Reason Code C7114
Reason Code Narrative
AN OUTPATIENT CLAIM THAT CONTAINS THERAPEUTIC SERVICES AGAINST A POSTED INPATIENT HISTORY CLAIM WITH THE THRU DATE GREATER THAN THE INPATIENT ADMISSION DATE, MINUS FOUR DAYS, OR IS EQUAL TO THE ADMISSION DATE.
Common Reason Code Errors
- Admission date of an inpatient claim falls within 72 hours of outpatient claim containing diagnostic services
Common Reason Code Corrections
- Roll all diagnostic services into inpatient claim
- Non-diagnostic services, other than ambulance and maintenance renal dialysis services, provided within 72 hours of an inpatient admission must be reviewed by facility. If services are not related include condition code 51 in "Condition Code" field
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 3, Section 40.3
View reason code list, return to Reason Code Guidance page.
Last Updated May 22, 2018