IS REQUIRED. DM005 FOR INTERMEDIARY USE ONLY. NO PROVIDER ACTION IS REQUIRED. DM012 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. DM013 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. DM014 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. DM015 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 015 0 CODE EXTERNAL NARRATIVE DM015 REASON CODE REQUIRING CORRECTION IS PRESENT. DM016 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. DM041 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. DM042 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. DM043 ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. DT00F ST/LOC IS "A" AND REQUIRES NO ACTION. THIS CODE APPEARS ONLY WHEN ANOTHER REASON CODE REQUIRING CORRECTION IS PRESENT. DT001 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT002 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT003 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT004 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT005 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT007 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT009 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT010 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT011 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT012 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT013 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT014 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT015 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT016 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 016 0 CODE EXTERNAL NARRATIVE DT017 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT018 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT021 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT023 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT024 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT025 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT026 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT027 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. DT028 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7108 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7171 ALERT ***** OUTPATIENT CLAIM WITH FROM/THRU DATES OF SERVICE OR IF PRESENT OCCURRENCE SPAN CODE 72 DATES EQUAL OR OVERLAP PART B OF SERVICE. D7211 DISPOSITION 01 WITH A TRAILER 13 RECEIVED. D7325 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THRID POSITION IS EQUAL TO 5. THE THRID POSITION OF THE PROVIDER NUMBER IS EQUAL TO S, T, OR U AND THE MATCHING RECORD WAS FOUND ON HISTORY. D7326 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS EQUAL TO 5. THE THIRD POSITIONS OF THIS RECORD'S PROVIDER NUMBER IS MODIFIED FROM S, T OR U TO O AND A MATCHING RECORD WAS FOUND ON HISTORY. D7510 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7520 SNF CLAIM (INITIAL ONLY) WITH NO QUALIFYING INPATIENT SERVICE DATES. NO MEDICARE PAYMENT CAN BE MADE. IF THIS REJECT IS IN ERROR, PLEASE SUBMIT A CLAIM WITH THE CORRECTED INFORMATION. D7530 SNF CLAIM (INITIAL ONLY) WITH NO QUALIFYING INPATIENT SERVICE DATES. NO MEDICARE PAYMENT CAN BE MADE. IF THIS REJECT IS IN ERROR, PLEASE SUBMIT A CLAIM WITH THE CORRECTED INFORMATION. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 017 0 CODE EXTERNAL NARRATIVE D7531 SNF CLAIM (INITIAL ONLY) WITH NO QUALIFYING INPATIENT SERVICE DATES. NO MEDICARE PAYMENT CAN BE MADE. IF THIS REJECT IS IN ERROR, PLEASE SUBMIT A CLAIM WITH THE CORRECTED INFORMATION. D7532 SNF CLAIM (INITIAL ONLY) WITH NO QUALIFYING INPATIENT SERVICE DATES. NO MEDICARE PAYMENT CAN BE MADE. IF THIS REJECT IS IN ERROR, PLEASE SUBMIT A CLAIM WITH THE CORRECTED INFORMATION. D7533 ALERT ***** OUTPATIENT CLAIM WITH FROM/THRU DATES OF SERVICE EQUAL TO OR OVERLAPPING PART B FOR SAME SERVICES FOR DME/PROSTHETIC DEVICE. D7534 ALERT ***** OUTPATIENT CLAIM WITH FROM/THRU DATES OF SERVICE EQUAL TO OR OVERLAPPING PART B FOR SAME SERVICES FOR DME/PROSTHETIC DEVICE. D7535 ALERT ***** OUTPATIENT CLAIM WITH FROM/THRU DATES OF SERVICE EQUAL TO OR OVERLAPPING PART B FOR SAME SERVICES FOR DME/PROSTHETIC DEVICE. D7536 ALERT ***** OUTPATIENT CLAIM WITH FROM/THRU DATES OF SERVICE EQUAL TO OR OVERLAPPING PART B FOR SAME SERVICES FOR DME/PROSTHETIC DEVICE. D7537 ALERT ***** OUTPATIENT CLAIM WITH FROM/THRU DATES OF SERVICE EQUAL TO OR OVERLAPPING PART B FOR SAME SERVICES FOR DME/PROSTHETIC DEVICE. D7540 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7545 