Reason Code 13314

Description
This is a SNF and the occurrence span code 70 (qualifying stay) from date is greater than the claim admission from date or this is a SNF, and the occurrence span code 80 (prior same-SNF stay) from date is greater than the claim admission from date.

Resolution
On most of the claims receiving this reason code, the admission date billed on the claim is before the Qualifying Stay Date (occurrence code 70), which is incorrect. It appears that an “old” (prior) admit date is being used rather than the admit date that relates to the “From” and “Through” dates on the current claim. Please review the admit date, the qualifying stay date and the from and through date on the claim to assure that the appropriate, current dates are being used and that they are in the proper sequence.

Resource
CMS Internet Only Manual (IOM), Publication 100-4, chapter 6 (PDF, 532 KB).

 

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