Skip to Main Content

Print | Bookmark | Font Size: + |

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 Payment Alerts.

RTP Reason Codes Total KY OH
34977 7,888 1,695 6,193
34963 5,273 1,268 4,005
34978 4,578 23 4,555
U5065 4,140 1,017 3,123
W7113 3,069 1,506 1,563

Rejection Reason Codes Total KY OH
U5233 5,519 2,585 2,934
38200 4,050 1,273 2,777
39929 3,356 837 2,519
39934 2,039 581 1,458
U5200 1,856 347 1,509

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.

Updated 06.09.2025

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved