Reason Code 32403

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

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Last Updated Oct 19, 2018