An old claims error is causing new frustration for providers in 2023 as CMS reactivates a requirement when logging dates on the claim.
 
Error code 31755 relates to the date requirement for the 0023 revenue code line, according to an alert from the MACs on Jan. 11, 2023.
  • For initial periods of care, the date on the 0023 line is the date of the first covered visit provided during the period.
  • For subsequent periods, the date should be the first visit provided during the period, regardless of whether the visit was covered or non-covered.
Most of the claims that are being returned with error code 31755 are for subsequent periods where the agency is using the first day of the period on the revenue code line instead of the first visit, according to an alert to providers Jan. 11, 2023.
 
“The majority of the claims being returned are provider billing error and need to be corrected,” the MACs noted in their message.
 
In 2021, agencies were instructed to temporarily use the first day of the period on this line so that the system could match the claim with the no-pay RAP — a problem unique to 2021 claims.
 
CMS eventually deactivated the error code to allow 2021 claims to be processed through the end of 2022, at which time the claims would no longer be timely.
 
CMS told providers in December 2022 that the code would be reactivated beginning Jan. 3, 2023, and that all 2022 claims processed in the new year should be compliant with this 0023 date rule.
 
Legitimate error on other claims
 
There is a system issue for some claims that is erroneously causing a return with code 31755. This has to do with another short-term fix related to the date on the 0023 line.
 
When CMS shifted from RAPs to Notice of Admission (NOA) in January 2022, agencies were instructed to create an artificial admission date for patients with subsequent periods in January 2022. This was an issue unique to claims in that first month of the NOA process and only for those 2021 patients continuing care into a new period in January.
 
Reactivation of the 31755 error code is causing these January 2022 claims to be returned by mistake. The MACs are researching what actions to take on these claims, according to the alert to providers.