Claims that RTP with reason codes 153XX-154XX indicate that the total charges revenue line 0001 contains a charge not equal to the sum total of all line items billed (covered and non-covered) on the claim.

There may have been updates or changes to some of the line items billed, but the total charge line was not deleted and re-entered with the correct amount.

To avoid this reason code from recurring, the following steps should be taken prior to updating the claim:

• Verify total charges for all line items billed (covered and non-covered)
• Delete revenue code line 0001, and re-key calculated charges

Refer to the Part A Reason Code Lookup 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.

Direct data entry (DDE)

The processes for deleting and re-keying revenue code lines are outlined below.

• Access the claims correction menu under option 03
• Enter the appropriate selection that matches your provider type
  • Enter the NPI, then T B9997 in the S/LOC field
• Select the claim under the SEL field
• Go to claims page 02 or the MAP1712 screen
  • Do not key over the existing line item when making corrections (such as, revenue codes, units, charges, etc.)
  • Delete line(s) requiring revisions, by keying D000 over the revenue code, press the ‘Home’ key, then ‘Enter’
  • Add line items back to the claim by typing in the new revenue code line information under the 0001 line, press the ‘Home’ key, then ‘Enter’
  • Update the total charge and/or non-covered charge amount on the 0001 revenue code line to reflect the correct amount
  • Press the ‘F9’ key for claim submission

Reference

• Medicare Part A direct data entry (DDE) training manual