Resubmit Rejected OPPS Claims, CMS Says

The Centers for Medicare & Medicaid Services (CMS) has identified a Medicare claims processing issue that is causing certain hospital outpatient services rendered in an institutional setting to be processed incorrectly.

Medicare contractors have been instructed to not reject claims with Reason Codes 38038, 38074, 38151, 38033, and 38154 when the discharge date of the outpatient claim (13X) is the same as the admission date of the inpatient ancillary claim (12X).

If your claims have rejected with the above reason codes in error, you can now begin resubmitting claims.

Find more information at CMS’ hospital outpatient center.

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