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Last Modified: 10/7/2020 Location: FL, PR, USVI Business: Part A

Reason codes for denied claims FAQ

Q: What are the reason code ranges for claims when they have denied?
A: For claims that have been reviewed by the medical review department and denied, the reason code will start with a "5". If your claim was denied through the fiscal intermediary shared system (FISS) the reason code will start with a "7", which is a non-medical denial.
Click here for the description of a Medicare Part A reason code. Enter the reason code into the box and click the submit button.
Source: Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE) manual
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