Reason Code 31605

Published 09/25/2020

Description
The dates of services on the claim cannot be within the span code 77 dates unless the charges are non-covered.

Resolution
The occurrence span code 77 is used to indicate the span of days that were not covered on claims when one of the following situations occurred:
The recertification was not obtained timely (by the end of the third calendar day after the start of each benefit period). Enter the “From” and “To” dates of the period of care for which the provider is liable. Condition code 85 (delayed recertification of hospice terminal illness) must be reported for claims received on or after January 1, 2017. Refer to MLN Matters® Article MM9590 (PDF) for additional information.

The NOE was not submitted timely (within five calendar days after the hospice admission date). Enter the “From” and “To” dates of the period of care for which the provider is liable

Note: This code should not be used to indicate and untimely face-to-face encounter.


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