Reason Code 37022

Reason Code Narrative

SAME-DAY TRANSFER CLAIM WITH CONDITION CODE '40', CONTAINS EITHER INPATIENT ADMIT DATE NOT EQUAL TO INPATIENT STAY FROM DATE OR INPATIENT ADMIT DATE NOT EQUAL TO INPATIENT STAY THRU DATE OR UTILIZATION DAYS GREATER THAN '0', OR VALUE CODE 'A1', '08', OR '09', OR PATIENT STATUS IS NOT EQUAL TO '02', '03', '05', '50', '51', '61', '62', '63', '64', '65', '66', '71', OR '72'. IF APPROPRIATE, MAKE CORRECTIONS AND SUBMIT A NEW CLAIM TO THE INTERMEDIARY.

Common Reason Code Errors

  • Day is in covered day field for a same day transfer claim
  • Accommodation charges are listed as non-covered for room and board revenue code
  • Claim contains incorrect patient status

Common Reason Code Corrections

  • Enter "1" in "Non-Covered Day" field on page one of Direct Data Entry (DDE) or enter a value code 81 with "1.00"
    • Must include condition code 40 in "Condition Code" field
    • Accommodation charges must be listed as covered for room and board revenue code
  • Verify patient status is appropriate for a same day transfer

Resource

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

 

Last Updated Oct 19, 2018