Claims Submission Error Help

Understand Reason Codes on Medicare Claims
Preventing and knowing how to resolve Claim Submission Errors (CSEs) by understanding the reason codes will help expedite the processing of your claims and may save time and money.

The CSE Help tool may assist you in your compliance efforts by providing information about how to resolve incorrect denials and avoid rejections.

Data analysis reports generate the top CSEs made by providers, which shows the Top 10 denial reason codes in ranking order and the total count of denied claims. This count includes denied, rejected or returned to provider (RTP) claims. The Percent of Denied Claims are given as both including and excluding RTP claims found in T status in the Fiscal Intermediary Shared System (FISS).

October through December, 2019, Quarterly Total Denials

JM Part A Denial Code
Claim Count w/Denial Code
% Denied to Total w/any Denial Code
% Denied to Total excluding RTPs
140,103
32.4
3.5
66,072
15.3
1.7
24,375
5.6
0.6
17,620
4.1
0.5
12,311
2.8
0.3
11,628
2.7
0.3
10,223
2.4
0.2
9,684
2.3
0.2
7,936
1.9
0.2
7,811
1.8
0.2
6,443
1.5
0.2

Latest Articles

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Reason Code 54NCD 03/13/2020
Reason Code U5233 01/10/2020
Reason Code 39934 12/17/2019
Reason Code 10420 12/16/2019
Reason Code 11503 12/16/2019
Reason Code 12205 12/16/2019
Reason Code 12206 12/16/2019
Reason Code 12302 12/16/2019
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Reason Code 13599 12/16/2019
Reason Code 14610 12/16/2019
Reason Code 1461A 12/16/2019
Reason Code 15202 12/16/2019
Reason Code 15701 12/16/2019
Reason Code 17701 12/16/2019
Reason Code 19301 12/16/2019
Reason Code 19401 12/16/2019
Reason Code 30905 12/16/2019
Reason Code 30906 12/16/2019
Reason Code 30912 12/16/2019
Reason Code 30928 12/16/2019
Reason Code 30940 12/16/2019
Reason Code 30949 12/16/2019
Reason Code 30955 12/16/2019
Reason Code 31023 12/16/2019
Reason Code 31094 12/16/2019
Reason Code 31102 12/16/2019
Reason Code 31241 12/16/2019
Reason Code 31255 12/16/2019
Reason Code 31256 12/16/2019
Reason Code 31257 12/16/2019
Reason Code 31259 12/16/2019
Reason Code 31276 12/16/2019
Reason Code 31324 12/16/2019
Reason Code 31337 12/16/2019
Reason Code 31346 12/16/2019
Reason Code 31398 12/16/2019
Reason Code 31406 12/16/2019
Reason Code 31409 12/16/2019
Reason Code 31413 12/16/2019
Reason Code 31486 12/16/2019
Reason Code 31593 12/16/2019
Reason Code 31605 12/16/2019
Reason Code 31608 12/16/2019
Reason Code 31689 12/16/2019
Reason Code 31814 12/16/2019
Reason Code 31860 12/16/2019
Reason Code 31947 12/16/2019
Reason Code 32073 12/16/2019
Reason Code 32078 12/16/2019
Reason Code 32105 12/16/2019
Reason Code 32114 12/16/2019
Reason Code 32242 12/16/2019
Reason Code 32352 12/16/2019
Reason Code 32400 12/16/2019
Reason Code 32402 12/16/2019
Reason Code 32404 12/16/2019
Reason Code 32415 12/16/2019
Reason Code 34538 12/16/2019
Reason Code 34932 12/16/2019
Reason Code 34961 12/16/2019
Reason Code 34977 12/16/2019
Reason Code 34978 12/16/2019
Reason Code 37541 12/16/2019
Reason Code 37544 12/16/2019
Reason Code 38032 12/16/2019
Reason Code 38038 12/16/2019
Reason Code 38117 12/16/2019
Reason Code 38119 12/16/2019
Reason Code 38200 12/16/2019
Reason Code 39011 12/16/2019
Reason Code 39132 12/16/2019
Reason Code 39910 12/16/2019
Reason Code 39929 12/16/2019
Reason Code 51MUE 12/16/2019
Reason Code 53NCD 12/16/2019
Reason Code 55503 12/16/2019
Reason Code 56900 12/16/2019
Reason Code C7010 12/16/2019
Reason Code C7080 12/16/2019
Reason Code C7252 12/16/2019
Reason Code U5061 12/16/2019
Reason Code U5200 12/16/2019
Reason Code U5210 12/16/2019
Reason Code U5607 12/16/2019
Reason Code U6819 12/16/2019
Reason Code W7006 12/16/2019
Reason Code W7062 12/16/2019
Reason Code W7088 12/16/2019
Reason Code W7099 12/16/2019
Reason Code 37205 01/10/2019
U6805 12/27/2018
U6825 12/27/2018
31689 01/12/2018
Reason Code W7040 10/10/2016
   

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