Reason Code 37537
Reason Code Narrative
UB92 PROVIDER SUBMITTED ADJUSTMENT (XX7) AND IS MAKING AN ORIGINAL NO PAY CLAIM A PAYMENT CLAIM. NON PAY CODE ON ORIGINAL EQUALS 'C ', 'B ', 'E', 'N ', 'R ', 'X ' 'Y ' OR 'Z '.
Common Reason Code Errors
- A non-covered claim is being moved to covered on an adjustment and claim change condition code D1 is not being billed
- Medicare is being changed to primary or secondary and the appropriate claim change condition code is not billed
- Claim change condition code is billed but a more appropriate claim change condition code is available
Common Reason Code Corrections
- Changes made to total covered charges must be billed with a D1 claim change condition code
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 1, Section 130.1.2
View reason code list, return to Reason Code Guidance page.
Last Updated May 22, 2018