OPPS RETURN CODES

Claim Level :

01 			Claim processed

50 Wage Index not located  -  processing discontinued

51 Wage Index equal zero  -  processing discontinued

52 Wage Index - Invalid Reclassification Change Code
              - processing discontinued
53 Service From Date not numeric or less than OPPS Start date
              - processing discontinued  (i.e. 20000801)

54 Service From Date not in range with Provider Effective Date
              - termination date - processing discontinued


Line Level :

01 Line processed

11 Reduced for absent quality reporting

20 Payment equal to zero (Bene deductible > Payment) - line processed

22 Daily Coinsurance limitation - line processed

25 Provider elected coinsurance reduction for APC - line processed

30 APC not found in table - line processing discontinued
   or APC deleted

38 Discount Factor Indicator Invalid - line processing discontinued

40			Service Indicator Invalid - line processing discontinued

41	Service Indicator Invalid for OPPS Pricer
  	                            - line processing discontinued

42	APC equal to '00000' - line processing discontinued	
     OR   Packaging Flag = '1' or '2' or '4'

43 Payment Indicator not equal to 1 or 5 thru 9
                               - line processing discontinued

44 Service Indicator equal to 'H' but Payment Indicator not equal to '6'
                        - line processing discontinued

45 Packaging Flag not equal to zero - line processing discontinued

46 Line Item Denial/Reject Flag not equal zero AND Line Item Action Flag
         not equal to 1 - line processing discontinued

47 Line Item Action Flag equal to '2' or '3'
                        - line processing discontinued

48 Payment Adjustment Flag invalid  - line processing discontinued

49 Type of Bill Inclusion Flag not equal zero
                        - line processing discontinued





