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Last Modified: 5/13/2020 Location: FL, PR, USVI Business: Part A

Avoiding RTP reason code 37544 FAQ

Q: We are receiving a return to provider (RTP) reason code 37544, so what steps can we take to avoid this reason code?
Click here for a description associated with the Medicare Part A reason code(s). Enter a valid reason code into the box and click the submit button.
A: A claim adjustment was submitted with condition code D1 to specify that there were changes in the charges. However, the line item and total charges on the adjustment are the same as the original claim.
Condition code D1 is used when charges are the only change on the claim
Condition code D1 should not be used even though other claim change reasons frequently change charges
Click here for a list of condition codes that may be used for claim adjustments
Source: CMS internet-only manual (IOM) Pub. 100-04, Chapter 1, Section 130.1.2 external pdf file
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