Reason Code: 38119

Error Description:

This claim reports DOS that are part of a continuing stay. We have not received the claim immediately preceding the DOS on this bill.

SNF inpatient claims have to be processed in sequence. That means that when the beneficiary is going to be in the SNF as an inpatient for several months in a row, claims for the months the beneficiary is in the SNF must be submitted one at a time, in sequential order. Subsequent claims in the stay should not be submitted until the prior month’s claim has processed and finalized.

Avoiding/Correcting This Error

Submit continuing-stay claims one month at a time and allow the claim to process before submitting the next month’s claim.

• Prior to submitting a continuing-stay claim, check the claim status using the FISS Inquiry Claim Summary option, the IVR, or the NGSConnex application to verify the prior month’s claim has finalized
• The prior claim must appear on your remittance advice before the next claim can be processed
• Once the prior claim has shown on the remittance advice, resubmit the RTP claim using claim correction options