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7546 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7548 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7549 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7550 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7551 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7555 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7560 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7570 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7580 PART B LINE PHYSICIAN SERVICE** DATES OVERLAP DENIED INPATIENT/SNF 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 018 0 CODE EXTERNAL NARRATIVE D7580 CLAIM. (PLACE OF SERVICE ON CLAIM MUST MATCH HISTORY.) **PHYSICIAN SERVICE = PROVIDER SPECIALTY 01-40, 49, 70, 99. NO MEDICARE PAYMENT CAN BE MADE. IF THIS REJECT IS IN ERROR, PLEASE SUBMIT A CLAIM WITH THE CORRCTED INFORMATION. D7585 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7610 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7611 DUPLICATE CLAIM WITH DIFFERENT DCN NUMBER. THE FIRST TWO POSITIONS OF THE TOB'S ARE EQUAL, THE 3RD POSITION OF THIS RECORD'S PROVIDER NUMBER = S, T, OR U AND THE MATCHING HISTORY RECORD'S PROVIDER NUMBER= O. D7612 DUPLICATE CLAIM WITH DIFFERENT DCN NUMBER. THE FIRST TWO POSITIONS OF THE TOB'S ARE EQUAL, THE 3RD POSITION OF THE RECORD'S PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO O AND A MATCHING RECORD WAS FOUND ON HISTORY. D7614 DUPLICATE CLAIM WITH DIFFERENT DCN NUMBER. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS NOT = TO 5. THE THIRD POSITION OF THE PROVIDER NUMBER WAS MODIFIED FRO S, T, OR U TO 0 AND A MATCHING RECORD WAS FOUND ON HISTORY. D7615 DUPLICATE CLAIM WITH DIFFERENT DCN NUMBER. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS = TO 5. THE THIRD POSITION OF THE PROVIDER NUMBER= S, T OR U AND THE MATCHING RECORD WAS FOUND ON HISTORY. D7616 A TOB = TO 5 HAS ALREADY PROCESSED FOR THIS HIC NUMBER. D7620 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. D7621 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. THE FIRST TWO POSITIONS OF THE TOB'S ARE EQUAL, THE THIRD POSITION OF THIS RECORDS PROVIDER NUMBER IS EQUAL TO S, T, OR U AND THE MATCHING HISTORY RECORDS PROVIDER NUMBER EQUALS 0. D7622 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. THE FIRST TWO POSITIONS OF THE TOB'S ARE EQUAL, THE THIRD POSITION OF THE RECORD'S PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO O AND A MATCHING RECORD WAS FOUND ON HISTOY. D7623 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS NOT EQUAL TO 5. THE THIRD POSITION OF THE PROVIDER NUMBER IS EQUAL TO S, T, OR U AND THE MATCHING HISTORY RECORD WAS FOUND. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 019 0 CODE EXTERNAL NARRATIVE D7624 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS NOT EQUAL TO 5. THE THIRD POSITION OF THE PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO O AND A MATCHING RECORD WAS FOUND ON HISTORY. D7625 BENEFICIARY RECEIVED DUPLICATES SERVICES FROM DIFFERENT PROVIDERS. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THRID POSITION IS EQUAL TO 5. THE THIRD POSITION OF THE PROVIDER NUMBER IS EQUAL TO S, T, OR U AND THE MATCHING RECORD WAS FOUND ON HISTORY. D7626 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT PROVIDERS. THE THREE POSITIONS OF THE TH TOB'S ARE EQUAL AND THE THIRD POSITION IS EQUAL TO 5. THE THIRD POSTION OF THIS RECORD'S PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO O AND A MATCHING RECORD WAS FOUND ON HISTORY. D7630 OUTPATIENT CLAIM: ACCORDING TO THE HEALTH CARE FINANCING ADMINISTRATION'S RECORDS, THE SERVICE DATES ON THIS CLAIM OVERLAP A HOSPICE PERIOD, AND EQUAL OR OVERLAP THE SERVICE DATES ON A HOSPICE CLAIM. THEREFORE, NO PAYMENT CAN BE MADE ON THIS CLAIM. IF THE INFORMATION BILLED ON THE CLAIM IS INCORRECT, PLEASE SUBMIT A CLAIM WITH CORRECTED INFORMATION. THE CORRECTED CLAIM MAY BE SUBMITTED VIA ELECTRONIC MEDIA. D7631 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. THE FIRST TWO POSITIONS OF THE TOB'S ARE EQUAL, THE 3RD POSITION OF THIS RECORD'S PROVIDER NUMBER = S, T, OR U AND THE MATCHING HISTORY RECORD'S PROVIDER NUMBER = O. D7632 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. THE FIRST TWO POSITIONS OF THE TOB'S ARE EQUAL, THE 3RD POSTION OF THE RECORD'S PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO O AND A MATCHING RECORD WAS FOUND ON HISTORY. D7633 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERNT. THE THREE POSITION OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS NOT = TO 5. THE THRID POSITION OF THE PROVIDER NUMBER = S, T OR U AND THE MATCHING HISTORY RECORD WAS FOUND. D7634 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS NOT = 5. THE THIRD POSITION OF THE PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO O AND AN MATCHING RECORD WAS FOUND ON HISTORY. