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

Contact Palmetto GBA JM Part A Medicare


Provider Contact Center: 855-696-0705

Email Part A

Contact a specific JM Part A department

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

Anonymous

 

Click to Chat Now