12206

FISS Narrative

• The "From" and "Thru" dates are not the same on inpatient or SNF bill types 11x, 18x, 21x, 28x, 41x or 51x
• The number of days represented must equal the sum of the covered days plus the non-covered days, unless the patient status is 30 and one additional day is used in the calculation
• If the dates are the same, the bill must show only one day
• This reason code will be bypassed if the type of bill is xx5, the UB82-92 indicator is a "9" and there are no covered days
  

Explanation and Suggestion:

• This reason code indicates the number of days represented by the "From" and "Thru" dates on the claim have not been counted correctly
• Frequently this count is incorrect by one day based upon whether the patient status code is a discharge status or still patient (code 30)
• If the patient status code is a discharge status, the through date is not included in the count
• If the patient status code is still patient (30), the through date is added to the count of total days