31486

FISS Narrative
The claim is a SNF claim with a statement covers from date of July 1, 1998, or greater, and the sum of all revenue codes 0022 does not equal the claim covered days count less any provider liable days reported under occurrence span code 77.

Explanation and suggestion:

  • This reason code can indicate that the units field billed on the revenue line for the HIPPS code (Revenue Code 0022) does not match the number of covered days shown on page 1 of the claim in FISS
  • However, for most of the claims receiving this reason code the problem is that a non-covered claim is being billed, but the provider is showing covered units (field name = COV UNIT) for revenue code 0022
  • If the claim is a totally non-covered claim, please remove all covered units

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