Edit 00784

SUBSEQUENT DRG BILLS MUST BE AFTER THE THRESHOLD DATE

HIPAA Claim Adjustment Reason Code: 16
            Remark Code: M52
HIPAA Healthcare Claim Status Code: 187
            Entity Identifier Code: N/A

Potential Causes:
The Outlier period are those days that fall after the High Trim point (Threshold date) for the DRG. The rate code on the claim is for the Outlier period but the beginning date of service in the date range on the header is for a date that is before the high trim point.