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Top Claim Submission Errors and How to Resolve
Claim Submission Errors (CSEs) cause your billing transactions to either reject or move to your Return to Provider (RTP) file for correction, and create unnecessary costs to the Medicare program. Remember that it is your responsibility as a Medicare provider to ensure the information submitted on your billing transaction is correct and compliant with Medicare regulations.
Providers should be aware what action may be taken when they demonstrate a pattern of submitting claims inappropriately, incorrectly or erroneously, including a referral to the Office of Inspector General (OIG) for Medicare fraud or abuse.
Below is a list of the top errors. Please click on the link under the appropriate state, to access the specific reason code, as well as resources you can use to avoid future billing errors.
| Alabama Providers | Georgia Providers | Tennessee Providers |
| C7010 | C7010 | C7010 |
| U5200 | U5233 | N5052 |
| U5233 | 10416 | U5233 |
| 10416 | 19301 | 31577 |
| 13315 | 31265 | 32105 |
| 15701 | 31715 | 32200 |
| 31265 | 32402 | 32203 |
| 31715 | 36222 | 38032 |
| 32105 | 38032 | 38119 |
| 38200 | 38200 | 38200 |
Page last updated: June 23, 2010
