Reason Code: 37402

Error Description:

Hospice: The TOB is equal to a hospice claim (TOB 81X or 82X) and the claim From date is greater than 4/1/1998 and the receipt date is greater than or equal to 10/1/2005 and there is no claim with TOB 81x or 82x whose Thru date is exactly one day less than this claim's From date. Also, the reason code authorization field (claim page 9) does not contain this reason code.

Avoiding/Correcting This Error

Hospice – This error occurs when a claim is submitted and the previous month's claim has not been found in the system or there is a gap between Through date of the previous claim and From date on this claim. Verify dates of service submitted on claim and ensure claims have been submitted in date order (no missing months).

Note that there is a workaround when submitting adjustments to claims where there is a transfer in the benefit period. Enter the "Start Date 1" in the current benefit period as the admission date on the claim rather than the admission date. This will allow all days in the period to be counted in the RHC payment calculation. When resubmitting enter remarks: "adjust due to RHC errors SE17014."