Reason Code 32404 - JE Part A
Reason Code 32404
Reason Code Narrative
THE REVENUE CODE FILE INDICATES THAT A HCPCS CODE IS REQUIRED, HOWEVER, THE HCPCS CODE THAT WAS ENTERED ON THE CLAIM IS NOT LOCATED ON MEDICARE'S FILE, OR HCPCS CODE IS MISSING. IF REVENUE CODE 0022 IS PRESENT ON A SNF TYPE OF BILL 21X, THEN A VALID HIPPS CODE MUST BE PRESENT. VERIFY BILLING AND IF APPROPRIATE, CORRECT.
Common Reason Code Errors
- Reason code 32404 assigns to claims when a Healthcare Common Procedure Code (HCPC) is either not valid or is billed with an invalid revenue code.
- A system update is needed.
Common Reason Code Corrections
- Verify HCPC and timeframe billed is valid and appropriate. The Addendum B can be helpful when determining valid HCPCs. If there is a different or more appropriate code, correct claim.
- Verify HCPC is allowable on revenue code billed. Coding help can be obtained from the American Medical Association. If a more appropriate revenue code/HCPC combination is found, correct coding on claim.
- If the HCPC is valid for date of service and it is billed on appropriate revenue code, call Provider Contact Center (PCC).
View reason code list, return to Reason Code Guidance page.
Last Updated Thu, 22 Dec 2022 18:42:12 +0000