Inpatient Part A claims that contain a hemophilia clotting factor HCPCS codes must have a valid supporting diagnosis present. If a valid diagnosis is not present, the claim will be returned to the provider with reason code 31591. If the diagnosis was inadvertently left off, it should be added to the claim. If there is no valid supporting diagnosis, the charges for the hemophilia clotting factor should be made noncovered to allow the claim to process and make the appropriate DRG payment.
CMS Joint Signature Memorandum (JSM-06063) (12/01/05) Posted: 12/19/2005 CPT codes, descriptions, and other data only are copyright 2005 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.
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