Top Claims Submission Errors

Data analysis reports generate the top Claim Submission Errors (CSEs) made by providers, which shows the top denial reason codes in ranking order and the total count of denied claims. This count includes denied, rejected or returned to provider (RTP) claims. The Percent of Denied Claims are given as both including and excluding RTP claims found in T status in the Fiscal Intermediary Shared System (FISS).

January through March, 2020, Quarterly Total Denials

Denial Reason Code
Claim Count w/Denial Code
% Denied to Total w/any Denial Code
% Denied to Total excluding RTPs
108,100
25.9
3.8
81,373
19.4
2.8
51,622
12.4
1.8
21,960
6.0
0.9
17,712
4.3
0.6
10,904
2.6
0.4
8,580
2.1
0.3
7,611
1.8
0.3
3,704
0.9
0.2
6,724
1.6
0.2