31593

FISS Narrative
There is at least one of the following value codes present on the claim with an incorrect amount in the cents area to the right of the decimal point.

Guidelines and Suggestions
Verify the zeros following the decimal point for the value codes on your claim. If necessary, correct and resubmit. 

  1. The following list of value codes must have zeros following the decimal point:
    • 45 – Accident hour
    • 46 – Grace days
    • 50 – Physical therapy visits
    • 51 – Occupational therapy visits
    • 52 – Speech therapy visits
    • 53 – Cardiac rehab visits
    • 67 – Intermittent peritoneal dialysis (IPD) hours
    • 68 – Number of units of EPO provided during the billing period
  2. The following list of value codes must have a zero in the far right position:
    • 49 – Hematocrit reading
    • 48 – Hemoglobin reading
  3. The following value codes must have zeros following the decimal point:
    • 62 – Part A visits
    • 63 – Part B visits
  4. The following value code must have zeros following the decimal point and must have a value greater than 1.00:
    • 32 - Multiple patient ambulance transport

Note: This edit will be bypassed when a 72X TOB with a From date of service on or after 04/01/2012 is reporting a value code 48 or 49 with a value amount of 99.99.

Contact Palmetto GBA JM Part A Medicare


Provider Contact Center: 855-696-0705

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