Reason Code: 38038

Error Description:

Whether any revenue code lines are equal or not, OPPS bill types (12X, 13X, 14X, 76X, 75X, 34X, or any bill containing condition code 07) cannot have overlapping dates when the provider numbers are equal, unless condition code G0 or 20 or 21 is present on the claim.

Avoiding/Correcting This Error

Check OPPS claims for potential overlapping dates of service prior to claim submission and bill accordingly

An adjustment bill must be submitted

• For bill type 34X, only vaccines and their administration, splints, casts, and antigens are paid under the OPPS
• For bill type 75X, only vaccines and their administration are paid under OPPS
• For bills containing condition code 07, only splints, casts and antigens will be paid under OPPS
• Send an adjustment claim to add any changes to first claims billed if no G0, 20 or 21 condition code is on the claim