Reason Code 30004 - JF Part A

Reason Code Narrative

ONE OF THE FOLLOWING TWO ERROR SITUATIONS HAS OCCURRED:

1. DURING THE EMC LOAD PROCESS, IT WAS DETERMINED THAT THE LINE ITEM INDICATED BY SUBSCRIPT "FSSCCLMS-LINE" IS NOT THE 0001 LINE ITEM. THE "FSSCCLMS-LINES" FIELD SHOULD CONTAIN THE TOTAL NUMBER OF LINE ITEMS PRESENT ON THE CLAIM; AND WHEN USED AS A SUBSCRIPT, SHOULD POINT TO THE 0001 LINE ITEM.
2. THIS EMC CLAIM CONTAINED NO 0001 LINE ITEM MONETARY DATA AT THE TIME OF SUBMISSION. EITHER THE PROVIDER FAILED TO SUBMIT AN 0001 LINE ITEM, OR THE PROVIDER SUBMITTED AN 0001 LINE ITEM WITH NO MONETARY AMOUNTS. TO PREVENT PROCESSING PROBLEMS, THE SYSTEM GENERATES AN 0001 LINE ITEM (WITH NO MONETARY AMOUNTS) IF IT WAS NOT RECEIVED FROM THE PROVIDER. PROVIDER-SUBMITTED 0001 LINE ITEM WITH OUT MONETARY AMOUNTS ARE LOADED TO THE SYSTEM "AS-IS".

Common Reason Code Errors

• Claim submitted without total, covered and/or non-covered charges on HCPCS line or total line.

Common Reason Code Corrections

• Verify claim contains monetary values on each line and on total line.

Resource

• CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 25, Section 75.4 and 75.5

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