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Printed Date: 9/22/2015
Covered days: the sum of the utilization days calculated plus the number of the non-utilization days calculated must equal the number of days between the from and through dates in the statements covers period unless:
This reason code is an indication that the total number of days represented by the "From" and "Through" dates has not been calculated correctly. This reason code may frequently be received in conjunction with reason code 12206. Be certain to take note of the factors indicated in the reason code narrative to assure that the days are being calculated as expected by FISS and the Medicare program.
CMS Internet Only Manual (IOM), Publication 100-4, Medicare Claims Processing Manual.
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Last Updated: 12/16/2019