Reason Code 32403 - JE Part A

Reason Code Narrative

ACCORDING TO THE REVENUE CODE TABLE, A HCPC IS REQUIRED FOR THE LINE ITEM BEING EDITED; HOWEVER, THE STATEMENT COVERAGE DATES ON THE CLAIM FALL OUTSIDE OF THE EFFECTIVE/TERMINATION DATES FOR THE HCPC ON THE HCPC TABLE FILE, SO THE HCPC WAS NOT VALID DURING THE STATEMENT COVERAGE PERIOD.

• HOME HEALTH CLAIMS (TOB 32X AND 33X) ARE BYPASSED WHEN THE FROM AND THRU DATES OF SERVICE SPAN 2007 AND 2008 WHEN A VALID 2007 HIPPS CODE (HAEJ1 - HDIM8) IS PRESENT ON THE 0023 LINE.

Common Reason Code Errors

• HCPC and revenue code are not compatible.
• Revenue code reported requires valid HCPC.

Common Reason Code Corrections

• Verify correct HCPC is billable with revenue code reported.
• If revenue code does not contain a HCPC, validate a HCPC is necessary.
• If combination has been verified and is valid, call Provider Contact Center.

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