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Last Modified: 1/26/2012
Location: FL
Business: Part A
Top Part A rural health return to provider (RTP) reason codes
The following is a list of the most frequent return to provider (RTP) reason codes for claims processed by Florida Medicare Part A. The codes link to tips and resources to help you avoid these errors.
Please share this information with all who need to know, such as your IT staff, billing service, vendor, and/or clearinghouse. Remember -- billing Medicare correctly the first time saves everyone time and money.
• Click here for general Part A inquiries (e.g., claims, eligibility information)
• For tips on rejects for services other than rural health, click here.
Note: Under current guidelines, any reference to "UPIN" within the definition of codes should be interpreted as "NPI," the provider's national provider identifier. The Centers for Medicare & Medicaid Services (CMS) is not responsible for updating denial codes, so some definitions may reflect outdated verbiage.
Select an RTP reason code from the list below for tips on how to avoid the error:
• 32291
• E0401 -- see RTP reason code E0401 FAQ
• N5052 -- see RTP reason code N5052 FAQ
• Other common tips on inquiries and denials -- click here
Would you like to create an account and receive your own personalized Provider Data Summary (PDS) report?
The Provider Data Summary (PDS) is a comprehensive billing report designed to be utilized along with Medicare Remittance Notices (MRNs) and other provider-accessible billing resources to help identify potential Medicare billing issues. The PDS provides a detailed analysis of your billing patterns compared to similar providers.
Please visit our Provider Data Summary page to request the report via the PDS portal. Select the link titled “PDS Portal.” You will be given the option to log in, get help with a misplaced password, or create an account. The Provider Data Summary page also contains PDS resources including a guide and FAQs.
Source: FCSO Education Action Team
