VA · guidance
Va. DMAS Hospice Provider Manual ch. V, Denial Messages For Nursing Facility Residents
Denial Messages For Nursing Facility Residents
A denied claim is unacceptable for payment for the stated reason. Proper interpretation
of the denial message will allow proper resubmission of an acceptable claim.
• RUG Code Invalid - Check the RUG code to confirm the RUG
grouper and version and revenue code 0022 for the dates of
service.
Action to Take: Resubmit claim with correct RUG code with
revenue code 0022 with zero (0) charges.
•
Invalid RUG Units – Check if the sum of the RUG units match the
covered days submitted on the claim.
Action to Take: Resubmit the claim with the RUG units that match
the covered days for the billing period.
•
Calculated RUG Amount is Zero – Confirm all claim information
submitted is correct.
Action to Take: Resubmit the claim with corrected claim information.
DMAS has removed the previous rate tables from the exhibit section in this manual.
Hospice rates can be found on our website: www.dmas.virginia.gov. Click on Providers
and then click on Rates and Rate Setting, and scroll down to Hospice rates.
Provenance
- Source
- vamedicaid.dmas.virginia.gov
- Retrieved
- 2026-10-02
- Edition
- dmas-hospice-v-2025-12-05
- Content hash
2ef9395d15ade4dcefa81ffd37fc98c5a3884a641bb15c4ec1ecda30ac44ee2b
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