Claim Exception Codes
(This list is updated daily)




  Claim Exception Code     Claim Exception Code Short Description   Claim Exception Code Long Description Remark Code Remark Code Description Adjust Reason Code Adjust Reason Code Description
0005  CLMS TO BE REPRO IN ENVISION CLAIMS TO BE REPROCESSED IN ENVISION
0014  FCN NOT VAL FOR VOID/ADJ REQ FCN NUMBER IS MISSING OR INVALID FOR VOID/ADJUSTMENT REQUEST M47 Missing/incomplete/invalid internal or document control number. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0025  SUB UNITS NOT CONSIST W/DOS SUBMITTED UNITS NOT CONSISTENT WITH DATES OF SERVICE M53 Missing/incomplete/invalid days or units of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0028  FAM PLNG COE-PREGNANCY INDCTD BENEFICIARY FAMILY PLANNING COE BUT SERVICES ON THE CLAIM IDENTIFY PREGNANCY FOR THE BENEFICIARY N448 This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement 204 This service/equipment/drug is not covered under the patient's current benefit plan.
0029  SERVICE NOT FAMILY PLANNING SERVICE NOT FAMILY PLANNING RELATED N448 This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement 204 This service/equipment/drug is not covered under the patient's current benefit plan.
0032  CLAIM TYPE CANNOT BE ASSIGNED CLAIM TYPE CANNOT BE ASSIGNED N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0046  TOTL REV CHARGE '0001' MISS TOTAL REVENUE CHARGE "0001" LINE MISSING M54 Missing/incomplete/invalid total charges. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0051  SUM OF ACCM DYS NOT=TOT DYS SUM OF ACCOMMODATION DAYS DOES NOT EQUAL TOTAL COVERED DAYS MA32 Missing/incomplete/invalid number of covered days during the billing period. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0057  CAP CLAIM FOR NON MCO BENE CAPITATION CLAIM BILLED & CLIENT ID IS NOT ENROLLED IN AN MCO N52 Patient not enrolled in the billing provider's managed care plan on the date of service. 32 Our records indicate that this dependent is not an eligible dependent as defined.
0058  PAT STAT/ TYPE BILL CONFL PATIENT STATUS CONFLICTS WITH TYPE OF BILL MA30 Missing/incomplete/invalid type of bill. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0059  CHP CAP CLAIM FOR NON CHP BENE CAPITATION CLAIM BILLED & CLIENT ID IS NOT ENROLLED IN AN CHIP M N52 Patient not enrolled in the billing provider's managed care plan on the date of service. 32 Our records indicate that this dependent is not an eligible dependent as defined.
0072  ACCOM REV CODE MISSING ACCOMMODATION REVENUE CODE IS MISSING M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0075  SURG PROC CODE IS REQUIRED SURG PROC CODE IS REQUIRED M20 Missing/incomplete/invalid HCPCS. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0077  SERV DATE SPAN MORE ONE DOS SERVICE DATES SPAN MORE THAN ONE DAY OF SERVICE MA31 Missing/incomplete/invalid beginning and ending dates of the period billed. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0092  MORE THAN 1 SL FOR SAME SVC MORE THAN 1 SERVICE LIMIT FOR SAME SERVICE N640 Exceeds number/frequency approved/allowed within time period. B5 Coverage/program guidelines were not met or were exceeded.
0104  EXACT DUPLICATE CLAIM EXACT DUPLICATE CLAIM M86 Service denied because payment already made for similar procedure within set time frame. 97 Payment is included in the allowance for another service/procedure.
0105  SUSPECT DUPLICATE CLAIM SUSPECT DUPLICATE CLAIM M86 Service denied because payment already made for similar procedure within set time frame. 97 Payment is included in the allowance for another service/procedure.
0106  SUSPECT DUPLICATE CLAIM SUSPECT DUPLICATE CLAIM - SUSPENSE M86 Service denied because payment already made for similar procedure within set time frame. 97 Payment is included in the allowance for another service/procedure.
0107  SUSPECT DUPLICATE IP CLAIM SUSPECT DUPLICATE INPATIENT CLAIM (3-DAY WINDOW EDIT) M86 Service denied because payment already made for similar procedure within set time frame. 97 Payment is included in the allowance for another service/procedure.
0108  SUSPECT DUPLICATE OP CLAIM SUSPECT DUPLICATE OUTPATIENT CLAIM (3 DAY WINDOW) M86 Service denied because payment already made for similar procedure within set time frame. 97 Payment is included in the allowance for another service/procedure.
0110  DATE BUNDLING NOT ALLOWED DATE BUNDLING NOT ALLOWED 110 Billing date predates service date.
0111  DATE BUNDLING LMT EXCEED DATE BUNDLING LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
0112  DOS CANNOT SPAN MONTHS DATE OF SERVICE CANNOT SPAN ACROSS MONTHS N62 Inpatient admission spans multiple rate periods. Resubmit separate claims. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0113  ADMIT/FROM DATE CNFL ADMIT DATE/FROM DATE CONFLICT MA40 Missing/incomplete/invalid admission date. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0114  ADMIT SOURCE MISS/INV ADMIT SOURCE MISSING OR INVALID MA42 Missing/incomplete/invalid admission source. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0117  FIRST PROC CODE MOD INVALID FIRST PROCEDURE CODE MODIFIER INVALID N519 Invalid combination of HCPCS modifiers 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
0118  MCARE ALLOWED AMT CNFL MEDICARE ALLOWED AMOUNT CONFLICT M79 Missing/incomplete/invalid charge. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0119  TOOTH SURFACE INVALID TOOTH SURFACE INVALID N75 Missing/incomplete/invalid tooth surface information. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0120  BILLING PROVIDER# IS MISSING BILLING PROVIDER NUMBER IS MISSING N257 Missing/incomplete/invalid billing provider/supplier primary identifier 207 Precertification/authorization exceeded.
0121  MOD 2 INVALID MODIFIER 2 INVALID N519 Invalid combination of HCPCS modifiers 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
0122  MOD 3 INVALID MODIFIER 3 INVALID N519 Invalid combination of HCPCS modifiers 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
0123  MOD 4 INVALID MODIFIER 4 INVALID N519 Invalid combination of HCPCS modifiers 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
0124  FROM DOS IS MISSING FROM DATE OF SERVICE IS MISSING M52 Missing/incomplete/invalid ôfromö date(s) of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0125  LAB CLM INPAT HOSP-BILL HOSP LAB CLAIM FOR INPATIENT SERVICE-BILL HOSPITAL N428 171 Payment is denied when performed/billed by this type of provider in this type of facility. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0126  FIRST DOS AFTER LAST DOS FIRST DATE OF SERVICE IS AFTER LAST DATE OF SERVICE MA31 Missing/incomplete/invalid beginning and ending dates of the period billed. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0127  LAST DOS AFTER RECEIPT DATE LAST DATE OF SERVICE AFTER RECEIPT DATE M59 Missing/incomplete/invalid ôtoö date(s) of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0129  BENE ID IS MISSING/INVALID BENEFICIARY ID IS MISSING OR INVALID N382 Missing/incomplete/invalid patient identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0130  BENE DOB IS MISS/INV BENEFICIARY DATE OF BIRTH IS MISSING OR INVALID N329 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0132  SUBM CHARGE IS MISSING SUBMITTED CHARGE IS MISSING M79 Missing/incomplete/invalid charge. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0135  CLAIM PRICED AT ZERO CLAIM PRICED AT ZERO B13 Previously paid. Payment for this claim/service may have been provided in a previous payment.
0140  BENE NOT FOUND - RECYCLE BENEFICIARY NOT FOUND - RECYCLE 21 DAYS 31 Patient cannot be identified as our insured .
0142  BENE NOT ELIG - RECYCLE BENEFICIARY NOT ELIGIBLE - RECYCLE 177
0143  BENE NOT ELIGIBLE/NOT FOUND BENEFICIARY NOT ELIGIBLE OR NOT FOUND 31 Patient cannot be identified as our insured .
0147  ADMIT TYPE INVALID ADMIT TYPE INVALID MA41 Missing/incomplete/invalid admission type. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0148  REV CODE IS MISSING REVENUE CODE IS MISSING M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0149  BENE HAS PARTIAL ELIGIBILITY BENEFICIARY HAS PARTIAL ELIGIBILITY 239
0150  PLACE OF SERV MISS/INV PLACE OF SERVICE IS MISSING OR INVALID N563 Missing required provider/supplier issuance of advance patient notice of non-coverage. The patient is not liable for payment for this service. 58 Treatment was deemed by the payer to have been renderedin an inappropriate or invalid place of service.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0155  LAST DOS IS MISSING LAST DATE OF SERVICE IS MISSING M59 Missing/incomplete/invalid ôtoö date(s) of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0156  SIG/BILL DT GRTR THAN BTCH DT SIGNATURE/BILLED DATE IS GREATER THAN BATCH DATE N354 Incomplete/invalid invoice. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0157  LINE COUNT IS INVALID LINE COUNT IS INVALID N232 Incomplete/invalid itemized bill/statement. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0158  BILLING DATE BEFORE LAST DOS BILLING DATE IS BEFORE LAST DATE OF SERVICE 110 Billing date predates service date.
0159  EOB LI INVALID EOB LINE IS INVALID MA69 Missing/incomplete/invalid remarks. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0160  TOTAL CLAIM CHARGE CNFL TOTAL CLAIM CHARGE DOES NOT MATCH SUM OF LINE ITEM CHARGES M54 Missing/incomplete/invalid total charges. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0161  SEQUENCE NUMBER INVALID SEQUENCE NUMBER INVALID N232 Incomplete/invalid itemized bill/statement. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0162  LI DOS OUTSIDE FROM DATE LINE ITEM DATES OF SERVICE ARE OUTSIDE FROM DATES OF SERVICE M52 Missing/incomplete/invalid ôfromö date(s) of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0163  LI DOS OUTSIDE THRU DATE LINE ITEM DATES OF SERVICE ARE OUTSIDE THRU DATES OF SERVICE M59 Missing/incomplete/invalid ôtoö date(s) of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0164  CT MATCH LIST PARM 4463 CLAIM TYPE MATCHES A CLAIM TYPE IN PARAMETER LIST 4463 (USED TO SUPER-SUSPEND SPECIFIC CLAIM TYPES) N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0165  ICD9 AND ICD10 ON SAME CLAIM ICD9 AND ICD10 SERVICE ON SAME CLAIM - MUST SPLIT BILL M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
0166  ICD9-SVC DISCHARGE DT CONFLICT ICD9 SERVICES WITH DISCHARGE AFTER ICD10 CUTOVER M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
0167  ADMIT DATE IS MISSING ADMISSION DATE IS MISSING MA40 Missing/incomplete/invalid admission date. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0168  MEDICARE DENIED THE LINE MEDICARE DENIED THE LINE MA04 Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0169  MCARE ALLOWED AMT IS ZERO MEDICARE ALLOWED AMOUNT IS ZERO M54 Missing/incomplete/invalid total charges. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0172  PROCEDURE CODE MISSING PROCEDURE MISSING M20 Missing/incomplete/invalid HCPCS. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0173  SPECIFIC PHAR PROC REQ REV CD SPECFIC PHARMACY PROC CODES REQUIRES 0636 REV CODE N657 This should be billed with the appropriate code for these services 199 Revenue code and Procedure code do not match.
0174  TRAUMA PROC BILLED WITH REV CD TRAUMA TEAM ACTIVATION PROC MUST BE BILLED WITH 0681-0684 REV CODE N657 This should be billed with the appropriate code for these services 199 Revenue code and Procedure code do not match.