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 020 0 CODE EXTERNAL NARRATIVE D7635 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. D7636 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE REVENUE CODES ARE DIFFERENT. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS EQUAL TO 5. THE THIRD POSITION OF THIS RECORDS PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO 0 AND A MATCHING RECORD WAS FOUND ON HISTORY. D7640 CWF ERROR RETURN BECAUSE SNF DATES OVERLAP HOSPICE A HOSPICE PERIOD AND THE SERVICE DATES ARE EQUAL OR OVERLAP A HSOPICE CLAIM. NO PROVIDER ACTION REQUIRED AT THIS TIME. D7641 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPC CODES ARE DIFFERENT. D7642 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPC CODES ARE DIFFERENT. D7643 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPC CODES ARE DIFFERENT. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION OF THE PROVIDER NUMBER = S, T, OR U AND THE MATCHING HISTORY RECORD WAS FOUND. D7644 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPC CODES ARE DIFFERENT. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS NOT = 5. THE THIRD POSITION OF THE PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO 0 AND A MATCHING RECORD WAS FOUND ON HISTORY. D7645 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPC CODES ARE DIFFERENT. D7646 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE HCPC CODES ARE DIFFERENT. D7651 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE CHARGES ARE DIFFERENT. D7652 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE CHARGES ARE DIFFERENT. THE FIRST TWO POSITIONS OF THE TOB'S ARE EQUAL, THE 3RD POSITION OF THE RECORD'S PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO 0 AND A MATCHING RECORD WAS FOUND ON HISTORY. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 021 0 CODE EXTERNAL NARRATIVE D7653 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE CHARGES ARE DIFFERENT. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS NOT = TO 5. THE THIRD POSITION OF THE PROVIDER NUMBER = S, T, OR U AND THE MATCHING HISTORY RECORD WAS FOUND. D7654 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE CHARGES ARE DIFFERENT. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS NOT = TO 5. THE THIRD POSITION OF THE PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO O AND A MATCHING RECORD WAS FOUND ON HISTORY. D7655 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE CHARGES ARE DIFFERENT. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS EQUAL TO 5. THE THIRD POSITION OF THE PROVIDER NUMBER = S, T, OR U AND THE MATCHING RECORD WAS FOUND ON HISTORY. D7656 BENEFICIARY RECEIVED DUPLICATE SERVICES WHERE ONLY THE CHARGES ARE DIFFERENT. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS EQUAL TO 5. THE THIRD POSITION OF THE PROVIDER NUMBER = S, T, OR U AND THE MATCHING RECORD WAS FOUND ON HISTORY. D7661 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. THE FIRST TWO POSTITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION OF THIS RECORD'S PROVIDER NUMBER = S, T, OR U AND THE MATCHING HISTORY RECORD'S PROVIDER NUMBER=O. D7662 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. THE FIRST TWO POSITIONS OF THE TOB'S ARE EQUAL, THE 3RD POSITION OF THE RECORD'S PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO O AND A MATCHING RECORD WAS FOUND ON HISTORY. D7663 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS NOT = 5. THE THIRD POSITION OF THE PROVIDER NUMBER = S, T, OR U AND THE MATCHING HISTORY RECORD WAS FOUND. D7664 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. THE THREE POSITIONS OF THE TOB'S ARE EQUAL AND THE THIRD POSITION IS NOT =5. THE THIRD POSITION OF THE PROVIDER NUMBER WAS MODIFIED FROM S, T, OR U TO O AND A MATCHING RECORD WAS FOUND ON HISTORY. D7665 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. D7666 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. D7701 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 022 0 CODE EXTERNAL NARRATIVE D7702 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. D7703 