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Reason Code Search and Resolution

Disclaimer: This is not a complete listing of reason codes.

The Reason Code Search and Resolution tool allows you to view a reason code description and determine how to prevent/resolve the edit. You may search by reason code or keyword. All records matching your search criteria will be returned for your review. You may also select "Show all Reason Codes" to view the complete list.

If the reason code you enter does not display here, you may access any reason code description in the Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE) Reason Codes Inquiry Menu (Option 17). For additional information, please reference the FISS DDE User Manual.

We also welcome your feedback. Requests to add or clarify information provided in this tool may be submitted to: J15_PartA_Education@cgsadmin.com.

Reason Code

Reason Code 34986

Description:
  • Modifier PN is not present on the claim and a practice location is reported that has a practice effective date on/after 11/2/15 (non- excepted).
Resolution:
  • Modifier PN must be reported with non-excepted items or services billed on an institutional claim. Make appropriate corrections to the claim and resubmit.

Reference

Disclaimer: CGS' online tools and calculators are informational and educational tools only, designed to assist suppliers and providers in submitting claims correctly. CGS makes no guarantee that this resource will result in Medicare reimbursement for services provided. Although we've made every reasonable effort to provide effective resources, CGS is not responsible for the consequences of any decisions or actions taken in reliance upon or as a result of the information that these tools provide. CGS is not responsible for any human or mechanical errors or omissions.

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