0175  HDR LEVEL OVR LOCATION CD INV HEADER LEVEL OVERRIDE LOCATION CODE INVALID N354 Incomplete/invalid invoice. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0177  VOID/ADJUST OF DENIED CLAIM VOID/ADJUSTMENT OF DENIED CLAIM N152 Missing/incomplete/invalid replacement claim information. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0178  VALID POA REQUIRED DIAGNOSIS NOT EXEMPT/VALID POA REQUIRED N434 Missing/Incomplete/Invalid Present on Admission indicator. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0179  HAC NEVER EVENT MOD PRESENT HAC NEVER EVENT MOD PRESENT M20 Missing/incomplete/invalid HCPCS. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0180  HAC NEVER EVENT DX PRESENT HAC NEVER EVENT DX PRESENT M20 Missing/incomplete/invalid HCPCS. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0181  CLM REQS MANUAL PRICING - POA CLAIM REQUIRES MANUAL RE-PRICING THAT ARE BILLED FOR POA VALUE (N OR U) OR E CODES. N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0182  CV/NONCV DYS - VAL CD MISS/INV COVERED/NONCOVERED DAYS MISSING OR INVALID DUE TO MISSING/INVALID VALUE CODE MA32 Missing/incomplete/invalid number of covered days during the billing period. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0183  POA DIAG CD WITH SURG CD COMB POA DIAG CODE BILLED WITH SURG CODE COMBINATION M20 Missing/incomplete/invalid HCPCS. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0184  HOSPICE UNIT OF SERV INVALID HOSPICE UNITS OF SERVICE IS INVALID M53 Missing/incomplete/invalid days or units of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0185  HOSPICE SUBM UNT GRT TOT DYS HOSPICE SUBMITTED UNITS GREATER THAN TOTAL DAYS M53 Missing/incomplete/invalid days or units of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0187  HEADER EOB INVALID HEADER EOB INVALID MA69 Missing/incomplete/invalid remarks. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0188  PATIENT STATUS INVALID PATIENT STATUS INVALID MA43 Missing/incomplete/invalid patient status. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0189  SUB UNITS OF SERV MISSING SUBMITTED UNITS OF SERVICE IS MISSING M53 Missing/incomplete/invalid days or units of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0201  VOID/ADJUST TCN MISS/INV VOID/ADJUSTMENT TCN MISSING OR INVALID N152 Missing/incomplete/invalid replacement claim information. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0205  REFERRING PROV REQUIRED REFERRING PROVIDER REQUIRED N286 Missing/incomplete/invalid referring provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0206  NONCVD CHARGE CONFLICT NON-COVERED CHARGE CONFLICTING M54 Missing/incomplete/invalid total charges. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0221  BENE NAME MISMATCH BENEFICIARY NAME MISMATCH 140 Patient/Insured health identification number and name do not match.
0230  PROV NOT ALLWD TO BILL PC/TC PROVIDER IS NOT ALLOWED TO BILL FOR PROFESSIONAL OR TECHNICAL COMPONENT. N95 This provider type/provider specialty may not bill this service. 170 Payment is denied when performed/billed by this type of provider. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present
0238  SUB UNITS EXCEED MAX ALLOWED SUBMITTED UNITS EXCEED MAXIMUM ALLOWED UNITS N640 Exceeds number/frequency approved/allowed within time period. B5 Coverage/program guidelines were not met or were exceeded.
0239  SUB UNITS EXCEED MAX ALLOWED LINE SUBMITTED UNITS EXCEED MAXIMUM ALLOWED UNITS IN THE PROCEDURE FILE N640 Exceeds number/frequency approved/allowed within time period. B5 Coverage/program guidelines were not met or were exceeded.
0253  DIAG NOT VALID FOR DOS DIAGNOSIS NOT VALID FOR DATE OF SERVICE M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
0260  DIAGNOSIS CODE NOT SPECIFIC DIAGNOSIS CODE NOT SPECIFIC M81 PatientÆs diagnosis in a narrative form is not provided on an attachment or diagnosis code(s) is truncated, incorrect or missing; you are required to code to the highest level of specificity. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0263  XOVER CLAIM - NO MCARE ON FILE CROSSOVER CLAIM - NO MEDICARE ON FILE MA92 Missing plan information for other insurance. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0264  MCARE PT A ELIG - W/O ATTACH BENEFICIARY IS MEDICARE PART A ELIGIBILE - WITHOUT ATTACHMENT N29 Missing documentation/orders/notes/summary/report/chart. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0265  MCARE PT B ELIG - W/O ATTACH BENEFICIARY IS MEDICARE PART B ELIGIBLE - WITHOUT ATTACHMENT N4 Missing/incomplete/invalid prior insurance carrier EOB. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0266  QMB BENE/ BILL XOVER ONLY QMB BENEFICIARY IS ELIGIBLE FOR MCARE CROSSOVERS ONLY N30 Recipient ineligible for this service. B1 Non-covered visits.
0267  NET-COE NOT COVERED NET ENCOUNTER CLAIM-CATEGORY OF ELIGIBILITY NOT COVERED N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0268  CAN OR CHP LOCK-IN ON DOS NET ENCOUNTER CLAIM-BENE IN CAN OR CHIP ON DOS N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0270  DMERC CLAIM MUST BILL NDC DMERC CLAIM MUST BILL NATIONAL DRUG CODE (NDC)
0272  MCARE PART A - EOB REQ REV MEDICARE PART A AVAILABLE - NON XOVER CLAIM - EOB REQUIRES REVIEW N4 Missing/incomplete/invalid prior insurance carrier EOB. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0273  MCARE PART B - EOB REQ REV MEDICARE PART B AVAILABLE - NON XOVER CLAIM - EOB REQUIRES REVIEW N4 Missing/incomplete/invalid prior insurance carrier EOB. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0275  MAJOR PROG/SERVICE CONFLICT MAJOR PROGRAM - SERVICE CONFLICT N354 Incomplete/invalid invoice. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0280  DOC REVIEW REQ BY FAS PROCEDURE CODE REQUIRES REVIEW BY FISCAL AGENT STAFF. RESUBMIT CLAIM VIA WEB OR PAPER WITH DOCUMENTATION N232 Incomplete/invalid itemized bill/statement. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0286  MCARE PAID DATE MISS/INV MEDICARE PAID DATE MISSING OR INVALID N307 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0289  JUSTFCTN OF MED NECESS REQ JUSTIFICATION OF MEDICAL NECESSITY REQUIRED N29 Missing documentation/orders/notes/summary/report/chart. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0297  DX REQUIRES REVIEW BY FAS DIAGNOSIS REQUIRES REVIEW BY FISCAL AGENT STAFF N232 Incomplete/invalid itemized bill/statement. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0300  BILLING PROV NOT ON FILE BILLING PROVIDER NOT ON FILE N257 Missing/incomplete/invalid billing provider/supplier primary identifier 208 National Provider Identifier - Not matched
0301  BLNG PROV TY NOT FOUND FOR DOS BILLING PROVIDER TYPE IS NOT FOUND FOR DATES OF SERVICE N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0302  ATNDG PROV IS NOT ON FILE ATTENDING PROVIDER IS NOT ON FILE N253 Missing/incomplete/invalid attending provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0303  ATTENDING PROV IS MISSING ATTENDING PROVIDER IS MISSING N253 Missing/incomplete/invalid attending provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0304  INVALID BATCH TYPE INVALID BATCH TYPE N354 Incomplete/invalid invoice. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0305  MCD CV DAY<= INT CLAIM THRSHLD MEDICAID COVERED DAYS LESS THAN OR EQUAL TO INTERIM CLAIM THRESHOLD MA32 Missing/incomplete/invalid number of covered days during the billing period. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0306  EYEGLAS/DENT NOT CVRD FOR BENE EYEGLASS OR DENTAL SERVICES NOT COVERED FOR BENEFICIARY N448 This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement 204 This service/equipment/drug is not covered under the patient's current benefit plan.
0307  LEGACY EDIT LEGACY DENIED LINE ITEMS CONVERTED IN ERROR W/ALLOWED STATUS
0313  CAT OF SERV CANNOT BE DTRMND CATEGORY OF SERVICE CANNOT BE DETERMINED N34 Incorrect claim form for this service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0317  BENEFICIARY NOT ELIGIBLE FOR S BENEFICIARY NOT ELIGIBLE FOR SERVICE N448 This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement 204 This service/equipment/drug is not covered under the patient's current benefit plan.
0320  CLIA CERT DOES NOT MATCH DOS CLIA CERTIFICATION DOES NOT COVER THIS PROCEDURE FOR THE DATES OF SERVICE B23 Procedure billed is not authorized per your ClinicalLaboratory Improvement Amendment (CLIA) proficiency test.
0325  TRAUMA/ACCIDENT CLAIM TRAUMA/ACCIDENT CLAIM MA04 Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible. 22 This care may be covered by another payer per coordination of benefits.
0331  NO LTC SPAN AVAIL FOR FRST DOS NO LTC SPAN AVAILABLE FOR FIRST DATES OF SERVICE N141 The patient was not residing in a long-term care facility during all or part of the service dates billed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0332  DIAG/RELATED DIAG CODE MISSING DIAGNOSIS/RELATED DIAGNOSIS CODE MISSING M76 Missing/incomplete/invalid diagnosis or condition. 146 Diagnosis was invalid for the date(s) of service reported.
0336  BLNG PROV N/AUTH BY LCKN SPAN BILLING PROVIDER NOT AUTHORIZED BY LTC SPAN OR LOCKIN SPAN N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0338  SERV NOT PAYABLE - LTC BENE SERVICE NOT PAYABLE FOR LTC BENEFICIARY N30 Recipient ineligible for this service. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0343  BLNG PROV NOT AUTH FOR PROG BILLING PROVIDER NOT AUTHORIZED FOR PROGRAM N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0344  PROV NOT AUTH TO RENDR SERVICE PROVIDER NOT AUTHORIZED TO RENDER SERVICE N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0345  PROV TYPE REQUIRES PA PROVIDER TYPE DPO WITH CLAIM TYPE N (LONG TERM CARE) REQUIRES A PA. 197
0346  PROV NOT ALLWD TO BILL SERVICE PROVIDER IS NOT ALLOWED TO BILL OTHER THAN EYE GLASSES. N95 This provider type/provider specialty may not bill this service. 170 Payment is denied when performed/billed by this type of provider. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present
0347  REV CODE NOT FOUND ON DB REVENUE CODE CANNOT BE FOUND ON THE DATABASE M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0351  HIGH VARIANCE HIGH VARIANCE M79 Missing/incomplete/invalid charge. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0352  LOW VARIANCE LOW VARIANCE M79 Missing/incomplete/invalid charge. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0357  NO HOSPICE LOCKIN AVAILABLE NO HOSPICE LOCKIN AVAILABLE FOR DATES OF SERVICE N143 The patient was not in a hospice program during all or part of the service dates billed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0360  MODIFIER PROV SPEC MISMATCH MODIFIER/SERVICING PROVIDER SPECIALITY MISMATCH M119 Missing/incomplete/invalid National Drug Code (NDC). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0361  TOOTH/QUADRANT # REQUIRED TOOTH/QUADRANT NUMBER REQUIRED N37 Missing/incomplete/invalid tooth number/letter. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0362  TOOTH SURFACE REQUIRED TOOTH SURFACE REQUIRED N75 Missing/incomplete/invalid tooth surface information. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0363  PROC/MOD 1 CNFL PROCEDURE/MODIFIER 1 CONFLICTING N519 Invalid combination of HCPCS modifiers 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
0364  PROC/TOOTH NUMBER CNFL PROCEDURE CODE/TOOTH NUMBER CONFLICT N39 Procedure code is not compatible with tooth number/letter. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0365  PROC/PLACE OF SVC CNFL PROCEDURE/PLACE OF SERVICE CONFLICT M77 Missing/incomplete/invalid/inappropriate place of service. 5 The procedure code/bill type is inconsistent with the place of service.
0366  PROC/SERV PROV SPEC MISMATCH PROCEDURE/SERVICING PROVIDER SPECIALITY MISMATCH N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0367  PROC/SERV PROV TYPE CNFL PROCEDURE/SERVICING PROVIDER TYPE CONFLICTING N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0368  REV/BLNG PROV TYPE CNFL BILLING PROVIDER NOT ALLOWED TO BILL REVENUE CODE N95 This provider type/provider specialty may not bill this service. 170 Payment is denied when performed/billed by this type of provider. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present
0369  REV/BLNG PROV SPEC MISMATCH REVENUE CODE/BILLING PROVIDER SPECIALTY MISMATCH N95 This provider type/provider specialty may not bill this service. 170 Payment is denied when performed/billed by this type of provider. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present
0370  SRVC EXCLUDED-PLAD/HM WAIVER SERVICE EXCLUDED FOR PLAD/HM WAIVER N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
0371  PROC/MOD 2 CNFL PROCEDURE/MODIFIER 2 CONFLICTING N519 Invalid combination of HCPCS modifiers 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
0372  PROC/CLM TYPE CNFL PROCEDURE/CLAIM TYPE CONFLICTING N34 Incorrect claim form for this service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0373  REV/TYPE OF BILL CNFL REVENUE/TYPE OF BILL CONFLICT MA30 Missing/incomplete/invalid type of bill. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0374  PROC/MOD 3 CNFL PROCEDURE/MODIFIER 3 CONFLICTING N519 Invalid combination of HCPCS modifiers 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
0375  PROC/MOD 4 CNFL PROCEDURE/MODIFIER 4 CONFLICTING N519 Invalid combination of HCPCS modifiers 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
0376  PROC REQUIRES MODIFIER PROCEDURE REQUIRES MODIFIER N572 Not covered when performed for the reported diagnosis 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
0377  HCPCS REQUIRED NDC THIS HCPCS CODE MUST BE BILLED WITH AN NDC M119 Missing/incomplete/invalid National Drug Code (NDC). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0378  CLM TBLE COUNT GRT THAN MAX CLAIM TABLE COUNTS GREATER THAN MAXIMUM N232 Incomplete/invalid itemized bill/statement. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0379  SYSTEM ERROR SYSTEM ERROR (INTERNAL ERROR) N354 Incomplete/invalid invoice. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0380  INVALID DRG PERCENTAGE RATE INVALID DRG PERCENTAGE RATE N232 Incomplete/invalid itemized bill/statement. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0381  RATE RECORD NOT FOUND RATE RECORD NOT FOUND N65 Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0382  REV CODE REQ REVIEW BY FAS REVENUE CODE REQUIRES REVIEW BY FISCAL AGENT N232 Incomplete/invalid itemized bill/statement. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0383  PDX INVALID AS DISCHARG DX PDX INVALID AS DISCHARG DX N50 Missing/incomplete/invalid discharge information. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0384  UNGROUPABLE DRG CODE UNGROUPABLE DRG CODE N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0385  VOID FAILED DURING SVE PROCESS VOID FAILED DURING SAVE PROCESS M47 Missing/incomplete/invalid internal or document control number. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0386  INV PARM PCT/NUM/AMT/TYPE INVALID PARAM PCT/NUM/AMT/TYPE CODE FOR THE SYSTEM PARAMETER M47 Missing/incomplete/invalid internal or document control number. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0387  CLM CAN'T BE ADJ W/O RPLCMNT A PAID/DENIED CLAIM CANNOT BE VOIDED/ADJUSTED W/O REPLACED N152 Missing/incomplete/invalid replacement claim information. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0388  FQHC PROV CANT BILL X-OVER FQHC PROVIDER NOT ALLOWED TO BILL MEDICARE CROSSOVER N95 This provider type/provider specialty may not bill this service. 170 Payment is denied when performed/billed by this type of provider. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present
0389  INVALID FREQUENCY CODE INVALID FREQUENCY CODE MA30 Missing/incomplete/invalid type of bill. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0390  RELATIVE WEIGHT NOT FOUND RELATIVE WEIGHT NOT FOUND N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0391  INVALID OUTLIER ELIGIBLE CODE INVALID OUTLIER ELIGIBLE CODE N232 Incomplete/invalid itemized bill/statement. 252 An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
0395  SCH BSED SVC INV FOR PROV TYP SCHOOL BASED SERVICE INVALID FOR PROVIDER TYPE N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0400  92507/92508/T02 & < 21 REQ PA PROCEDURE CODES 92507 & 92508 BILLED BY PROVIDER TYPE OF T02 WHERE THE BENE IS < 21, REQUIRE A PA N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0404  NET PAYTO NOT ALLOWED PAY TO PROVIDER CANNOT BE NET ENCOUNTER PROVIDER N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0406  PROV NOT ALLWD FOR NONXOVR CLM PROVIDER IS NOT ALLOWEED TO SUBMIT NON-CROSSOVER CLAIM- ONLY CROSSOVER CLAIMS ARE ALLOWED FOR THIS PROVIDER N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0409  CHOW R PROV NOT REVLID-RECYCL CHOW RNDR PROV NOT REVALIDATED ON ADJUD-RECYC 30 DAYS N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0410  CHOW B PROV NOT REVLID-RECYC CHOW BLNG PROV NOT REVALIDATED ON ADJUD-RECYC 30 DAYS N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0411  BILLING PROV IS UNDER REVIEW BILLING PROVIDER IS UNDER REVIEW N35 Program integrity/utilization review decision. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0412  SERV PROV MISSG OR NOT ON FILE SERVICING PROVIDER IS MISSING OR NOT ON FILE N32 Provider performing service must submit claim. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0413  SERV PROV IS UNDER REVIEW SERVICING PROVIDER IS UNDER REVIEW N35 Program integrity/utilization review decision. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0414  LTC NEW ADMIT W/SANCT PERIOD LTC NEW ADMIT WITHIN PROVIDER SANCTION PERIOD N35 Program integrity/utilization review decision. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0415  RGLR R PROV NOT REVLID-RECYCL RGLR RNDR PROV NOT REVALIDATED ON ADJUD-RECYC 21 DAYS N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0416  RGLR B PROV NOT REVLID-RECYC RGLR BLNG PROV NOT REVALIDATED ON ADJUD-RECYC 21 DAYS N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0418  B PROV NOT ENROLL ON DOS-RECYC BILLING PROVIDER NOT ENROLLED ON DOS- RECYCLE 21 DAYS N257 Missing/incomplete/invalid billing provider/supplier primary identifier 208 National Provider Identifier - Not matched
0422  SERV PROV NOT ENROLLED SERVICING PROVIDER NOT ENROLLED N253 Missing/incomplete/invalid attending provider primary identifier. 208 National Provider Identifier - Not matched
0423  SERV PROV NOT IN BILLING GROUP SERVICING PROVIDER NOT IN BILLING GROUP N198 Rendering provider must be affiliated with the pay-to provider. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0424  BILL PROV NOT ENROLL ON DOS BILLING PROVIDER NOT ENROLLED ON DATES OF SERVICE N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0425  PROV NOT A VALID BILL PROV PROVIDER IS NOT A VALID BILLING PROVIDER N95 This provider type/provider specialty may not bill this service. 170 Payment is denied when performed/billed by this type of provider. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present
0426  BILL PROV NPI MISS/ INVALID BILLING PROVIDER NPI IS MISSING OR INVALID N257 Missing/incomplete/invalid billing provider/supplier primary identifier 207 Precertification/authorization exceeded.
0427  SVC PROVIDER NPI MISS/ INVALID SERVICING PROVIDER NPI IS MISSING OR INVALID N253 Missing/incomplete/invalid attending provider primary identifier. 208 National Provider Identifier - Not matched
0428  POS 21,22,23 NA FQHC/RHC PRV SERVICES IN POS 21, 22, 23 NOT PAID TO FQHC/RHC PROVIDERS N563 Missing required provider/supplier issuance of advance patient notice of non-coverage. The patient is not liable for payment for this service. 58 Treatment was deemed by the payer to have been renderedin an inappropriate or invalid place of service.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0429  NPI/PROVIDER NUMBER MISMATCH NPI/PROVIDER NUMBER MISMATCH N77 Missing/incomplete/invalid designated provider number. 208 National Provider Identifier - Not matched
0430  PROCEDURE NOT ON FILE PROCEDURE NOT ON DATA BASE M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
0431  PROCEDURE NOT COVERED PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0432  PROC CODE REQUIRES REVIEW PROCEDURE CODE REQUIRES REVIEW N35 Program integrity/utilization review decision. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0434  PROC/AGE CNFL PROCEDURE/AGE CONFLICT N129 This amount represents the dollar amount not eligible due to the patient's age. 6 The procedure/revenue code is inconsistent with the patient's age.