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. D8100 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. D8101 BENEFICIARY RECEIVED DUPLICATE SERVICES FROM DIFFERENT INTERMEDIARIES. EA001 INVALID RESPONSE CODE. EA002 BENEFICIARY IDENTIFICATION NUMBER (HIC#) IS INCORRECT. EA003 BENEFICIARY IDENTIFICATION NUMBER (HIC#) IS INCORRECT OR MISSING. EA004 INVALID SURNAME. NO MEDICARE PAYMENT CAN BE MADE. IF THIS REJECT IS IN ERROR, PLEASE SUBMIT A CLAIM WITH THE CORRECTED INFORMATION. EA005 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA006 INVALID DATE OF BIRTH. NO MEDICARE PAYMENT CAN BE MADE. IF THIS REJECT IS IN ERROR, PLEASE SUBMIT A CLAIM WITH THE CORRECTED INFORMATION. EA007 INVALID SEX CODE. NO MEDICARE PAYMENT CAN BE MADE. IF THIS REJECT IS IN ERROR, PLEASE SUBMIT A CLAIM WITH THE CORRECTED INFORMATION. EA008 INVALID INTERMEDIARY NUMBER EA009 INVALID INTERMEDIARY NUMBER 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 NO PAYMENT CAN BE MADE UNDER THE MEDICARE MEDICAL INSURANCE PLAN UNTIL THE BENEFICIARY HAS INCURRED EXPENSES GREATER THAN THE MEDICARE PART B DEDUCTIBLE ($100.00) FOR THE CALENDAR YEAR. EA023 TO MENTAL HEALTH INSTUTITIONS: PHYSICIAN SERVICES PROVIDED ON OR AFTER MARCH 1, 1992 MUST BILLED TO THE PART B CARRIER. EA024 INVALID SECOND INITIAL 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 023 0 CODE EXTERNAL NARRATIVE EA025 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. EA026 FOR INTERMEDIARY USE ONLY. EA027 FOR INTERMEDIARY USE ONLY. EA028 FOR INTERMEDIARY USE ONLY. EA029 FOR INTERMEDIARY USE ONLY. EA030 FOR INTERMEDIARY USE ONLY. EA031 IF YOUR ARE A PPS TEACHING HOSPITAL AND ARE SUBMITTING A CLAIM TO REQUEST IME/GME SUPPLIMENTAL PAYMENT, YOU MUST SUBMIT CLAIM WITH CONDITION CODE 04 AND 69 OR IF YOU ARE NOT A PPS TECHING HOSPITAL, YOU MUST FILE CLAIM TO HMO EA033 IF YOUR ARE A PPS TEACHING HOSPITAL AND ARE SUBMITTING A CLAIM TO REQUEST IME/GME SUPPLIMENTAL PAYMENT, YOU MUST SUBMIT CLAIM WITH CONDITION CODE 04 AND 69 OR IF YOU ARE NOT A PPS TECHING HOSPITAL, YOU MUST FILE CLAIM TO HMO EA034 IF YOUR ARE A PPS TEACHING HOSPITAL AND ARE SUBMITTING A CLAIM TO REQUEST IME/GME SUPPLIMENTAL PAYMENT, YOU MUST SUBMIT CLAIM WITH CONDITION CODE 04 AND 69 OR IF YOU ARE NOT A PPS TECHING HOSPITAL, YOU MUST FILE CLAIM TO HMO EA035 IF YOUR ARE A PPS TEACHING HOSPITAL AND ARE SUBMITTING A CLAIM TO REQUEST IME/GME SUPPLIMENTAL PAYMENT, YOU MUST SUBMIT CLAIM WITH CONDITION CODE 04 AND 69 OR IF YOU ARE NOT A PPS TECHING HOSPITAL, YOU MUST FILE CLAIM TO HMO EA036 IF YOUR ARE A PPS TEACHING HOSPITAL AND ARE SUBMITTING A CLAIM TO REQUEST IME/GME SUPPLIMENTAL PAYMENT, YOU MUST SUBMIT CLAIM WITH CONDITION CODE 04 AND 69 OR IF YOU ARE NOT A PPS TECHING HOSPITAL, YOU MUST FILE CLAIM TO HMO EA037 IF YOUR ARE A PPS TEACHING HOSPITAL AND ARE SUBMITTING A CLAIM TO REQUEST IME/GME SUPPLIMENTAL PAYMENT, YOU MUST SUBMIT CLAIM WITH CONDITION CODE 04 AND 69 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 024 0 CODE EXTERNAL NARRATIVE EA037 OR IF YOU ARE NOT A PPS TECHING HOSPITAL, YOU MUST FILE CLAIM TO HMO EA038 IF YOUR ARE A PPS TEACHING HOSPITAL AND ARE SUBMITTING A CLAIM TO REQUEST IME/GME SUPPLIMENTAL PAYMENT, YOU MUST SUBMIT CLAIM WITH CONDITION CODE 04 AND 69 OR IF YOU ARE NOT A PPS TECHING HOSPITAL, YOU MUST FILE CLAIM TO HMO EA039 IF YOUR ARE A PPS TEACHING HOSPITAL AND ARE SUBMITTING A CLAIM TO REQUEST IME/GME SUPPLIMENTAL PAYMENT, YOU MUST SUBMIT CLAIM WITH CONDITION CODE 04 AND 69 OR IF YOU ARE NOT A PPS TECHING HOSPITAL, YOU MUST FILE CLAIM TO HMO EA040 IF YOUR ARE A PPS TEACHING HOSPITAL AND ARE SUBMITTING A CLAIM TO REQUEST IME/GME SUPPLIMENTAL PAYMENT, YOU MUST SUBMIT CLAIM WITH CONDITION CODE 04 AND 69 OR IF YOU ARE NOT A PPS TECHING HOSPITAL, YOU MUST FILE CLAIM TO HMO EA041 IF YOUR ARE A PPS TEACHING HOSPITAL AND ARE SUBMITTING A CLAIM TO REQUEST IME/GME SUPPLIMENTAL PAYMENT, YOU MUST SUBMIT CLAIM WITH CONDITION CODE 04 AND 69 OR IF YOU ARE NOT A PPS TECHING HOSPITAL, YOU MUST FILE CLAIM TO HMO EHIC# FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. 