Reason Code 39011

Published 09/16/2021

Description
The claim was not submitted timely. Medicare regulations require claims to be submitted within one year of the date of service (through "To" date of service on the claim).

The timely filing period for both paper and electronic Medicare claims is no later than one calendar year after the date of service.

Resolution
Please refer to the Timely Filing Job Aid (JJA, JMA) and What is the timeframe for submitting a claim adjustment? (JJA, JMA). Further information is available on the CMS IOM 100-4, Chapter 34 (PDF) — Reopening and Revision of Claim Determinations and Decisions.

Note: If claim is not timely, a Reopening Adjustment (XXQ) type of bill may be applicable. Please see CR8581 (PDF) for further guidance.


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