31346

FISS Narrative:
A value code 50 is present but no occurrence code 35 is present, or an occurrence code 35 is present but no value code 50 was reported. Verify billing and if appropriate, correct.

  • Online providers: Press F9 to store the claim
  • Other providers: Return to the intermediary

Explanation and Suggestion:

  • This reason code indicates that you have entered a value code without the corresponding occurrence code or vice versa
  • When billing revenue code 42x, the occurrence code 35 (date treatment began), occurrence code 11 (onset of illness/injury) and the value code 50 (cumulative number of visits) must appear on the claim
  • Value code 50 is entered as a dollar amount, i.e., 10 visits would appear as 10.00

Contact Palmetto GBA JM Part A Medicare


Provider Contact Center: 855-696-0705

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