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This procedure or procedure/modifier combination is not compatible with another procedure or procedure /modifier combination provided on the same day according to the National Correct Coding Initiative.
Prior to submitting your claim, verify the revenue code(s) and/or HCPCS or CPT code combination is correct, complete, and/or valid (as applicable).
The following reason codes are frequently associated with this edit:
Use the left menu find tips to avoid common denials and claims rejections. Billing Medicare correctly the first time increases your cash flow while reducing provider burden.
Read this article for helpful hints for SNF claim reviews by CERT.
View this new provider roadmap for guidance through the Medicare process.
Read this article for tips on how to prevent reject reason code 31997.
There are a few scenarios that exist for denial reason code CO 97, as outlined below. Please review the associated remittance advice remark code (RARC) noted on the remittance advice for your claim and then refer to the specific resources a…
First Coast offers several online tools for you to diagnose why your Medicare claims were denied and resources to help you prevent future claims from such a fate. When a claim gets denied, with First Coast’s web tools you can solve many iss…
A claim on status T (RTP) was returned to provider for corrections. The assigned reason code will provide you instructions for the necessary corrections.
Providers billing Medicare should determine if a patient is enrolled in hospice before billing Medicare Part A. This article has tips on checking patient eligibility and avoiding hospice claim rejects.