Reason Code 31257

Published 12/16/2019

Description
TOB of 12x, 13x, 22x, 23x, 34x, 74x or 75x with revenue code 044x without an occurrence code 30 or claim billed with occurrence code 30 without revenue code 044x.

Resolution
Revenue Code 044x is used to indicate charges related to speech-language pathology therapy. Outpatient speech language pathology claims must be billed to include occurrence code 30 to indicate the date the outpatient speech language pathology plan was established or last reviewed. Please correct and resubmit.

Resource
CMS Internet Only Manual (IOM), Publication 100-4, chapter 4 (PDF).


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