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).

July through September, 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
143,959
32.5
3.8
66,094
15.0
1.7
23,312
5.3
0.6
20,420
4.6
0.5
11,056
2.5
0.3
9,771
2.2
0.2
10,496
2.5
0.3
9,306
2.1
0.2
10,052
2.3
0.3
8301
1.9
0.2

Latest Articles

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Reason Code 39934 12/17/2019
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Reason Code 30906 12/16/2019
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Reason Code 31860 12/16/2019
Reason Code 32114 12/16/2019
Reason Code 32242 12/16/2019
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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
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