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{"DID":"crit2354e3","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"02-12-2024 14:15","End Date":"02-19-2024 13:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Monday, February 19, 2024, for staff training.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crita42d51","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"08-31-2023 15:00","End Date":"09-04-2023 17:00","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Monday, September 4, 2023, in observance of Labor Day.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critb12ec4","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"01-09-2024 08:00","End Date":"01-15-2024 17:00","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Monday, January 15, 2024, in observance of Martin Luther King Jr.'s Birthday.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critce3553","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"02-05-2024 13:16","End Date":"02-07-2024 08:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, February 9, 2024, for staff training","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critd44e1c","Sites":"JJA","Start Date":"03-11-2024 10:47","End Date":"04-18-2024 09:47","Content":"Join us for Spring Tour 2024: Columbia, S.C. on April 2, 2024, Bessemer, Ala. on April 8, 2024, Cleveland, Tenn. on April 10, 2024, Decatur, Ga. on April 11, 2024, Charleston, W. Va. on April 16, 2024, and Richmond, Va. on April 18, 2024. ","URL":"https://palmettogba.com/palmetto/jja.nsf/DID/SY9IONT0ZJ","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critdbc2e4","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"10-05-2023 13:16","End Date":"10-09-2023 17:30","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed for an 8-hour training on Columbus Day, Monday, October 9, 2023.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}

Reason Code 31608

Published 12/16/2019

Description
Non-teaching IPPS hospitals, IRFs, and long-term care hospitals (LTCH) are required to submit informational only bills to the Fiscal Intermediary for MA beneficiaries. in order for these days to be captured by CMS in the DSH (or LIP for IRF) calculations, non-teaching hospitals are required to submit covered claims with a condition code 04. IPPS teaching hospitals have always been required to submit MA claims with condition codes 04 and 69 in order to be reimbursed for the indirect medical education payment. the IPPS teaching hospitals must continue to bill inpatient claims with condition codes 04 and 69.

This claim was submitted with a condition code 04 only and the discharge date is either prior to 10/1/06 or it has been submitted by an IPPS teaching hospital and the condition code 69 is missing.

Resolution
Only IRF, LTCH and IPPS hospitals should be billing with 04 condition code to capture the days for the DSH (or LIP for IRF) calculations. If you are not one of these providers, you should not be billing with 04 condition code. Correct and resubmit, if appropriate.

Resource
Disproportionate Share Hospital (DSH).

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