0435  PROC/GENDER CNFL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
0436  AUTH REQ- PA IS MISS/INV AUTHORIZATION IS REQUIRED - PA# ON CLAIM IS MISSING OR INVALID N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0437  PROC NOT VALID FOR SERV DATE PROCEDURE NOT VALID FOR SERVICE DATE M20 Missing/incomplete/invalid HCPCS. 181
0438  PROC REQUIRES MANUAL PRICE PROCEDURE REQUIRES MANUAL PRICE M51 Missing/incomplete/invalid procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0439  PROC NOT A BENEFIT FOR DOS PROCEDURE NOT A BENEFIT FOR SERVICE DATE N517 Resubmit a new claim with the requested information. 181
0441  PAYTO NPI/PROV-ID MISS/INVALID PAY TO NPI/PROVIDER ID IS MISSING OR INVALID N280 Missing/incomplete/invalid pay-to provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0443  ORD/REF NPI NOT ON FIL/ELG EXP ORDERING/REFERRING PROVIDER NPI NOT ON FILE/ELIGIBILITY EXPIRED (RE-CYCLE FOR 90 DAYS) N280 Missing/incomplete/invalid pay-to provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0444  ORD/REF PROV NPI NOT ON FILE ORDERING/REFERRING PROVIDER NPI NOT ON FILE/ELIGIBILITY EXPIRED (90 DAY RE-CYCLE OF 0443 ELAPSED) N280 Missing/incomplete/invalid pay-to provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0445  ORD/REF PROV NPI MISSING ORDERING/REFERRING PROVIDER NPI IS MISSING N280 Missing/incomplete/invalid pay-to provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0446  NPI NOT ALLOWED AS ORD/REF PRV SUBMITTED NPI NOT ALLOWED AS ORDERING/REFERRING PROVIDER N280 Missing/incomplete/invalid pay-to provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0447  ORP PROV NOT VALID BILL PROV ORP PROVIDER NOT VALID BILLING PROVIDER N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0448  ORP PROV NOT VALID SRVC PROV ORP PROVIDER NOT VALID SERVICING PROVIDER N290 Missing/incomplete/invalid rendering provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0449  PROV TYP REQUIRES MODIFIER PROVIDER TYPE REQUIRES MODIFIER N253 Missing/incomplete/invalid attending provider primary identifier. 208 National Provider Identifier - Not matched
0450  PROV CAN'T BILL HW MODIFIER PROVIDER CANNOT BILL HW MODIFIER N253 Missing/incomplete/invalid attending provider primary identifier. 208 National Provider Identifier - Not matched
0451  X00/X01 BILL&RND SHULD BE SAME X00/X01 SHOULD HAVE THE SAME BILLING AND RENDERING PROVIDER TYPES. N253 Missing/incomplete/invalid attending provider primary identifier. 208 National Provider Identifier - Not matched
0452  BLNG & SRV PROV TYPES ARE DIFF BILLING AND RENDERING PROVIDER TYPES SHOULD BE SAME. N253 Missing/incomplete/invalid attending provider primary identifier. 208 National Provider Identifier - Not matched
0453  PROVIDER TYPE REQUIRES U7 MOD RENDERING PROVIDER TYPE REQUIRES U7 MODIFIER. N253 Missing/incomplete/invalid attending provider primary identifier. 208 National Provider Identifier - Not matched
0454  PROVIDER TYPE REQUIRES HA MOD RENDERING PROVIDER TYPE REQUIRES HA MODIFIER. N253 Missing/incomplete/invalid attending provider primary identifier. 208 National Provider Identifier - Not matched
0455  RGLR R PROV NOT REVALIDATED REGULAR RNDR PROVIDER NOT REVALIDATED ON ADJUD DATE N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0456  RGLR B PROV NOT REVALIDATED REGULAR BLNG PROVIDER NOT REVALIDATED ON ADJUD DATE N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0457  CHOW B PROV NOT REVALIDATED CHOW BILLING PROVIDER NOT REVALIDATED ON ADJUD DATE N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0458  CHOW R PROV NOT REVALIDATED CHOW RNDR PROVIDER NOT REVALIDATED ON ADJUD DATE N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0459  BILL PROV TERMINATED ON DOS BILLING PROVIDER TEMINATED ON DATES OF SERVICE N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0460  RNDR PROV TERMINATED ON DOS RENDERING PROVIDER TEMINATED ON DATES OF SERVICE N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0461  ORD/REF PROV FAILED TO REVALID ORP ORDERING/REFERRING PROV IS TERMINATED ON CLAIM DOS N280 Missing/incomplete/invalid pay-to provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0501  AUTH IS PENDING AUTHORIZATION IS PENDING N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0502  AUTH/BENE CNFL AUTHORIZATION/BENEFICIARY CONFLICT N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0503  AUTH IS DENIED AUTHORIZATION IS DENIED 39 Services denied at the time authorization/pre-certification was requested.
0504  AUTH/MOD CNFL AUTHORIZATION/MODIFIER CONFLICT N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0510  AUTH/PROV CNFL AUTHORIZATION/PROVIDER CONFLICT N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0511  AUTH/SERV CNFL AUTHORIZATION/SERVICE CONFLICT N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0514  AUTH LINE STATUS PENDING AUTHORIZATION LINE STATUS PENDING N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0515  LTC ACCOM REV CD 0101 MISSING LTC ACCOMMODATION REVENUE CODE 0101 NOT BILLED/MISSING. M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0518  AUTH LINE STATUS DENIED AUTHORIZATION LINE STATUS DENIED 39 Services denied at the time authorization/pre-certification was requested.
0536  REV REQUIRES MANUAL PRICE REVENUE REQUIRES MANUAL PRICE M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0541  REV NOT A BENEFIT FOR DOS REVENUE NOT A BENEFIT FOR SERV DATE M25 Payment has been (denied /reduced) because the claim furnished does not justify the need for a more extensive service. If no review is requested in 120 days, we will, upon request, reimburse the patient for the amounts collected in excess of those applicable to the reduced service. We will recover the excess from you 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0544  REV NOT VALID FOR DOS REVENUE NOT VALID FOR DATES OF SERVICE M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0545  REV REQUIRES MANUAL REVIEW REVENUE REQUIRES MANUAL REVIEW N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0546  PROC REQUIRES PRICE PROCEDURE REQUIRES PRICE M51 Missing/incomplete/invalid procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0547  REV REQUIRES PRICE REVENUE REQUIRES PRICE N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0548  APC PROC REQUIRES PRICE APC PROCEDURE CODE REQUIRES PRICE M51 Missing/incomplete/invalid procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0576  PROC/REV PRICE 'SPECIFIC' RATE THE PROCECURE/REVENUE CODE CAN ONLY BE PRICED BASED ON THE PROCEDURE OR REVENUE M51 Missing/incomplete/invalid procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0582  DRG RECORD NOT ON FILE DRG RECORD NOT ON FILE N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0583  DRG INVALID PRINCIPAL DX DRG INVALID PRINCIPAL DX N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0584  NO DRG IN MDC FOR PRIN DX NO DRG IN MDC FOR PRINCIPAL DIAGNOSIS N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0585  DRG PRICING SPAN NOT FOUND DRG PRICING SPAN NOT FOUND N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0586  DRG INVALID BIRTH WEIGHT DRG INVALID BIRTH WEIGHT N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0587  DRG INV BENE AGE DRG INVALID BENEFICIARY AGE N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0588  DRG REL VALUE MISSING DRG RELATIVE VALUE MISSING N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0589  DRG INV BENE GENDER DRG INVALID BENEFICIARY GENDER N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0590  DRG INV DISCH STAT DRG INVALID DISCHARGE STATUS N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0591  GESTATIONAL AGE/BIRTH WT CNFLT DRG GESTATIONAL AGE/BIRTH WEIGHT CONFLICT N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0592  DRG ILLOG PRIN DIAG DRG ILLOGICAL PRINCIPAL DIAGNOSIS N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0593  DRG INV PRIN DIAG DRG INVALID PRINCIPAL DIAGNOSIS N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0596  DIAG RELATED CODE INVALID DIAGNOSIS RELATED CODE INVALID M81 PatientÆs diagnosis in a narrative form is not provided on an attachment or diagnosis code(s) is truncated, incorrect or missing; you are required to code to the highest level of specificity. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0605  AUTH/SVC DATE CNFL AUTHORIZATION/SERVICE DATE CONFLICT N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0608  AUTH/TOOTH NUM CNFL AUTHORIZATION/TOOTH NUMBER CONFLICT N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0609  AUTH/TOOTH SURF CNFL AUTHORIZATION/TOOTH SURFACE CONFLICT N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0610  EOB REQ REV OR IS MISS/INV EOB REQUIRES REVIEW OR IS MISSING OR INVALID N4 Missing/incomplete/invalid prior insurance carrier EOB. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0611  MCARE AMOUNTS LESS THAN ZERO MCARE DED/BLOOD DED/COINS/PAID/ALLOW/COPAY/SEQUESTRATION AMT < 0 MA04 Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0612  AWAITING CONSENT FORM AWAITING APPROPRIATE STERILIZATION, HYSTERECTOMY OR ABORTION FORM N3 Missing/incomplete/invalid consent form. 251 The attachment/other documentation content received did not contain the content required to process this claim or service.
0617  AUTH LI UNITS/AMT INSUFFICIENT AUTHORIZED LINE ITEM UNITS/AMOUNT INSUFFICIENT N54 Claim information is inconsistent with pre-certified/authorized services. 198
0630  EXACT DUP CLAIM- ELEC XOVER EXACT DUP CLAIM- ELEC XOVER VS ELEC XOVER N522 Duplicate of a claim processed, or to be processed, as a crossover claim 18 Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO).
0631  VACC/ADM CDS BILL WITH PRV EVO VACC/ADM CODES BILLED WITH PROVIDER TYPE EVO N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0632  90472 MST BILL WITH 2 VACC CDS 90472 MUST BE BILLED WITH 2 VACCINE CODES M51 Missing/incomplete/invalid procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0633  BLNG & SERV PROV MUST BE SAME BILLING AND SERVICING PROVIDER MUST BE THE SAME N290 Missing/incomplete/invalid rendering provider primary identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0634  CLIENT MERGE IS DUE CLAIMS MERGE IS DONE AND CLIENT MERGE IS DUE N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0635  EXCLUDED MNTL HLTH SVC - SED EXCLUDED MENTAL HEALTH SERVICES CANNOT BE BILLED FOR BENEFICIARY IN SED LOCK-IN N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
0636  MYPAC-CLAIM MONITORING MYPAC- CLAIM MONITORING N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0637  RELATED CAUSE VALUE INVALID RELATED CAUSE VALUE INVALID (ASSOCIATED WITH EMPL, ACCI, OTHR CHECKBOXES) 107 The related or qualifying claim/service was not identifiedon this claim. Note: Refer to the 835 Healthcare PolicyIdentification Segment (loop 2110 Service Payment Information REF), if present.
0638  ACCIDENT DATE INVALID ACCIDENT DATE INVALID N305 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0673  CONSENT NOT APPROVED CONSENT NOT APPROVED - STERILIZATION, ABORTION AND HYSTERECTOMY N28 Consent form requirements not fulfilled. 251 The attachment/other documentation content received did not contain the content required to process this claim or service.
0674  PEND MEDICAL REVIEW CLAIM PENDED FOR MEDICAL REVIEW N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0675  CONSENT REQUIRED 0675 - VALID CONSENT FORM MUST BE ON FILE OR MEDICAL DOCUMENTATION IS REQUIRED FOR PROCESSING CLAIM. N28 Consent form requirements not fulfilled. 251 The attachment/other documentation content received did not contain the content required to process this claim or service.
0701  DME LINE CHARGES EXCEED LIMIT DME BILLED LINE ITEM CHARGES ARE OVER THE SPECIFIED LIMIT N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
0702  DOS IS BEFORE DOB DATE OF SERVICE IS BEFORE DATE OF BIRTH 13 The date of death precedes the date of service.
0703  BENEFICIARY MUST BE DUAL ELIG BENEFICIARY MUST BE MEDICARE/MEDICAID DUALLY ELIGIBLE 177
0704  MEDICAL DIAGNOSIS REQUIRED MEDICAL DIAGNOSIS REQUIRED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
0707  PROC NOT PREGNANCY RELATED PROCEDURE NOT PREGNANCY-RELATED N56 Procedure code billed is not correct/valid for the services billed or the date of service billed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0708  REV PHY STATEMENT FOR MODIFIER REVIEW PHYSICIAN STATEMENT FOR SERVICE MODIFIER N517 Resubmit a new claim with the requested information. 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
0709  PROCED NOT VALID FOR DME PROVD PROCEDURE NOT VALID FOR PROVIDER TYPE. THIS PROVIDER IS NOT AUTHORIZED TO BILL FOR THE PROCEDURE ON THE CLAIM. N95 This provider type/provider specialty may not bill this service. 170 Payment is denied when performed/billed by this type of provider. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present
0710  GRND AMB SVC REQ ATTACH GROUND AMBULANCE SERVICE REQUIRES ATTACHMENT N29 Missing documentation/orders/notes/summary/report/chart. 251 The attachment/other documentation content received did not contain the content required to process this claim or service.
