What it means on your remittance
A verified visit exists, but the claim bills more units than the visit's verified time supports. Pennsylvania does not automatically cut the claim back to the verified units — it denies the whole line. Home-health twin: ESC 937.
Why it happens
- The claim bills more units than the verified clock-in/out span supports.
- Unit rounding: the verified minutes fall just under the unit boundary billed.
- Claim units keyed from the schedule rather than the verified visit.
How to fix it, step by step
- 1Compare the claim line's units to the verified span on the visit record.
- 2If the visit times are wrong, correct them with a reason code and re-verify (this counts as a manual edit — see Pennsylvania's 85% rule).
- 3If the times are right, reduce the claim's units to what the visit verified.
- 4Resubmit. Pennsylvania will not auto-reduce for you — the whole line denies until units agree.
How to tell it apart
927/937 is Pennsylvania's RA-level equivalent of the national N820: verified visit exists, units don't fit. The critical PA-specific behavior is NO automatic cutback — a one-unit overage denies the entire line.
Note: state edit codes like this one often appear on the paper Remittance Advice rather than inside the 835 file. If you only have the 835, our team can read the full remittance for you.
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Run the free Denial X-RayCommon questions
What does denial ESC 927 mean?
A verified visit exists, but the claim bills more units than the visit's verified time supports. Pennsylvania does not automatically cut the claim back to the verified units — it denies the whole line. Home-health twin: ESC 937.
How do I fix a ESC 927 denial?
Either correct the claim units down to what the visit verified, or fix the visit's call times (with a reason code) if they're wrong, re-verify, and resubmit. Check DHS's rounding rules — unit rounding is a common silent cause.
If the visit verified 3 units and I billed 4, why not just pay 3?
Pennsylvania's published behavior is to deny the line outright rather than downgrade it. The state puts the correction burden on the provider — bill only what the verified visit supports.