30949

FISS Narrative
Type of bill equals XX7, XXQ or XX8, but no condition code is present on the bill. Please include the appropriate condition code from the following list:

D0 - Changes in service dates
D1 - Changes in charges
D2 - Changes in revenue code/HCPC
D3 - Second or subsequent interim PPS bill
D4 - Change in grouper input (DRG)
D5 - Cancel only - to correct a patient's Medicare ID number or provider number
D6 - Cancel only – duplicate payment, outpatient to inpatient overlap, OIG overpayment
D7 - Change to make Medicare secondary payer
D8 - Change to make Medicare primary payer
D9 - Any other changes
E0 - Change in patient status

Explanation and Suggestion
When submitting adjustment claims (XX7 or XXQ) or cancel claims (XX8), an appropriate condition code must be submitted.

Resubmit this claim adding the condition code, an adjustment reason code and remarks as to why the claim is being adjusted or cancelled.

Changes in charges may be done on adjustment claims but are not needed on cancel claims.

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Provider Contact Center: 855-696-0705

TDD: 866-830-3188

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