0713  IP ADMISSION < 24 HRS INPATIENT ADMISSION LESS THAN 24 HOURS, REBILL AS OUTPATIENT N321 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0718  NO DED/COINS/COPAY ON XOVER NO DEDUCTIBLE, COINSURANCE OR COPAY ON CROSSOVER CLAIM MA04 Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0719  MCAR PAY DATE BFORE LDOS MEDICARE PAYMENT DATE BEFORE LAST DATE OF SERVICE OR AFTER BATCH DATE M59 Missing/incomplete/invalid ôtoö date(s) of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0720  PT/OT/ST SERVICES REQUIRE PA PT/OT/ST SERVICES REQUIRE PA 197
0721  SERVICING PROVIDER NOT ENROLL SERVICING PROVIDER NOT ENROLLED ON DOS - RECYCLE 21 DAYS N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0722  REV CODE REQ REVIEW BY DOM REVENUE CODE REQUIRES REVIEW BY DOM N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 50 These are non-covered services because this is not deemed a `medical necessity' by the payer.
0723  MCARE DED+COINS>ALWD AMT THE SUM OF THE MEDICARE DEDUCTIBLE PLUS THE COINSURANCE IS GREATER THAN THE MEDICARE ALLOWED AMOUNT 22 This care may be covered by another payer per coordination of benefits.
0724  SERV PROV NOT ALLOWED TO TREAT SERVICING PROVIDER NOT ALLOWED TO PROVIDE TREATMENT N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0725  AUTH REQ FOR OUT OF STATE BILL OUT OF STATE BILLING REQUIRES REVIEW 197
0727  PRIOR AUTH # NOT ON FILE PRIOR AUTHORIZATION # ON CLAIM BUT NOT ON FILE N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0728  DX REQ REVIEW BY DOM DIAGNOSIS CODE REQUIRES REVIEW BY DOM N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0729  PROC CODE REQ REV BY DOM PROCEDURE CODE REQUIRES REVIEW BY DOM N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0730  SURG PROC CD REQ REV BY DOM SURGERY PROCEDURE CODE REQUIRES REVIEW BY DOM N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0731  ITEM NOT COVERED FOR AMBULANCE ITEM NOT COVERED FOR AMBULANCE N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
0750  TPL-FOR BENE-RESUB W/TPL EOB TPL-BENEFICIARY HAS PRIMARY INSURANCE COVERAGE - RESUBMIT WITH TPL EOB MA64 Our records indicate that we should be the third payer for this claim. We cannot process this claim until we have received payment information from the primary and secondary payers. 251 The attachment/other documentation content received did not contain the content required to process this claim or service.
0753  TPL-MCARE PARTB ELIG-ATT PRSNT RECIPIENT IS MEDICARE PART B ELIGIBLE-ATTACHMENT PRESENT MA04 Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible. 22 This care may be covered by another payer per coordination of benefits.
0754  RECIPIENT IS MEDICARE PART A RECIPIENT IS MEDICARE PART A ELIGIBLE - ATTACHMENT PRESENT. MA04 Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible. 22 This care may be covered by another payer per coordination of benefits.
0756  TPL-PAYMENT < PARM 4025 % TPL-PAYMENT IS LESS THAN THE PERCENTAGE SPECIFIED ON SYSTEM PARAMETER 4025 MA04 Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible. 22 This care may be covered by another payer per coordination of benefits.
0757  TPL-IND ON CLM-NO RES ON FILE TPL-INDICATED ON CLAIM FORM - NO RESOURCE ON FILE MA92 Missing plan information for other insurance. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0758  BILLED NDC INVALID NDC BILLED ON CLAIM IS INVALID M119 Missing/incomplete/invalid National Drug Code (NDC). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0759  CANNOT BILL DESI 1,5,6/COD 5,6 DESI 1, 5 AND 6 OR COD VALUE 5 OR 6 CANNOT BE BILLED WITH HCPCS CODE N448 This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0760  CANNOT BILL NON-REBATED DRUG NDC BILLED WITH HCPCS CODE MUST BE FOR REBATEABLE DRUG M119 Missing/incomplete/invalid National Drug Code (NDC). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0770  TPL - PAY/REPORT COST AVOID TPL-PAY AND REPORT COST AVOIDANCE STATUS N4 Missing/incomplete/invalid prior insurance carrier EOB. 22 This care may be covered by another payer per coordination of benefits.
0771  TPL-PAY/RPT CST AVD, CLM$,INQ TPL-PAY/REPORT COST AVOID, TPL $ ON CLAIM, SEND INQUIRY MA92 Missing plan information for other insurance. 22 This care may be covered by another payer per coordination of benefits.
0772  TPL-PAY/RPT CST AVD,CLM$/ATT,I TPL-PAY/REPORT COST AVOID, TPL $ AND TPL ATTACHMENT ON CLAIM, SEND INQUIRY MA92 Missing plan information for other insurance. 22 This care may be covered by another payer per coordination of benefits.
0773  TPL - DENY CLAIM TPL-INQUIRY TPL - DENY THE CLAIM MA64 Our records indicate that we should be the third payer for this claim. We cannot process this claim until we have received payment information from the primary and secondary payers. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0774  PREOP VISIT IN GLOBAL SURG PAC PRE-OPERATIVE VISIT INCLUDED IN GLOBAL SURGICAL PACKAGE M144 Pre-/post-operative care payment is included in the allowance for the surgery/procedure. 97 Payment is included in the allowance for another service/procedure.
0775  TPL-PAY/REPORT TPL ATTACHMENT TPL-PAY/REPORT TPL ATTACHMENT MA92 Missing plan information for other insurance. 22 This care may be covered by another payer per coordination of benefits.
0776  TPL-PAY & CHASE (EPSDT) TPL-PAY & CHASE FOR EPSDT N4 Missing/incomplete/invalid prior insurance carrier EOB. 22 This care may be covered by another payer per coordination of benefits.
0777  TPL-PAY&CHASE-ABSENT PARENT TPL-PAY & CHASE - ABSENT PARENT N4 Missing/incomplete/invalid prior insurance carrier EOB. 22 This care may be covered by another payer per coordination of benefits.
0778  TPL PAY AND CHASE FOR PRENATAL TPL PAY AND CHASE FOR PRENATAL MA92 Missing plan information for other insurance. 22 This care may be covered by another payer per coordination of benefits.
0779  TPL-PAY/NO CHS,RPT ATT(EPSDT) TPL-PAY AND CHASE, REPORT ATTACHMENT(EPSDT) N4 Missing/incomplete/invalid prior insurance carrier EOB. 22 This care may be covered by another payer per coordination of benefits.
0780  TPL-PAY/NO CHS,RPT ATT(ABSNT) TPL-PAY AND CHASE REPORT ATTACHMENT(ABSENT PARENT) N4 Missing/incomplete/invalid prior insurance carrier EOB. 22 This care may be covered by another payer per coordination of benefits.
0800  APR-DRG GROUPER GLOBAL ERROR APR-DRG GROUPER GLOBAL ERROR N657 This should be billed with the appropriate code for these services A8 Ungroupable DRG
0801  NO HAC CODE PRESENT HAC CODE IS NOT PRESENT ON THE CLAIM 233
0802  HAC WITH PRICE CHANGE HAC IS PRESENT RE-PRICE THE CLAIM WITH POST HAC DRG 233
0803  HAC WITH NO PRICE CHANGE HAC IS PRESENT BUT NO CHANGE IN PRICING 233
0804  MULTIPLE HAC MORE THAN ONE HAC CATEGORY CODES ARE RETURNED FOR A CLAIM 233
0805  NOT A VALID ICD10 DIAG CODE ICD9 NOT A VALID DIAG CODE WHEN THE CLAIM IS ON OR AFTER ICD10 CUTOVER DATE. M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
0822  INVALID DISCHARGE AGE INVALID DISCHARGE AGE IN DAYS N647 Adjusted based on diagnosis-related group (DRG). 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0823  TPL AMT IS INVALID TPL AMOUNT IS INVALID MA92 Missing plan information for other insurance. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0824  PROC NOT COVERED FOR CHIRO PROCEDURE NOT COVERED FOR CHIROPRACTOR N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
0825  NET CLM CHRG CNFL NET CLAIM CHARGE CONFLICT M54 Missing/incomplete/invalid total charges. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0834  NET CLM CHRG CNFL-XOVERS NET CLAIM CHARGE CONFLICT - CROSSOVERS M54 Missing/incomplete/invalid total charges. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0837  NET CLM CHRG CNFL-HMO TPL CVRG NET CLAIM CHARGE CONFLICT - HMO TPL COVERAGE 24 Payment for charges adjusted. Charges are covered under a capitation agreement/managed care plan.
0840  VOID OR ADJUST IS IN PROCESS VOID OR ADJUSTMENT IS IN PROCESS N522 Duplicate of a claim processed, or to be processed, as a crossover claim 18 Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO).
0842  BENE ID MATCH NOT FOUND BENEFICIARY ID MATCH NOT FOUND 31 Patient cannot be identified as our insured .
0843  BILL PROV MATCH NOT FOUND BILLING PROVIDER MATCH NOT FOUND N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0845  CLM ALREADY VOID OR ADJUSTED CLAIM ALREADY VOID OR ADJUSTED N522 Duplicate of a claim processed, or to be processed, as a crossover claim 18 Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO).
0850  VOID/ADJUSTED CLAIM NOT FOUND VOID/ADJUSTED CLAIM NOT FOUND N152 Missing/incomplete/invalid replacement claim information. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0853  FIN TRAN CANT BE VOID/ADJUSTED FINANCIAL TRANSACTION CANNOT BE VOIDED OR ADJUSTED N152 Missing/incomplete/invalid replacement claim information. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0854  1ST CYCLE MASS ADJ 1ST CYCLE MASS ADJUSTMENT N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0855  1ST CYCLE SPECIAL BATCH 1ST CYCLE SPECIAL BATCH N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0856  VOID/CREDIT CANNOT BE ADJUSTED VOID/CREDIT CANNOT BE ADJUSTED N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0857  PAY TO PROV NOT MSCAN CLAIM BATCH NUMBER IS FOR MSCAN PAY TO PROVIDER M56 Missing/incomplete/invalid payer identifier. 109 Claim/Service not cobered by this payer/contractor. You mustsend the claim/service to the correc pyer/contractor.
0868  TOOTH/QUADRANT NBR INVALID TOOTH/QUADRANT NUMBER INVALID N37 Missing/incomplete/invalid tooth number/letter. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0870  TYPE OF BILL IS MISS/INV TYPE OF BILL IS MISSING OR INVALID MA30 Missing/incomplete/invalid type of bill. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
0888  FACTOR CODE PA PRICING THE FACTOR MODE INDICATES USE OF PA PRICING BUT THERE IS NO PA ON FILE OR THE PA PRICE = $0.00 N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
0891  BASE RATE CHNG RSNS EXCEEDED BASE RATE CHANGE REASONS EXCEEDED N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0892  ON-SIZE ERROR ON-SIZE ERROR N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
0899  MAX NUM OF EXCEPTIONS EXCEEDED MAXIMUM NUMBER OF EXCEPTIONS EXCEEDED N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1000  ANES MUST BILL WITH MODIFIER AN ANESTHESIA CPT CODE MUST BE BILLED WITH MODIFIER AA, QX OR QZ N572 Not covered when performed for the reported diagnosis 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
1001  BILL 1 UNIT ONLY ON BILAT PROC PROVIDER MUST BILL ONLY 1 UNITS ON A BILATERAL PROCEDURE N644 Reimbursement has been made according to the bilateral procedure rule 59 Processed based on multiple or concurrent procedure rules.(For example multiple surgery or diagnostic imaging, concurrent anesthesia.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1002  BILL PROC ONLY ONCE PER DOS A SURGERY PROCEDURE CODE CAN ONLY BE BILLED ONCE PER DATE OF SERVICE UNLESS IDENTIFIED ON SYSTEM LIST 4003 N644 Reimbursement has been made according to the bilateral procedure rule 59 Processed based on multiple or concurrent procedure rules.(For example multiple surgery or diagnostic imaging, concurrent anesthesia.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1003  NOT BILATERAL-NO MOD 50 NOT BILATERAL CODE-NO MODIFIER 50 N657 This should be billed with the appropriate code for these services 236 This procedure or procedure/modifier combination is not compatible with another procedure or procedure/modifier combination provided on the same day according to the National Correct Coding Initiative or workers compensation state regulations/ fee schedule requirements.
