Reason Code 5H501: Billed in Error
The service(s) billed (was/were) not covered because, according to the documentation in the medical record, the Skilled Nursing Facility has made a billing error. Therefore, no Medicare payment will be made. The Skilled Nursing Facility may not charge the beneficiary for service(s) that (was/were) billed in error.
To Prevent This Denial
Ensure that all charges for accuracy/timeliness prior to submitting the final bill to Medicare. Check to ensure that all documentation submitted in response to the ADR corresponds to the service(s) rendered and the dates of service(s) billed.
- CMS Internet-Only Manual (IOM), Medicare Claims Processing Manual, Publication 100-04, Chapter 6 external link (PDF)
- CMS Internet-Only Manual (IOM), Medicare Claims Processing Manual, Publication 100-04, Chapter 1, Section 60.1.1 (PDF)