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. ET008 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. ET012 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. ET017 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. ET018 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. ET023 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 025 0 CODE EXTERNAL NARRATIVE EXMPT FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0011 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0012 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0013 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0014 DEMONSTRATION NUMBERS OTHER THAN 03, 05, 06, 07, 08, 15, 30, 31, 38, 39, 40 44, 46, 48, 49 OR 51 ARE INVALID E0015 DEMONSTRATION NUMBERS OTHER THAN 03, 05, 06, 07, 08, 15, 30, 31, 38, 39, 40 44, 46, 48, 49 OR 51 ARE INVALID E0016 DEMONSTRATION NUMBERS OTHER THAN 03, 05, 06, 07, 08, 15, 30, 31, 38, 39, 40 44, 46, 48, 49 OR 51 ARE INVALID E0017 DEMONSTRATION NUMBERS OTHER THAN 03, 05, 06, 07, 08, 15, 30, 31, 38, 39, 40 44, 46, 48, 49 OR 51 ARE INVALID E0018 DEMONSTRATION NUMBERS OTHER THAN 03, 05, 06, 07, 08, 15, 30, 31, 38, 39, 40 44, 46, 48, 49 OR 51 ARE INVALID E0019 DEMONSTRATION NUMBERS OTHER THAN 03, 05, 06, 07, 08, 15, 30, 31, 38, 39, 40 44, 46, 48, 49 OR 51 ARE INVALID E0020 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0021 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED E0022 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED E0042 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0043 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0044 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0045 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0046 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0047 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E0048 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 026 0 CODE EXTERNAL NARRATIVE E0401 THE TYPE OF BILL IS IMPOSSIBLE, INCOMPLETE, MISSING, OR IS INCONSISTENT WITH THE PROVIDER NUMBER, OR THE TOB IS INVALID FOR SERVICES BILLED. E0402 THE TYPE OF BILL IS IMPOSSIBLE, INCOMPLETE, MISSING, OR IS INCONSISTENT WITH THE PROVIDER NUMBER, OR THE TOB IS INVALID FOR SERVICES BILLED. E0406 THIS IS A MAMMOGRAPHY CLAIM BUT THE HCPC CODE USED IS EITHER AN INVALID HCPC OR IS NOT THE CORRECT HCPC FOR THE CLAIM DATE OF SERVICE. E0408 THIS IS A MAMMOGRAPHY CLAIM BUT THE HCPC CODE USED IS EITHER AN INVALID HCPC OR IS NOT THE CORRECT HCPC FOR THE CLAIM DATE OF SERVICE. E041A THIS IS A MAMMOGRAPHY CLAIM BUT THE HCPC CODE USED IS EITHER AN INVALID HCPC OR IS NOT THE CORRECT HCPC FOR THE CLAIM DATE OF SERVICE. E0410 REVENUE CODE 636 MUST BE PRESENT WHEN OCCURRENCE CODE 36 IS ON THE CLAIM. E0412 LATE CHARGE BILLS ARE TO BE USED FOR OUTPATIENT CLAIMS ONLY. PLEASE CORRECT AND RESUBMIT. E0413 LATE CHARGE BILLS ARE TO BE USED FOR OUTPATIENT CLAIMS ONLY. PLEASE CORRECT AND RESUBMIT. E0414 LATE CHARGE BILLS ARE TO BE USED FOR OUTPATIENT CLAIMS ONLY. PLEASE CORRECT AND RESUBMIT. E0415 LATE CHARGE BILLS ARE TO BE USED FOR OUTPATIENT CLAIMS ONLY. PLEASE CORRECT AND RESUBMIT. E0416 LATE CHARGE BILLS ARE TO BE USED FOR OUTPATIENT CLAIMS ONLY. PLEASE CORRECT AND RESUBMIT. E0417 LATE CHARGE BILLS ARE TO BE USED FOR OUTPATIENT CLAIMS ONLY. PLEASE CORRECT AND RESUBMIT. E0418 LATE CHARGE BILLS ARE TO BE USED FOR OUTPATIENT CLAIMS ONLY. PLEASE CORRECT AND RESUBMIT. E0419 LATE CHARGE BILLS ARE TO BE USED FOR OUTPATIENT CLAIMS ONLY. PLEASE CORRECT AND RESUBMIT. E0701 PROVIDER NUMBER POSITIONS 1-2 IS NOT NUMERIC. E0702 PROVIDER NUMBER NOT CONSISTENT WITH THE TYPE OF BILL 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 027 0 CODE EXTERNAL NARRATIVE E0703 INVALID SEX CODE FOR A SCREENING MAMMOGRAPHY CLAIM. E1001 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E1501 THE ADMISSION DATE IS IMPOSSIBLE OR INCOMPLETE. PLEASE CORRECT AND RESUBMIT THE CLAIM. E1502 THE ADMISSION DATE IS AFTER THE CLAIM FROM DATE. PLEASE CORRECT AND RESUBMIT THE CLAIM. E1503 BILLS WITH DATES OF SERVICE PRIOR TO 1/1/89 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 55,56,57, OR 58. ONE OF THESE MUST BE PRESENT. PLEASE CORRECT AND RESUBMIT. E1504 DATES OF SERVICE ON CLAIM ARE GREATER THAN THE CURRENT DATE. E1505 AN INPATIENT CLAIM WITH BLOOD CLOTTING FACTOR HCPCS (J7190, J7192, J7194 J7196) HAS BEEN RECEIVED AND THE STATEMENT COVERS FROM DATE IS GREATER THAN 09/30/94. E1801 AN INPATIENT CLAIM WITH BLOOD CLOTTING FACTOR HCPCS (J7190, J7192, J7194 J7196) HAS BEEN RECEIVED AND THE STATEMENT COVERS FROM DATE IS GREATER THAN 09/30/94. E1803 AN INPATIENT CLAIM WITH BLOOD CLOTTING FACTOR HCPCS (J7190, J7192, J7194 J7196) HAS BEEN RECEIVED AND THE STATEMENT COVERS FROM DATE IS GREATER THAN 09/30/94. E2101 PATIENT STATUS OMITTED OR CODE IMPOSSIBLE E2102 PATIENT STATUS CODE IS NOT CORRECT E2103 PATIENT STATUS CODE IS NOT CORRECT E2201 THE STATEMENT 'FROM' DATE IS IMPOSSIBLE OR INCOMPLETE E2202 THE STATEMENT 