1004  MULTI SURG APPLIES-MOD 51 REQ MULTIPLE SURGERY APPLIES-MODIFIER 51 REQUIRED N657 This should be billed with the appropriate code for these services 236 This procedure or procedure/modifier combination is not compatible with another procedure or procedure/modifier combination provided on the same day according to the National Correct Coding Initiative or workers compensation state regulations/ fee schedule requirements.
1005  CANNOT BILL MULTI BILAT/DOS CANNOT BILL THE SAME BI-LATERAL PROCEDURE MORE THAN ONCE ON THE SAM E DOS N644 Reimbursement has been made according to the bilateral procedure rule 59 Processed based on multiple or concurrent procedure rules.(For example multiple surgery or diagnostic imaging, concurrent anesthesia.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1010  ANEST B4 10-1-03-REQ MAN PRIC ANESTHESIA CLAIMS SUBMITTED PRIOR TO 10-1-03 REQUIRE MANUAL PRICING N670 This service code has been identified as the primary procedure code subject to the Medicare Multiple Procedure Payment Reduction (MPPR)rule. 59 Processed based on multiple or concurrent procedure rules.(For example multiple surgery or diagnostic imaging, concurrent anesthesia.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1015  CAS AUDIT ERROR CLAIM ADJUSTMENT SEGMENT ERROR N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1100  NEWBRN-PEND FOR BEN ELIG NEWBORN - PEND FOR BENEFICIARY ELIGIBILITY 31 Patient cannot be identified as our insured .
1101  HH SVC NOT CVRD FOR NF BENE HOME HEALTH SERVICE NOT COVERED FOR NURSING FACILITY BENEFICIARY N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
1102  PROV NOT AUTH FOR BHM BENE PROVIDER NOT AUTHORIZED FOR BHM (BENEFICIARY HEALTH MANAGEMENT) BENEFICIARY N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
1103  SERVICE MOD FND-MANUALLY PRICE SERVICE MODIFIER FOUND - CLAIM MUST BE MANUALLY PRICED N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1104  BENE UNDER REVW FOR FRD CONV BENEFICIARY IS UNDER REVIEW FOR FRAUD CONVICTION N35 Program integrity/utilization review decision. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1105  BENE UNDER REVW FOR FRD INVEST BENEFICIARY IS UNDER REVIEW FOR FRAUD INVESTIGATION N35 Program integrity/utilization review decision. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1106  HEALTHMACS MUST BE MAN PRICED HEALTHMACS MUST BE MAN PRICED N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1107  XOVER PROV NOT FND-21 DAY REC CROSSOVER CLAIM MEDICAID PROVIDER NUMBER NOT FOUND ON PROVIDER DATABASE - RECYCLE FOR 21 DAYS N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1108  CROSSOVER PROV NOT FND CROSSOVER CLAIM MEDICAID PROVIDER NUMBER NOT FOUND ON PROVIDER DATABASE N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
1109  SRV NOT AUTH FOR CAN BENE SERVICE NOT AUTHORIZED FOR MISSISSIPPICAN BENEFICIARY N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
1110  ROUTINE CIRCUMCISION NOT COVRD ROUTINE CIRCUMCISION IS NOT COVERED N130 Consult plan benefit documents for information about restrictions for this service. 50 These are non-covered services because this is not deemed a `medical necessity' by the payer.
1111  SRV NOT AUTH FOR CHIP BENE SERVICE NOT AUTHORIZED FOR MISSISSIPPICHIP BENEFICIARY N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
1112  BENE AGE AND PROV ID CONFLICT PEDIATRIC LTC BENE AGE AND PROV ID CONFLICT N130 Consult plan benefit documents for information about restrictions for this service. 50 These are non-covered services because this is not deemed a `medical necessity' by the payer.
1113  PROV CANNOT BILL SE MOD PROVIDER NOT AUTHORIZED TO BILL SE MODIFIER N95 This provider type/provider specialty may not bill this service. 170 Payment is denied when performed/billed by this type of provider. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present
1114  BENE NOT ENROLLED IN B2I /B2P BENEFICIARY NOT ENROLLED IN B2I OR B2P N216 We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1115  MISMATCH BTWN PROV/PROC/BEN/MO MISMATCH BETWEEN PROVIDER/BENEFICIARY/PROCEDURE CODE/MODIFIER N180 This item or service does not meet the criteria for the category under which it was billed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1116  B2I PROC CODE REQ MANL PRICING B2I PROC CODE REQUIRES MANUAL PRICING (RECYCLE) N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 50 These are non-covered services because this is not deemed a `medical necessity' by the payer.
1117  PROC/MOD IS NOT VALID FOR B2P PROCEDURE/MODIFIER CODE NOT VALID FOR B2P BENEFICIARY N180 This item or service does not meet the criteria for the category under which it was billed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1118  PROC CODE NOT MANUALLY PRICED PROCEDURE CODE NOT MANUALLY PRICED WITHIN ALLOTTED TIME N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 50 These are non-covered services because this is not deemed a `medical necessity' by the payer.
1124  LTC BENE/PROV TYP CONFLICT BILLNG & RENDRING PROVIDER TYPE CONFLICT FOR LTC BENEFICIARY. N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
1125  BENE AGE/PROVIDER TYP CONFLICT BENE AGE AND PROVIDER TYPE CONFLICT N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
1126  X08 SVC NOT CVRD FOR BENE>21 SERVICES NOT COVERED FOR BENE AGE > 21 FOR PROV TYPE X08 N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
1127  BENE NOT ENROLLED IN CTS/CTP BENEFICIARY NOT ENROLLED IN CTS OR CTP N216 We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1128  ACCIDENT DATE AFTER LDOS ACCIDENT DATE AFTER LAST DATE OF SERVICE M59 Missing/incomplete/invalid ôtoö date(s) of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1129  PROC/MOD IS NOT VALID FOR CTP PROCEDURE/MODIFIER CODE NOT VALID FOR CTP BENEFICIARY N180 This item or service does not meet the criteria for the category under which it was billed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1130  MISMATCH BTWN CTS PROV/PROC MISMATCH BETWEEN CTS PROVIDER/BENEFICIARY/PROCEDURE CODE/MODIFIER N180 This item or service does not meet the criteria for the category under which it was billed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1131  CTS SERVICE NOT AUTHORIZED PROVIDER NOT AUTHORIZED TO BILL FOR CST SERVICE N95 This provider type/provider specialty may not bill this service. 170 Payment is denied when performed/billed by this type of provider. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present
1132  CTS PROC CODE REQ MANL PRICING CTS PROC CODE REQUIRES MANUAL PRICING (RECYCLE) N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 50 These are non-covered services because this is not deemed a `medical necessity' by the payer.
1133  PROC CODE NOT MANUALLY PRICED PROCEDURE CODE NOT MANUALLY PRICED WITHIN ALLOTTED TIME N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 50 These are non-covered services because this is not deemed a `medical necessity' by the payer.
1134  DLY/MAX ALLOW EXCEEDED FOR CTP DAILY UNITS OR MAX ALLOWABLE UNITS ARE EXHAUSTED FOR CTP SERVICES N180 This item or service does not meet the criteria for the category under which it was billed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1135  INVALID ADJ REASON CODE INVALID ADJUSTMENT REASON CODE N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1136  DLY UNTS ARE EXCEEDED FOR CTS DAILY UNITS ARE EXCEEDED OR ALLOWABLE UNITS HAVE BEEN EXHAUSTED FOR CTS SERVICES N180 This item or service does not meet the criteria for the category under which it was billed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1186  ADMIT HOUR MISS/INV ADMIT HOUR MISSING OR INVALID N46 Missing/incomplete/invalid admission hour. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1211  MCARE DED GTR YEARLY AMT MEDICARE DEDUCTIBLE GREATER YEARLY AMOUNT M54 Missing/incomplete/invalid total charges. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1212  REV CODE 0169 CNFL REVENUE CODE 0169 CONFLICTING M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1213  NO MCARE ADVANTAGE PLAN ID NO MEDICARE ADVANTAGE PLAN ID M54 Missing/incomplete/invalid total charges. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1214  MCARE SEQ RED AMT IS NOT VALID MCARE SEQUESTRATION REDUCTION AMOUNT IS NOT VALID M54 Missing/incomplete/invalid total charges. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1215  MCARE PD > 0 & COPAY/COINS > 0 MCARE PAID AMOUNT MUST BE >0 WHEN COPAY/COINS >0 M54 Missing/incomplete/invalid total charges. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1234  DOD NOT ON FILE - 21 DAYS PATIENT STATUS CODE IS EXPIRED/DOD NOT ON FILE-RECYCLE 21 DAYS MA43 Missing/incomplete/invalid patient status. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1235  NO DOD ON FILE/SIA NOT APP DOD NOT ON FILE HOSPICE SIA NOT APPLIED MA43 Missing/incomplete/invalid patient status. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1253  CLAIM DOS/BENE DOD CNFL CLAIM DATE OF SERVICE AND BENEFICIARY DATE OF DEATH CONFLICT 13 The date of death precedes the date of service.
1255  BENE OVER 65 BILL MCARE BENEFICIARY OVER 65 BILL MEDICARE MA92 Missing plan information for other insurance. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1274  PATIENT STAT/BENE DOD CNFL PATIENT STATUS AND BENEFICIARY DATE OF DEATH CONFLICT MA43 Missing/incomplete/invalid patient status. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1295  FUTURE EDIT FUTURE EDIT
1325  BENE SPI IND SET FOR DOS BENEFICIARY STOP PAYMENT INDICATOR FOR THE CLAIM DOS N381 Consult our contractual agreement for restrictions/billing/payment information related to these charges. 109 Claim/Service not cobered by this payer/contractor. You mustsend the claim/service to the correc pyer/contractor.
1326  BENE SRVMOD/CLAIM DOS CONFLICT BENEFICIARY SERVICE MOD/COE SPAN/ CLAIM DOS OR PROC CD CONFLICT N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
1327  SRVNOT CVRD-PUB INST MODINPL SERVICE NOT COVERED - PUBLIC INSTITUTION MODIFIER IN PLACE N103 Soc. Security records show beneficiary was prisoner when the service was rendered. Payer doesn't cover services furnished while in custody under a penal authority, unless by law, beneficiary liable for the cost of health care while incarcerated and government pursues such debt in the same way/vigor as any other debt. 258
1328  LTC CAP LIMIT SPAN DOS LTC CAP LIMIT SPAN DOS N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
1347  BILL PROV IS INVALID BILLING PROVIDER IS INVALID N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1348  SERV PROV IS INVALID SERVICING PROVIDER IS INVALID N277 Missing/incomplete/invalid other payer rendering provider identifier. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1350  MANUAL PRICE > SUBMITTED CHRG MANUAL PRICE IS GREATER THAN THE SUBMITTED CHARGE N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1351  TOT CHRG EXCEED THRESHOLD AMT TOTAL CHARGES EXCEED THRESHOLD AMOUNT
1355  UNIQ SVC PROV REQ FOR GRP BILL UNIQUE SERVICING PROVIDER REQUIRED FOR GROUP BILLING N55 Procedures for billing with group/referring/performing providers were not followed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1377  CALC ALLOWED CHARGE TOO LARGE CALCULATED ALLOWED CHARGE TOO LARGE N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1396  CLAIM SPANS STATE FISCAL YEAR CLAIM SPANS STATE FISCAL YEAR MA31 Missing/incomplete/invalid beginning and ending dates of the period billed. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1420  IND LAB MUST BILL INDEPENDENT LABORATORY MUST BILL
1447  DRG INTERIM BILLS DENIED DRG INTERIM BILLS DENIED N213 Missing/incomplete/invalid facility/discrete unit DRG/DRG exempt status information. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1470  RADIOLOGY PROC/REV CNFL RADIOLOGY PROC/REV CNFL N657 This should be billed with the appropriate code for these services 199 Revenue code and Procedure code do not match.
