Get Request For Research Billing - Palmettohealth

Reason Code 31755 will assign correctly when: Revenue code 0023 is missing. For initial periods of care (admission claims), the “Admission” date, “From” date, 0023 revenue code's “Service” date and the first visit (earliest GX code) date reported on the claim do not all match.

Reason Code U537F will assign correctly when: Duplicate NOAs were submitted (same beneficiary, admission date, provider, etc.)

Reason Code 31485 For an initial hospice election, the OC 27 date on the initial claim does not match the 'FROM' date and the 'ADMIT DATE'.

Q1 – Routine clinical service provided in a clinical research study that is in an approved clinical research study.

Denial code 186 is related to a level of care change adjustment. This means that the claim has been denied because there was a change in the level of care provided to the patient. It could indicate that the services rendered were not consistent with the level of care initially authorized or requested.

Reason Code 31605 The dates of services on the claim cannot be within the span code 77 dates unless the charges are non-covered. NOTE: This code should not be used to indicate and untimely Face-To-Face encounter.

Providers should document which items and services are required as a part of ordinary clinical care, which are required in addition to meet the data collection requirements of the study, and should bill these respectively as covered or noncovered, respectively.

A national administrative code set that identifies the reasons for any differences, or adjustments, between the original provider charge for a claim or service and the payer's payment for it.