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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 15,864 4,299 11,565
34963 10,131 4,161 5,970
37544 6,756 164 6,592
34986 3,791 455 3,336
34985 3,753 1,372 2,381

Rejection Reason Codes Total KY OH
38200 4,935 1,802 3,133
U5233 3,938 1,752 2,186
39929 3,588 790 2,798
38038 2,521 751 1,770
38032 2,049 432 1,617

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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