1471  SURGERY PROC/REV CNFL SURGERY PROCEDURE/REVENUE CONFLICT
1480  1ST VALUE CODE/AMT MISS 1ST VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1481  1ST VALUE CODE INVALID 1ST VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1482  2ND VALUE CODE/AMT MISS 2ND VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1483  2ND VALUE CODE INVALID 2ND VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1484  3RD VALUE CODE/AMT MISS 3RD VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1485  3RD VALUE CODE INVALID 3RD VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1486  4TH VALUE CODE/AMT MISS 4TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1487  4TH VALUE CODE INVALID 4TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1488  5TH VALUE CODE/AMT MISS 5TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1489  5TH VALUE CODE INVALID 5TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1490  6TH VALUE CODE/AMT MISS 6TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1491  6TH VALUE CODE INVALID 6TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1492  7TH VALUE CODE/AMT MISS 7TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1493  7TH VALUE CODE INVALID 7TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1494  8TH VALUE CODE/AMT MISS 8TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1495  8TH VALUE CODE INVALID 8TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1496  9TH VALUE CODE/AMT MISS 9TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1497  9TH VALUE CODE INVALID 9TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1498  10TH VALUE CODE/AMT MISS 10TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1499  10TH VALUE CODE INVALID 10TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1500  11TH VALUE CODE/AMT MISS 11TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1501  11TH VALUE CODE INVALID 11TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1502  12TH VALUE CODE/AMT MISS 12TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1503  12TH VALUE CODE INVALID 12TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1504  13TH VALUE CODE/AMT MISS 13TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1505  13TH VALUE CODE INVALID 13TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1506  14TH VALUE CODE/AMT MISS 14TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1507  14TH VALUE CODE INVALID 14TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1508  15TH VALUE CODE/AMT MISS 15TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1509  15TH VALUE CODE INVALID 15TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1510  16TH VALUE CODE/AMT MISS 16TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1511  16TH VALUE CODE INVALID 16TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1512  17TH VALUE CODE/AMT MISS 17TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1513  17TH VALUE CODE INVALID 17TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1514  18TH VALUE CODE/AMT MISS 18TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1515  18TH VALUE CODE INVALID 18TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1516  19TH VALUE CODE/AMT MISS 19TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1517  19TH VALUE CODE INVALID 19TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1518  20TH VALUE CODE/AMT MISS 20TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1519  20TH VALUE CODE INVALID 20TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1520  21ST VALUE CODE/AMT MISS 21ST VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1521  21ST VALUE CODE INVALID 21ST VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1522  22ND VALUE CODE/AMT MISS 22ND VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1523  22ND VALUE CODE INVALID 22ND VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1524  23RD VALUE CODE/AMT MISS 23RD VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1525  23RD VALUE CODE INVALID 23RD VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1526  24TH VALUE CODE/AMT MISS 24TH VALUE CODE/AMOUNT MISSING M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1527  24TH VALUE CODE INVALID 24TH VALUE CODE INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1540  PRORATE PRICING APPLIED PRORATE PRICING APPLIED N647 Adjusted based on diagnosis-related group (DRG). 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1550  1ST CONDITION CODE INVALID 1ST CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1551  2ND CONDITION CODE INVALID 2ND CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1552  3RD CONDITION CODE INVALID 3RD CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1553  4TH CONDITION CODE INVALID 4TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1554  5TH CONDITION CODE INVALID 5TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1555  6TH CONDITION CODE INVALID 6TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1556  7TH CONDITION CODE INVALID 7TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1557  8TH CONDITION CODE INVALID 8TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1558  9TH CONDITION CODE INVALID 9TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1559  10TH CONDITION CODE INVALID 10TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1560  11TH CONDITION CODE INVALID 11TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1561  12TH CONDITION CODE INVALID 12TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1562  13TH CONDITION CODE INVALID 13TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1563  14TH CONDITION CODE INVALID 14TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1564  15TH CONDITION CODE INVALID 15TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1565  16TH CONDITION CODE INVALID 16TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1566  17TH CONDITION CODE INVALID 17TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1567  18TH CONDITION CODE INVALID 18TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1568  19TH CONDITION CODE INVALID 19TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1569  20TH CONDITION CODE INVALID 20TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1570  21ST CONDITION CODE INVALID 21ST CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1571  22ND CONDITION CODE INVALID 22ND CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1572  23RD CONDITION CODE INVALID 23RD CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1573  24TH CONDITION CODE INVALID 24TH CONDITION CODE INVALID M44 Missing/incomplete/invalid condition code. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1601  NEGATIVE CALCULATED ALLWD AMNT NEGATIVE CALCULATED ALLOWED AMOUNT N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1602  SUB AMT EXCEE MATRIX THRESHOLD SUBMITTED AMOUNT EXCEEDS MATRIX THRESHOLD N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
1700  HCPCS CODE MUST BE LAB WHEN BILLING LABORATORY SERVICES, THE PROVIDER MUST ENTER THE 4 DIGIT REVENUE CODE AND THE 5 DIGIT HCPCS PROCEDURE CODE. M126 Missing/incomplete/invalid individual lab codes included in the test. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1701  REV CODE MUST BE LABORATORY REVENUE CODE MUST BE LABORATORY M126 Missing/incomplete/invalid individual lab codes included in the test. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1702  SURG CODE NOT W/IN FR/THR DATE SURGICAL CODE NOT WITHIN FROM/THRU DATES N301 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1710  PROV MISS CLIA # FOR LAB SVC PROVIDER MISSING CLIA NUMBER FOR LAB SERVICE MA120 Missing/incomplete/invalid CLIA certification number. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1711  PRIN DIAG NOT ON DB PRINCIPAL DIAG NOT ON DB MA63 Missing/incomplete/invalid principal diagnosis. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1712  PRIN DIAG NOT COVERED PRINCIPAL DIAG NOT COVERED MA63 Missing/incomplete/invalid principal diagnosis. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1713  PRIN DIAG/AGE CNFL PRINCIPAL DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1714  PRIN DIAG/GENDER CNFL PRINCIPAL DIAGNOSIS/GENDER CONFLICT MA63 Missing/incomplete/invalid principal diagnosis. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1715  ADM DIAG NOT ON DB ADMITTING DIAGNOSIS NOT ON DB MA65 Missing/incomplete/invalid admitting diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1716  ADM DIAG NOT COVERED ADMITTING DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1717  ADM DIAG/AGE CNFL ADMITTING DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1718  ADM DIAG/GENDER CNFL ADMITTING DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1719  1ST DIAGNOSIS NOT ON DB 1ST DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1720  1ST DIAGNOSIS NOT COVERED 1ST DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1721  1ST DIAGNOSIS/AGE CONFLICT 1ST DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1722  1ST DIAGNOSIS/GENDER CONFLICT 1ST DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1723  2ND DIAGNOSIS NOT ON DB 2ND DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1724  2ND DIAGNOSIS NOT COVERED 2ND DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1725  2ND DIAGNOSIS/AGE CONFLICT 2ND DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1726  2ND DIAGNOSIS/GENDER CONFLICT 2ND DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1727  3RD DIAGNOSIS NOT ON DB 3RD DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1728  3RD DIAGNOSIS NOT COVERED 3RD DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1729  3RD DIAGNOSIS/AGE CONFLICT 3RD DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1730  3RD DIAGNOSIS/GENDER CONFLICT 3RD DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1731  4TH DIAGNOSIS NOT ON DB 4TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1732  4TH DIAGNOSIS NOT COVERED 4TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1733  4TH DIAGNOSIS/AGE CONFLICT 4TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1734  4TH DIAGNOSIS/GENDER CONFLICT 4TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1735  5TH DIAGNOSIS NOT ON DB 5TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1736  5TH DIAGNOSIS NOT COVERED 5TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1737  5TH DIAGNOSIS/AGE CONFLICT 5TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1738  5TH DIAGNOSIS/GENDER CONFLICT 5TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1739  6TH DIAGNOSIS NOT ON DB 6TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1740  6TH DIAGNOSIS NOT COVERED 6TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1741  6TH DIAGNOSIS/AGE CONFLICT 6TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1742  6TH DIAGNOSIS/GENDER CONFLICT 6TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1743  7TH DIAGNOSIS NOT ON DB 7TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1744  7TH DIAGNOSIS NOT COVERED 7TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1745  7TH DIAGNOSIS/AGE CONFLICT 7TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1746  7TH DIAGNOSIS/GENDER CONFLICT 7TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1747  8TH DIAGNOSIS NOT ON DB 8TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1748  8TH DIAGNOSIS NOT COVERED 8TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1749  8TH DIAGNOSIS/AGE CONFLICT 8TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1750  8TH DIAGNOSIS/GENDER CONFLICT 8TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1751  9TH DIAGNOSIS NOT ON DB 9TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1752  9TH DIAGNOSIS NOT COVERED 9TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1753  9TH DIAGNOSIS/AGE CONFLICT 9TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1754  9TH DIAGNOSIS/GENDER CONFLICT 9TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1755  10TH DIAGNOSIS NOT ON DB 10TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1756  10TH DIAGNOSIS NOT COVERED 10TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1757  10TH DIAGNOSIS/AGE CONFLICT 10TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1758  10TH DIAGNOSIS/GENDER CONFLICT 10TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1759  11TH DIAGNOSIS NOT ON DATABASE 11TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1760  11TH DIAGNOSIS NOT COVERED 11TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1761  11TH DIAGNOSIS/AGE CONFLICT 11TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1762  11TH DIAGNOSIS/GENDER CONFLICT 11TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1763  12TH DIAGNOSIS NOT ON DATABASE 12TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1764  12TH DIAGNOSIS NOT COVERED 12TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1765  12TH DIAGNOSIS/AGE CONFLICT 12TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1766  12TH DIAGNOSIS/GENDER CONFLICT 12TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1767  13TH DIAGNOSIS NOT ON DB 13TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1768  13TH DIAGNOSIS NOT COVERED 13TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1769  13TH DIAGNOSIS/AGE CONFLICT 13TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1770  13TH DIAGNOSIS/GENDER CONFLICT 13TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1771  14TH DIAGNOSIS NOT ON DB 14TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1772  14TH DIAGNOSIS NOT COVERED 14TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1773  14TH DIAGNOSIS/AGE CONFLICT 14TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1774  14TH DIAGNOSIS/GENDER CONFLICT 14TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1775  15TH DIAGNOSIS NOT ON DB 15TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1776  15TH DIAGNOSIS NOT COVERED 15TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1777  15TH DIAGNOSIS/AGE CONFLICT 15TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1778  15TH DIAGNOSIS/GENDER CONFLICT 15TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1779  16TH DIAGNOSIS NOT ON DB 16TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1780  16TH DIAGNOSIS NOT COVERED 16TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1781  16TH DIAGNOSIS/AGE CONFLICT 16TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1782  16TH DIAGNOSIS/GENDER CONFLICT 16TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1783  17TH DIAGNOSIS NOT ON DB 17TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1784  17TH DIAGNOSIS NOT COVERED 17TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1785  17TH DIAGNOSIS/AGE CONFLICT 17TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1786  17TH DIAGNOSIS/GENDER CONFLICT 17TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1787  18TH DIAGNOSIS NOT ON DB 18TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1788  18TH DIAGNOSIS NOT COVERED 18TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1789  18TH DIAGNOSIS/AGE CONFLICT 18TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1790  18TH DIAGNOSIS/GENDER CONFLICT 18TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1791  19TH DIAGNOSIS NOT ON DB 19TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1792  19TH DIAGNOSIS NOT COVERED 19TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1793  19TH DIAGNOSIS/AGE CONFLICT 19TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1794  19TH DIAGNOSIS/GENDER CONFLICT 19TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1795  20TH DIAGNOSIS NOT ON DB 20TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1796  20TH DIAGNOSIS NOT COVERED 20TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1797  20TH DIAGNOSIS/AGE CONFLICT 20TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1798  21ST DIAGNOSIS/GENDER CONFLICT 21ST DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1799  21ST DIAGNOSIS NOT ON DB 21ST DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1800  21ST DIAGNOSIS NOT COVERED 21ST DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1801  21ST DIAGNOSIS/AGE CONFLICT 21ST DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1802  21ST DIAGNOSIS/GENDER CONFLICT 21ST DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1803  22ND DIAGNOSIS NOT ON DB 22ND DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1804  22ND DIAGNOSIS NOT COVERED 22ND DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1805  22ND DIAGNOSIS/AGE CONFLICT 22ND DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1806  22ND DIAGNOSIS/GENDER CONFLICT 22ND DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1807  23RD DIAGNOSIS NOT ON DB 23RD DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1808  23RD DIAGNOSIS NOT COVERED 23RD DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1809  23RD DIAGNOSIS/AGE CONFLICT 23RD DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1810  23RD DIAGNOSIS/GENDER CONFLICT 23RD DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1811  24TH DIAGNOSIS NOT ON DB 24TH DIAGNOSIS NOT ON DB M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
1812  24TH DIAGNOSIS NOT COVERED 24TH DIAGNOSIS NOT COVERED N30 Recipient ineligible for this service. 167
1813  24TH DIAGNOSIS/AGE CONFLICT 24TH DIAGNOSIS/AGE CONFLICT N517 Resubmit a new claim with the requested information. 9 The diagnosis is inconsistent with the patient's age.
