Reason Code 31428
Published 09/25/2020
New
Reason Code 31428
Description
The claim contains a hospice discipline revenue code (42X, 43X, 44X, 55X, 56X or 57X) and is either missing or has an incorrect corresponding HCPCS code (G0151, G0152, G0153, G0154, G0155 or G0156).
Resolution
Ensure that your claim contains the appropriate HCPCS code on the discipline revenue code line.
|
Revenue Code (Discipline)
|
HCPCS Codes
|
|---|---|
|
042X (Physical therapy)
|
G0151
|
|
043X (Occupational therapy)
|
G0152
|
|
044X (Speech-language pathology)
|
G0153
|
|
055X (Skilled nursing)
|
G0299 (valid for services on or after January 1, 2016)
G0300 (valid for services on or after January 1, 2016)
G0154 (not valid for services on or after January 1, 2016)
|
|
056X (Medical social services)
|
G0155
|
|
057X (Aide)
|
G0156
|
- Ensure that the HCPCS code is keyed using a "0" (number zero); not an "O" (letter O).
- Ensure that the HCPCS code begins with the letter "G," not the letter "Q."
Additional resource: Medicare Claims Processing Manual (CMS Pub. 100-04), Ch. 11, §30.3 (PDF).