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FISS/DDE Provider Online Guide: Resources


FISS Reason Code/Claim Driver Overview

The following chart outlines the association between the FISS claim drivers and the reason code ranges.

Driver # Driver Definition Reason Code Range(s)
04 UB-04 10125–19999 (unibill)
05 Consistency I 30001–31299 (common to all bill types)
06 Consistency II 31300–31649
15 Administrative 31650–32999
W0001–W2999 (MCE/IOCE and Grouper)
25 Duplicate 38000–38599
30 Entitlement 39000–39499 (health maintenance organization editing)
35 Lab/HCPC 36300–36999
40 ESRD 36000–36299
50 Medical policy 50000–59999
55 Benefit utilization 39500–39699
60 ADR 39700–39799
63, 65 Home health PPS Pricer/PPS Pricer Range not assigned 37000–37150
70 Payment module 37500–37999
75 Post payment 38600–38999
80 MSP primary 34000–34499
85 MSP secondary 33000–33999
34500–34900
89 Claim clean up/final online edits NCOVD, 31949–31954, 31956–31958, 31960–31976, 31978–31979, 31981–31982, 31984–31989, 39928–39929, 39933, 80002
99 Session termination 37151–37199
FISS/DDE Provider Online Guide: Resources - FISS Reason Code/Claim Driver Overview
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