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Reason Code Search and Resolution

Disclaimer: This is not a complete list 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.

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Reason Code 31605


The dates of services on the claim cannot be within the span code 77 dates unless the charges are non-covered.


The occurrence span code 77 is used to indicate the span of days that were not covered on claims when one of the following situations occurred:

  • The recertification was not obtained timely (by the end of the 3rd calendar day after the start of each benefit period). Enter the FROM and TO dates of the period of care for which the provider is liable. Note that condition code 85 (Delayed recertification of hospice terminal illness) must be reported for claims received on or after January 1, 2017. Refer to MM9590External PDF for additional information.
  • The NOE was not submitted timely (within 5 calendar days after the hospice admission date). Enter the FROM and TO dates of the period of care for which the provider is liable.

NOTE: This code should not be used to indicate and untimely Face-To-Face encounter.

Refer the Occurrence Span Codes and Dates information found on the Claim Page 01 - Entering a Hospice Claim Web page.

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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