12302

FISS Narrative

• This reason code only applies to SNF and inpatient bills only with TOBs 11x, 41x, 18x, 21x, 22x, 23x, 24x and 51x
• 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 "Thru" dates in the statement covers period unless:
  1. Patient status = 30 (add one day to the calculation)
  2. Transfer – The "From" and "Thru" date are the same, patient status 02, 03, 05, 50, 51, 61, 62, 63, 71 or 72 with a condition code 40
  3. The "From" and "Thru" days are the same but no condition code 40 present