Description
Principal diagnosis code (required) and/or admitting diagnosis code (if present): must be three to seven positions left justified with no decimal points. Note: TOB 41x and 43x are not required to submit diagnosis codes on the claim and are excluded from reason code logic. Reason code updated to edit the patient reason for visit (PRV) fields.

Resolution
Please verify that the principal and admitting diagnosis codes have been listed correctly and do not contain decimal points. Make the appropriate corrections and resubmit the claim.

Resource
CMS Internet Only Manual (IOM), Publication
100-4, Medicare Claims Processing Manual.

Contact Palmetto GBA JJ Part A Medicare

Provider Contact Center: 877-567-7271

Email JJ Part A

Contact a specific JJ Part A department


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