Understanding Home Health Review Choice Demonstration (RCD) Reason Code 39621
Return to Provider (RTP) reason code 39621 is assigned to RCD claims for different home health or eligibility claim edits. To view these edits, home health agencies (HHAs) must review the line item pages in Direct Data Entry (DDE) or their related electronic billing software. Prior to RCD, reason codes were assigned to line items for a variety of edits. With RCD reason code 39621 and the addition of UTN edits and requirements, line item reason codes are applied more often on RCD claims.
To assist providers, Palmetto GBA has updated the narrative for reason code 39621. The updates are shown below.
Reason Code Narrative for 39621
Unique Tracking Number (UTN) is present, but the program code is unable to assign to this claim for one of the reasons listed below:
- UTNs should not be submitted on RAPs
- UTNs should not be submitted on claims for providers or beneficiaries currently involved in a Demonstration Program, such as ACO or BPCI demonstrations
- There is an additional reason code on the detail line in the “FMR” field in DDE Claim Entry Page 2
- There is an additional reject code on the claim in the “REJ CD” field in DDE Claim Entry Page 2
Providers should either remove the UTN as instructed above, or address the additional reason code and resubmit the claim. If the additional reason code begins with “5Z” (5ZXXX), remove the UTN and resubmit.
Additional Reason Codes for 39621
Per the DDE Manual Section 5: Claims Correction (PDF, 539 KB), you may find the additional reason codes for the 39621 RTP in DDE on Claim Entry, Page 2, Additional Detail. The DDE image below shows the locations to view the reason codes on claim line items.