'THRU' DATE IS LATER THAN THE STATEMENT 'FROM' DATE NOTE:: THIS EDIT IS PERFORMED ON HOSPICE NOTICE OF TERMINATION ONLY E2203 THE STATEMENT 'THRU' DATE IS AN IMPOSSIBLE OR INCOMPLETE ENTRY. E2204 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 028 0 CODE EXTERNAL NARRATIVE E2205 OUTPATIENT: 'FROM' DATE YEAR NOT THE SAME AS 'THRU' DATE YEAR. OUTPATIENT CLAIMS CANNOT SPAN YEARS. E2206 OUTPATIENT: 'FROM' DATE YEAR NOT THE SAME AS 'THRU' DATE YEAR. OUTPATIENT CLAIMS CANNOT SPAN YEARS. E2207 OUTPATIENT MAMMOGRAPHY DATE IS LESS THAN 123190. E2208 THE STATEMENT COVERED FROM DATE ON A SNF PPS CLAIMS IS BEFORE 7/1/98. E2209 THE STATEMENT COVERED FROM DATE ON A SNF PPS CLAIMS IS BEFORE 7/1/98. E2210 THE STATEMENT COVERED FROM DATE ON A SNF PPS CLAIMS IS BEFORE 7/1/98. E2211 THE STATEMENT COVERED FROM DATE ON A SNF PPS CLAIMS IS BEFORE 7/1/98. E2212 THE STATEMENT COVERED FROM DATE ON A SNF PPS CLAIMS IS BEFORE 7/1/98. E2213 THE STATEMENT COVERED FROM DATE ON A SNF PPS CLAIMS IS BEFORE 7/1/98. E2214 THE STATEMENT COVERED FROM DATE ON A SNF PPS CLAIMS IS BEFORE 7/1/98. E2215 THE STATEMENT COVERED FROM DATE ON A SNF PPS CLAIMS IS BEFORE 7/1/98. E2216 AN MCCD/DMD OUTPATIENT RECORD WITH DEMO NUMBER '37', OR OUTPATIENT ENCOUNTER RECORD, OR CLINICAL TRIAL RECORD WITH CONDITION CODE '30', OR IMPLANTABLE DEFIBRILLATOR CLAIM WITH CONDITION CODE '78' OR EXPENSES SUBJECT TO THE DEDUCTIBLE IS GREATER THAN ZERO, AND DATES OF SERVICE ARE ON OR AFTER 9/19/2000. E2301 A BILL CONTAINS A UTILIZATION DAYS ENTRY OTHER THAN A NUMBER, OR EXCEEDS THE NUMBER OF DAYS AVAILABLE FOR THE TYPE OF BILL (HOSPITAL - 150 DAYS; SNF - 100 DAYS) E2302 THE SUM OF UTILIZATION PLUS NONUTILIZATION DAYS MUST EQUAL THE DIFFERENCE BEWTEEN THE THRU DATE MINUS THE FROM DATE IN THE STATEMENT COVERS PERIOD. IF A PATIENT STATUS CODE IS 30, OR IF THE FROM DATE IS EQUAL TO THE THRU DATE, THE SUM OF UTILIZATION DAYS PLUS NONUTILIZATION DAYS MUST EQUAL THE DIFFERENCE BETWEEN THE THRU DATE MINUS THE FROM DATE PLUS 1. E2303 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E2304 NO UTILIZATION DAYS ARE SHOWN ON PATIENT FILED BILL 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 029 0 CODE EXTERNAL NARRATIVE E2305 UTILIZATION AND/OR NON-UTILIZATION DAYS ARE PRESENT ON A HOSPITAL INPATIENT OR SNF INPATIENT LATE-CHARGE CLAIM. E2306 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E2307 SAME DAY TRANSFER CLAIM WITH CONDITION CODE 40, CONTAINS EITHER UTILIZATION DAYS GREATER THAN OR EQUAL TO 0, OR VALUE CODE A1, 08, OR 09, AND PATIENT STATUS IS NOT A TRANSFER STATUS. E2308 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E2401 NONUTILIZATION DAYS ENTRY CONTAINS AN ENTRY OTHER THAN A NUMBER E2501 HOSPITAL/SNF: THE COINSURANCE DAYS ENTRY IS INCOMPLETE OR IS OTHER THAN A NUMBER. E2502 HOSPITAL/SNF: COINSURANCE DAYS OR LIFETIME RESERVE DAYS EXCEED THE NUMBER OF UNTILIZATION DAYS. E2503 HOSPITAL/SNF: IF HOSPITAL, UTILIZATION DAYS MINUS COINSURANCE DAYS EXCEED 60. IF SNF, UTILIZATION DAYS MINUS COINSURANCE DAYS EXCEED 20. E2504 HOSPITAL/SNF: THE COINSURANCE RATE (COINSURANCE AMOUNT DIVIDED BY COINSURANCE DAYS) EXCEEDS THE RATE THAT APPLIES TO THE CALENDAR YEAR IN WHICH THE COINSURANCE DAYS OCCUR. E2505 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E2506 HOSPITAL/SNF: COINSURANCE DAYS ARE SHOWN, BUT NO AMOUNT IS SHOWN FOR EITHER VALUE CODE 09, OR VALUE CODE 11. /////////////////////////////////////////////////////////////////////////// THIS ERROR CAN ALSO BE RECEIVED WHEN THE PROVIDER HAS BILLED BOTH AN A3, B3, OR C3 OCCURRENCE CODE (BENEFITS EXHAUSTED DURING STAY) AND A 74 OCCURRENCE SPAN (NON-COVERED LEVEL OF CARE). EITHER THE 74 OCCURRENCE SPAN OR THE BENEFITS EXCAUSTED OCCURRENCE CODE SHOULD BE USED. PLEASE CORRECT AND RESUBMIT. NOTE, PLEASE VERIFY APPROPRIATE CODES ARE PRESENT. NOTE: PLEASE REVIEW REMARKS PAGE ON CLAIM FOR ADDITIONAL CLAIM SPECIFIC PROCESSING INSTRUCTIONS E2507 HOSPITAL/SNF: THE SUM OF COINSURANCE DAYS PLUS LIFE TIME RESERVE DAYS IN EITHER THE YEAR OF ADMISSION OR THE YEAR OF DISCHARGE IN A BILL THAT SPANS CALENDAR YEAR END IS GREATER THAN THE NUMBER OF DAYS IN THE STATEMENT COVERS PERIOD FOR THAT PORTION OF THE BILL. