Reason Code 5D510: There Was No Evidence of at Least Three Consecutive Day of Inpatient Hospital Stay
Published 05/22/2019
The documentation submitted does not support medical necessity as listed in coverage requirements.
To Prevent This Denial
- Ensure that the beneficiary has had a qualifying hospital stay of three (3) consecutive days
- Provide documentation that supports the qualifying hospital stay
- Provide all supporting documentation to support the reason the beneficiary was hospitalized
More Information
- CMS Internet-Only Manual (IOM), Medicare Program Integrity Manual, Publication 100-08, Chapter 3, Section 3.4.1.3 (PDF)
- CMS Internet-Only Manual (IOM), Medicare Claims Processing Manual, Publication 100-08, Chapter 3, Sections 3.6.2.1, 3.6.2.2 (PDF)