Reason Code 37236
Claims are denied with reason code 37236 when the NPI and/or physician’s last name submitted on the home health claim does not match the physician’s information at the Provider Enrollment, Chain, and Ownership System (PECOS).
- Verify that the attending physician’s NPI is present in the PECOS eligible physician file
- Verify that the attending physician’s name submitted on the claim matches the physician’s name that is present in the PECOS file
- Verify that the special code is a valid code
If the physician NPI or name was entered incorrectly on the claim, or if the physician NPI or name was initially incorrect in PECOS, and has now been corrected, please submit an adjustment claim.