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

Resource

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Last Updated May 22, 2018