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Top Claim Submission Errors

The top five Return to Provider (RTP) and rejection reason codes for the J15 Part A Kentucky/Ohio region are listed below. This information is updated on a monthly basis.

Click on the reason code to view the description and resolution. The description will explain why the claim was RTP'd, or why the claim was rejected. Instructions for correcting these claims are in the Direct Data Entry (DDE) Manual linked below. Reason Codes with an asterisk (*) indicate they are listed on the Part A Claims Processing Issues Log.

RTP Reason Codes Total KY OH
34977 48,999 3,856 45,143
34963 13,284 4,358 8,912
34985 11,233 2,321 8,912
34986 8,416 481 7,935
30729 4,305 3,510 795

Rejection Reason Codes Total KY OH
38200 25,176 2,175 23,001
U5233 7,524 2,275 5,249
38001 4,292 485 3,807
39929 4,096 943 3,140
38038 3,797 657 3,140

For additional information on identifying, correcting, or adjusting claims in the DDE system, please reference the Claim Status and Corrections article or the DDE User Manual/FISS Reference Guide.

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