FISS Reason Code/Claim Driver Overview

The following chart outlines the association between the FISS claim drivers and the reason code ranges.

Driver #	Driver Definition	Reason Code Range(s)
04	UB-04
05	Consistency I	30001–31299 (common to all bill types)
06	Consistency II	31300–31649
15	Administrative	31650–32999 W0001–W2999 (MCE/IOCE and Grouper)
25	Duplicate	38000–38599
30	Entitlement	39000–39499 (health maintenance organization editing)
35	Lab/HCPC	36300–36999
40	ESRD	36000–36299
50	Medical policy	50000–59999
55	Benefit utilization	39500–39699
60	ADR	39700–39799
63, 65	Home health PPS Pricer/PPS Pricer	Range not assigned 37000–37150
70	Payment module	37500–37999
75	Post payment	38600–38999
80	MSP primary	34000–34499
85	MSP secondary	33000–33999 34500–34900
89	Claim clean up/final online edits	NCOVD, 31949–31954, 31956–31958, 31960–31976, 31978–31979, 31981–31982, 31984–31989, 39928–39929, 39933, 80002
99	Session termination	37151–37199

Revised 4/28/2016