Reason Code 5D510: There Was No Evidence of at Least Three Consecutive Day of Inpatient Hospital Stay
The documentation submitted does not support medical necessity as listed in coverage requirements.
To Prevent This Denial
- Ensure that the beneficiary has had a qualifying hospital stay of three (3) consecutive days
- Provide documentation that supports the qualifying hospital stay
- Provide all supporting documentation to support the reason the beneficiary was hospitalized
- CMS Internet-Only Manual (IOM), Medicare Program Integrity Manual, Publication 100-08, Chapter 3, Section 126.96.36.199 (PDF)
- CMS Internet-Only Manual (IOM), Medicare Claims Processing Manual, Publication 100-08, Chapter 3, Sections 188.8.131.52, 184.108.40.206 (PDF)