32078

FISS Narrative:

  1. TOB is 71x, provider range 3400-3499, 3800-3999, 8500-8899 (Facility Type=M) or 8900-8999 (Facility Type=S) and revenue code other than 0521, 0522, 0900 or 780 with line item DOS on or after April 1, 2005, is billed
  2. TOB is 73x, provider range 1800-1899 (Facility Type=S or M) and revenue code is other than 0520, 0900 or 0780 with line item DOS on or after April 1, 2005, is billed
  3. Revenue codes 0520, 0521, 0522, 0900 and 0780 can only be billed once per line item DOS on or after April 1, 2005, is billed
  4. TOB is 71x, 73x or 77x and there is no DOS on the line
  5. TOB is 77x, provider range 1000-1199 (Facility Type =S or M) and revenue code is other than 0520, 0900 or 0780 with line item DOS on or after April 1, 2010
  6. TOB is 77x, provider range 1800-1899 (Facility Type = S or M) and revenue code is other than 0520, 0900 or 0780 with line item DOS on or after April 1, 2010

Explanation and suggestion:

  • For TOB 71x (Rural Health Clinic – RHC) and TOB 73x (Federally Qualified Health Center – FQHC) billing is limited to the revenue codes indicated in the narrative for this reason code
  • Any other revenue codes should not appear on the claim and they must be removed for the claim to continue processing
  • The date of service is required for each and every line item
  • Per Change Request 6338, effective April 1, 2010, the type of bill for federally qualified health centers changed from 73x to 77x

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