FISS Narrative:
According to the revenue code file, a HCPCS code is required for the line item being edited; however, no HCPCS code is present and the covered charges for the line item are greater than zero.

Please refer to the most current version of the CPT-4 HCPCS coding book for the HCPCS code required. Online providers may access the HCPCS file for a list of revenue codes allowed with the HCPCS code billed.

Explanation and Suggestion:

  • Reason code 32400 is similar to reason code 32404. On the 0023 revenue code line of the final claim, the HHA must report the HIPPS code. The first four positions of the code must be identical to the value reported on the RAP. The fifth position may vary from the letter value reported on the RAP to the corresponding number which represents the same non-routine supply severity level but which reports that non-routine supplies were not provided.
  • In addition to the 0023 revenue code line of the final claim, all service or discipline visits must also be reported with the appropriate revenue code and corresponding HCPCS code
  • Reminder on the final claim: in addition to the 0023 line information, there must be a line entered with a discipline revenue code, corresponding HCPCS code and a service date that matches the 0023 line date. This line reflects the first billable service in the episode.
  • Please correct and resubmit/rekey
  • Hardcopy submitters resubmit this RTP report with your corrections
  • Notify software vendors if necessary

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