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 030 0 CODE EXTERNAL NARRATIVE E2508 COINSURANCE DAYS AND/OR LIFETIME RESERVE DAYS SHOULD NOT BE APPLIED TOWARD UTILIZATION DAYS FOR BILLING DATES FROM 010189 THRU 123189. E2601 HOSPITAL/SNF: IN A HOSPITAL BILL THIS ITEM CONTAINS AN ENTRY OTHER THAN A NUMBER OR A NUMBER THAT EXCEEDS 60. AN ENTRY FOR A SNF BILL IS INAPPROPRIATE AS LIFETIME RESERVE DAYS APPLY ONLY TO INPATIENT HOSPITAL STAYS. E2602 HOSPITAL: LIFETIME RESERVE DAYS ARE SHOWN, BUT NO AMOUNT IS SHOWN FOR EITHER VALUE CODE 08, OR VALUE CODE 10. ///////////////////////////////////////////////////////////////////////////// THIS ERROR CAN ALSO BE RECEIVED WHEN THE PROVIDER ATTEMPTS TO BILL FOR LIFETIME RESERVE DAYS ON AN OUTLIER CLAIM WHERE AT LEAST ONE REGULAR BENEFIT DAY REMAINS ON THE CLAIM. IN THIS INSTANCE, THE BENEFICIARY IS DEEMED TO HAVE ELECTED NOT TO USE LTR DAYS, AND THEY SHOULD BE REMOVED FROM THE BILL. E2603 FOR INTERMEDIARY USE ONLY; NO PROVIDER ACTION IS REQUIRED. E2604 THIS BILL CONTAINS LIFETIME RESERVE DAYS WHICH IS NOT EQUAL TO COVERED DAYS AND DOES NOT CONTAIN A DAY OUTLIER. PPS BILLS MAY NOT INCLUDE LIFETIME RESERVE DAYS UNLESS ALL DAYS USED ARE LIFETIME RESERVE DAYS OR THE BILL CONTAINS A DAY OUTLIER E28#A THIS BILL CONTAINS LIFETIME RESERVE DAYS WHICH IS NOT EQUAL TO COVERED DAYS AND DOES NOT CONTAIN A DAY OUTLIER. PPS BILLS MAY NOT INCLUDE LIFETIME RESERVE DAYS UNLESS ALL DAYS USED ARE LIFETIME RESERVE DAYS OR THE BILL CONTAINS A DAY OUTLIER E28#B THIS BILL CONTAINS LIFETIME RESERVE DAYS WHICH IS NOT EQUAL TO COVERED DAYS AND DOES NOT CONTAIN A DAY OUTLIER. PPS BILLS MAY NOT INCLUDE LIFETIME RESERVE DAYS UNLESS ALL DAYS USED ARE LIFETIME RESERVE DAYS OR THE BILL CONTAINS A DAY OUTLIER E28#C THIS BILL CONTAINS LIFETIME RESERVE DAYS WHICH IS NOT EQUAL TO COVERED DAYS AND DOES NOT CONTAIN A DAY OUTLIER. PPS BILLS MAY NOT INCLUDE LIFETIME RESERVE DAYS UNLESS ALL DAYS USED ARE LIFETIME RESERVE DAYS OR THE BILL CONTAINS A DAY OUTLIER E28#D THE DATE OF OCCURRENCE CODE (A3, B3, ORC3) ON A PPS CLAIM IS NOT EQUAL TO THE THRU DATE OF THE OCCURRENCE SPAN CODE 70'DATE. E28#E THE DATE OF OCCURRENCE CODE (A3, B3, ORC3) ON A PPS CLAIM IS NOT EQUAL TO THE THRU DATE OF THE OCCURRENCE SPAN CODE 70'DATE. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 031 0 CODE EXTERNAL NARRATIVE E28#L THE DATE OF OCCURRENCE CODE (A3, B3, ORC3) ON A PPS CLAIM IS NOT EQUAL TO THE THRU DATE OF THE OCCURRENCE SPAN CODE 70'DATE. E28#M THE DATE OF OCCURRENCE CODE (A3, B3, ORC3) ON A PPS CLAIM IS NOT EQUAL TO THE THRU DATE OF THE OCCURRENCE SPAN CODE 70'DATE. E28#N THE DATE OF OCCURRENCE CODE (A3, B3, ORC3) ON A PPS CLAIM IS NOT EQUAL TO THE THRU DATE OF THE OCCURRENCE SPAN CODE 70'DATE. E28#O THE DATE OF OCCURRENCE CODE (A3, B3, ORC3) ON A PPS CLAIM IS NOT EQUAL TO THE THRU DATE OF THE OCCURRENCE SPAN CODE 70'DATE. E28#P THE DATE OF OCCURRENCE CODE (A3, B3, ORC3) ON A PPS CLAIM IS NOT EQUAL TO THE THRU DATE OF THE OCCURRENCE SPAN CODE 70'DATE. E28#0 INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28#1 INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28#2 INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28#3 INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28#4 INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28#5 INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28#6 INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28#7 INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28#8 INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28#9 INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28AD INVALID OR MISSING OCCURRENCE CODE '42' DATE. E28AF A NON-COVERED SNF CLAIM CANNOT CONTAIN AN OCCURRENCE CODE 22 THAT IS WITHIN THE DATES OF SERVICE. PLEASE CORRECT AND RESUBMIT. E28AM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 032 0 CODE EXTERNAL NARRATIVE E28AO THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28AP THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28A1 THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 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 THROUGH DATE. E28BD 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 THROUGH DATE. E28BF A NON-COVERED SNF CLAIM CANNOT CONTAIN AN OCCURRENCE CODE 22 THAT IS WITHIN THE DATES OF SERVICE. PLEASE CORRECT AND RESUBMIT. E28BM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28BO THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28BP THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28B1 THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 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 CLAIM THROUGH DATE. E28CD 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 THROUGH DATE. