Reason Code 38117

All inpatient SNF and Non-PPS bills must be processed in sequence. There is a prior claim for this admission pending in the system.

Verify the admission date and from date on the claim. If admission and from dates are correctly reported, hold the claim until the pending bill has shown on your remittance advice. Once the prior claim has shown on the remittance advice, the next claim can be submitted.

  • This reason code is an "out of sequence" error which usually occurs because the initial, first, and admission claim in the sequence has not been processed or paid
  • The reason code also notes that this prior claim may be pending and/or in process in FISS
  • Check claims inquiry (Inquiry Menu option #12) for the claim in process
  • The current claim cannot be released until the "in process" claim is paid
  • If the "in sequence"/prior claim is not already in FISS, it must be submitted and paid before the current claim can process

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