The following information is provided by Novitas Solutions.
No Reimbursement Claims- Reason codes 39910 and 37187
Reason code 39910 causes claims to suspend when the provider reimbursement amount is equal to zero. Reason code 37187 is the finalized claim edit that indicates the claim has completed processing and no additional payment can be made.
These reason codes are most commonly received when the Medicare deductible amount matches the full payment amount on the claim. When no reimbursement is made to the provider due to the Medicare deductible, no Medicare payment will be issued to the provider.
These reason codes can also indicate that a billing error was made. When a claim is submitted with certain invalid or missing information, it can result in the claim receiving a zero dollar reimbursement amount. We encourage providers to confirm that their billing is correct.
Be sure to read this bulletin for more information regarding common billing scenarios that may result in a zero dollar reimbursement.
Medicare Learning Network (MLN) Articles from CMS
New:
- MM9091 – Payments to Hospice Agencies That Do Not Submit Required Quality Data
- MM9087 – ICD-10 Conversion/Coding Infrastructure Revisions/ICD-9 Updates to National Coverage Determinations (NCDs)--2nd Maintenance CR