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 033 0 CODE EXTERNAL NARRATIVE E28CF A NON-COVERED SNF CLAIM CANNOT CONTAIN AN OCCURRENCE CODE 22 THAT IS WITHIN THE DATES OF SERVICE. PLEASE CORRECT AND RESUBMIT. E28CM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28CO THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28CP THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28C1 THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 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 THROUGH DATE. E28DD 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 THROUGH DATE. E28DF A NON-COVERED SNF CLAIM CANNOT CONTAIN AN OCCURRENCE CODE 22 THAT IS WITHIN THE DATES OF SERVICE. PLEASE CORRECT AND RESUBMIT. E28DM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28DO THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28DP THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28D1 THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 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 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 034 0 CODE EXTERNAL NARRATIVE E28D8 PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THROUGH DATE. E28ED 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 THROUGH DATE. E28EF A NON-COVERED SNF CLAIM CANNOT CONTAIN AN OCCURRENCE CODE 22 THAT IS WITHIN THE DATES OF SERVICE. PLEASE CORRECT AND RESUBMIT. E28EM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28EO THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28EP THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28E1 THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 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 THROUGH DATE. E28FD 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 THROUGH DATE. E28FF A NON-COVERED SNF CLAIM CANNOT CONTAIN AN OCCURRENCE CODE 22 THAT IS WITHIN THE DATES OF SERVICE. PLEASE CORRECT AND RESUBMIT. E28FM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28FO THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28FP THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 035 0 CODE EXTERNAL NARRATIVE E28F1 THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 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 THROUGH DATE. E28GD 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 THROUGH DATE. E28GF A NON-COVERED SNF CLAIM CANNOT CONTAIN AN OCCURRENCE CODE 22 THAT IS WITHIN THE DATES OF SERVICE. PLEASE CORRECT AND RESUBMIT. E28GM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28GO THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28GP THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28G1 THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 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 THROUGH DATE. E28HD 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 THROUGH DATE. E28HF A NON-COVERED SNF CLAIM CANNOT CONTAIN AN OCCURRENCE CODE 22 THAT IS WITHIN THE DATES OF SERVICE. PLEASE CORRECT AND RESUBMIT. E28HM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 036 0 CODE EXTERNAL NARRATIVE E28HM DATE ON THE CLAIM. E28HO THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28HP THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28H1 THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 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 THROUGH DATE. E28ID 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 THROUGH DATE. E28IF A NON-COVERED SNF CLAIM CANNOT CONTAIN AN OCCURRENCE CODE 22 THAT IS WITHIN THE DATES OF SERVICE. PLEASE CORRECT AND RESUBMIT. E28IM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28IO THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28IP THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28I1 THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 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 THROUGH DATE. E28JD 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 1 M E D I C A R E P A R T A CURRENT DATE: 07/21/08 REQUESTED BY: WAS RPT NBR 970 REASON CODE -- EXTERNAL NARRATIVE REQUEST TYPE: C PAGE NUMBER: 037 0 CODE EXTERNAL NARRATIVE E28JD PRIOR TO THE CLAIM FROM DATE OR AFTER THE CLAIM THROUGH DATE. E28JF A NON-COVERED SNF CLAIM CANNOT CONTAIN AN OCCURRENCE CODE 22 THAT IS WITHIN THE DATES OF SERVICE. PLEASE CORRECT AND RESUBMIT. E28JM THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28JO THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28JP THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. E28J1 THE OCCURRENCE CODE '42' DATE DOES NOT EQUAL THE SERVICE THRU DATE ON THE CLAIM. 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