Reason Code 32078

Published 12/16/2019

Description
If any of the following criteria are met:

  1. TOB is 71x, provider range 3400–3499, 3800–3999, 8500–8899 (facility type=M) or 8900–8999 (facility type=S) and rev code other than 0521, 0522, 0900 or 780 with line item DOS on or after 04/01/05 is billed
  2. TOB is 71x, provider range 3400–3499, 3800–3999, 8500–8899 (facility type=M) or 8900–8999 (facility type=S) and rev code other than 0521, 0522, 0524, 0525, 0527, 0528, 0522, 0900 or 780 with line item dos on or after 7/1/06 is billed
  3. TOB is 73x, provider range 1800-1899 (facility type=S or M) and rev code is other than 0520, 0900 or 0780 with line item dos on or after 4/1/05 and prior to 4/1/2010 is billed
  4. TOB is 73x, provider range 1000–1199 (facility type=S or M) and rev code is other than 0520, 0900 or 0780 with line item dos on or after 4/1/05 and prior to 4/1/2010 is billed
  5. Rev codes 0520, 0521, 0522, 0900 and 0780 can only be billed once per line item dos on or after 4/1/05 is billed
  6. TOB is 71x, 73x or 77x and there is no dos on the line
  7. TOB is 77x, provider range 1000–1199 (facility type=S or M) and rev code is other than 0520, 0900 or 0780 with line item dos on or after 4/1/2010
  8. TOB is 77x, provider range 1800–1899 (facility type=S or M) and rev code is other than 0520, 0900 or 0780 with line item dos on or after 4/1/2010 
  9. TOB is 71x, line item date of service is on or after 04/01/2016, provider range 3400–3499, 3800–3999, 8500–8899 (facility type=M) or 8900–8999 (facility type=S) and rev code equals 002x-024x, 029x, 045x, 054x, 056x, 060x, 065x, 067x-072x, 080x-088x, 093x, or 096x-310x

*Revenue code 52x (rev code 0520 has been expanded to include the complete range of 052x for FQHC (TOB 77x, provider range 1000–1199 or 1800–1989) for dos 4/1/2010 and after. Note: effective 4/1/2010 FQHCs, free standing (xx1000–xx1199) and provider-based facilities (xx1800–xx1989), must be submitted on TOB 77x.

All references to TOB 73x now apply to TOB 77x. Rev codes 052x can be billed with multiple line item if billing preventative service HCPCS codes effective with dos 1/1/2011.

Resolution
Verify reasons 1–9, as applicable. Correct and resubmit the claim.

Resource
CMS Internet Only Manual (IOM), Publication 100-04, chapter 9 (PDF).


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