Reason Code 30955 - JE Part A

Reason Code Narrative

XREF DCN HAS BEEN CHANGED TO AN INVALID_DCN OR FOR A CANCEL (XX8 TOB) THE XREF DCN DOES NOT = THE CANCEL DCN. CORRECT INVALED DCN BEFORE UPDATING THIS CLAIM. IF THE FIRST POSITION OF THE XREF OR CANCEL XREF DCN IS NOT NUMERIC, THIS CLAIM CANNOT BE UPDATED OR MOVED TO A MANUAL LOCATION UNTIL THE FIRST POSITION IS MADE NUMERIC (1 THRU 9).

Common Reason Code Errors

Due to one of the below errors, Reason Code 30955 assigns to cancel claims (XX8 type of bills) that have been corrected via Direct Data Entry (DDE) system.

• Reason Code 30955 (on the original submission) - The claim includes an adjustment reason code (entered by providers on page 3 of DDE system). Cancel claims or XX8 Type of Bills (TOBs) should not be submitted with an adjustment reason code. Example of an adjustment reason code: OT for other change
• Reason Code 30947 or 30949 - The claim was submitted with an improper or missing condition code. One of the below referenced condition codes is required on a cancel claim
  • Condition codes D5 and D6 are the only valid condition codes to submit on a cancel claim or XX8 TOB
    • D5 is used when an incorrect Medicare ID or incorrect provider number was billed to Medicare (i.e submitted under incorrect Provider Transaction Access Number (PTAN) or National Provider Identifier (NPI))
    • D6 is used for everything else
• Reason Code 30960 or 30941 - The cancel claim did not include sufficient remarks. Remarks stating why the claim is being canceled are required on all cancel claims or XX8 TOBs
• Reason Code 30950 - The claim was submitted with multiple condition codes. Cancel claims should be submitted with only one condition code using the most appropriate condition code either D5 or D6

Common Reason Code Corrections

• The only option for a claim hitting edit 30955 is to resubmit a new cancel claim (XX8 Type of Bill) through DDE or other electronic system. Be sure appropriate condition code (D5 or D6) is being reported, do not report an adjustment reason code (e.g. OT for other change) and include the required remarks as to why you are cancelling claim

Note: Claims that are returned to Provider (RTP) for reason code 30955 cannot typically be suppressed in DDE; providers must wait until they are purged in DDE. RTP claims typically purge more quickly if they are not accessed by anyone through DDE corrections menu.

View reason code list, return to Reason Code Guidance page.