1814  24TH DIAGNOSIS/GENDER CONFLICT 24TH DIAGNOSIS/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 10 The diagnosis is inconsistent with the patient's gender.Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
1815  PRINC SURG PROC/GENDER CNFL PRINCIPAL SURGICAL PROCEDURE CODE/GENDER CNFL N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1816  PRINC SURG PROC NOT ON DB PRINCIPAL SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1817  PRINC SURG PROC NOT COVERED PRINCIPAL SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1818  PRINC SURG PROC CD/DT MISS/INV PRINCIPAL SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID MA66 Missing/incomplete/invalid principal procedure code or date. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1819  1ST SURG PROC/GENDER CNFL 1ST SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1820  1ST SURG PROC NOT ON DB 1ST SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1821  1ST SURG PROC NOT COVERED 1ST SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1822  1ST SURG PROC CD/DT MIS/INV 1ST SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1823  2ND SURG PROC/GENDER CNFL 2ND SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1824  2ND SURG PROC NOT ON DB 2ND SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1825  2ND SURG PROC NOT COVERED 2ND SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1826  2ND SURG PROC CD/DT MIS/INV 2ND SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1827  3RD SURG PROC/GENDER CNFL 3RD SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1828  3RD SURG PROC NOT ON DB 3RD SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1829  3RD SURG PROC NOT COVERED 3RD SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1830  3RD SURG PROC CD/DT MIS/INV 3RD SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1831  4TH SURG PROC/GENDER CNFL 4TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1832  4TH SURG PROC NOT ON DB 4TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1833  4TH SURG PROC NOT COVERED 4TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1834  4TH SURG PROC CD/DT MIS/INV 4TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1835  5TH SURG PROC/GENDER CNFL 5TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1836  5TH SURG PROC NOT ON DB 5TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1837  5TH SURG PROC NOT COVERED 5TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1838  5TH SURG PROC CD/DT MIS/INV 5TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1839  6TH SURG PROC/GENDER CNFL 6TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1840  6TH SURG PROC NOT ON DB 6TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1841  6TH SURG PROC NOT COVERED 6TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1842  6TH SURG PROC CD/DT MIS/INV 6TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1843  7TH SURG PROC/GENDER CNFL 7TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1844  7TH SURG PROC NOT ON DB 7TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1845  7TH SURG PROC NOT COVERED 7TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1846  7TH SURG PROC CD/DT MIS/INV 7TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1847  8TH SURG PROC/GENDER CNFL 8TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1848  8TH SURG PROC NOT ON DB 8TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1849  8TH SURG PROC NOT COVERED 8TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1850  8TH SURG PROC CD/DT MIS/INV 8TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1851  9TH SURG PROC/GENDER CNFL 9TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1852  9TH SURG PROC NOT ON DB 9TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1853  9TH SURG PROC NOT COVERED 9TH ICD9 SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1854  9TH SURG PROC CD/DT MIS/INV 9TH ICD9 SURGICAL PROCEDURE ??? M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1855  10TH SURG PROC/GENDER CNFL 10TH ICD9 SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1856  10TH SURG PROC NOT ON DB 10TH ICD9 SURGICAL PROCEDURE NOT ON DATABASE M20 Missing/incomplete/invalid HCPCS. 181
1857  10TH SURG PROC NOT COVERED 10TH ICD9 SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1858  10TH SURG PROC CD/DT MIS/INV 10TH ICD9 SURGICAL PROCEDURE ??? M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1859  11TH SURG PROC/GENDER CNFL 11TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1860  11TH SURG PROC NOT ON DB 11TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1861  11TH SURG PROC NOT COVERED 11TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1862  11TH SURG PROC CD/DT MIS/INV 11TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1863  12TH SURG PROC/GENDER CNFL 12TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1864  12TH SURG PROC NOT ON DB 12TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1865  12TH SURG PROC NOT COVERED 12TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1866  12TH SURG PROC CD/DT MIS/INV 12TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1867  13TH SURG PROC/GENDER CNFL 13TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1868  13TH SURG PROC NOT ON DB 13TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1869  13TH SURG PROC NOT COVERED 13TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1870  13TH SURG PROC CD/DT MIS/INV 13TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1871  14TH SURG PROC/GENDER CNFL 14TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1872  14TH SURG PROC NOT ON DB 14TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1873  14TH SURG PROC NOT COVERED 14TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1874  14TH SURG PROC CD/DT MIS/INV 14TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1875  15TH SURG PROC/GENDER CNFL 15TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1876  15TH SURG PROC NOT ON DB 15TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1877  15TH SURG PROC NOT COVERED 15TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1878  15TH SURG PROC CD/DT MIS/INV 15TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1879  16TH SURG PROC/GENDER CNFL 16TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1880  16TH SURG PROC NOT ON DB 16TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1881  16TH SURG PROC NOT COVERED 16TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1882  16TH SURG PROC CD/DT MIS/INV 16TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1883  17TH SURG PROC/GENDER CNFL 17TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1884  17TH SURG PROC NOT ON DB 17TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1885  17TH SURG PROC NOT COVERED 17TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1886  17TH SURG PROC CD/DT MIS/INV 17TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1887  18TH SURG PROC/GENDER CNFL 18TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1888  18TH SURG PROC NOT ON DB 18TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1889  18TH SURG PROC NOT COVERED 18TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1890  18TH SURG PROC CD/DT MIS/INV 18TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1891  19TH SURG PROC/GENDER CNFL 19TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1892  19TH SURG PROC NOT ON DB 19TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1893  19TH SURG PROC NOT COVERED 19TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1894  19TH SURG PROC CD/DT MIS/INV 19TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1895  20TH SURG PROC/GENDER CNFL 20TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1896  20TH SURG PROC NOT ON DB 20TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1897  20TH SURG PROC NOT COVERED 20TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1898  20TH SURG PROC CD/DT MIS/INV 20TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1899  21ST SURG PROC/GENDER CNFL 21ST SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1900  21ST SURG PROC NOT ON DB 21ST SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1901  21ST SURG PROC NOT COVERED 21ST SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1902  21ST SURG PROC CD/DT MIS/INV 21ST SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1903  22ND SURG PROC/GENDER CNFL 22ND SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1904  22ND SURG PROC NOT ON DB 22ND SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1905  22ND SURG PROC NOT COVERED 22ND SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1906  22ND SURG PROC CD/DT MIS/INV 22ND SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1907  23RD SURG PROC/GENDER CNFL 23RD SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1908  23RD SURG PROC NOT ON DB 23RD SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1909  23RD SURG PROC NOT COVERED 23RD SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1910  23RD SURG PROC CD/DT MIS/INV 23RD SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1911  24TH SURG PROC/GENDER CNFL 24TH SURGICAL PROCEDURE/GENDER CONFLICT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
1912  24TH SURG PROC NOT ON DB 24TH SURGICAL PROCEDURE NOT ON DB M20 Missing/incomplete/invalid HCPCS. 181
1913  24TH SURG PROC NOT COVERED 24TH SURGICAL PROCEDURE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). B15 Payment adjusted because this procedure/service is not paid separately.
1914  24TH SURG PROC CD/DT MIS/INV 24TH SURGICAL PROCEDURE CODE/DATE MISSING OR INVALID M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1915  1ST OCCUR CODE/DATE MIS/INV 1ST OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1916  1ST OCCUR CODE INVALID 1ST OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1917  1ST OCCUR SPAN DATE MIS/INV 1ST OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1918  1ST OCCUR SPAN CD INVALID 1ST OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1919  2ND OCCUR CODE/DATE MIS/INV 2ND OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1920  2ND OCCUR CODE INVALID 2ND OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1921  2ND OCCUR SPAN DATE MIS/INV 2ND OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1922  2ND OCCUR SPAN CD INVALID 2ND OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1923  3RD OCCUR CODE/DATE MIS/INV 3RD OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1924  3RD OCCUR CODE INVALID 3RD OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1925  3RD OCCUR SPAN DATE MIS/INV 3RD OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1926  3RD OCCUR SPAN CD INVALID 3RD OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1927  4TH OCCUR CODE/DATE MIS/INV 4TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1928  4TH OCCUR CODE INVALID 4TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1929  4TH OCCUR SPAN DATE MIS/INV 4TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1930  4TH OCCUR SPAN CD INVALID 4TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1931  5TH OCCUR CODE/DATE MIS/INV 5TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1932  5TH OCCUR CODE INVALID 5TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1933  5TH OCCUR SPAN DATE MIS/INV 5TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1934  5TH OCCUR SPAN CD INVALID 5TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1935  6TH OCCUR CODE/DATE MIS/INV 6TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1936  6TH OCCUR CODE INVALID 6TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1937  6TH OCCUR SPAN DATE MIS/INV 6TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1938  6TH OCCUR SPAN CD INVALID 6TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1939  7TH OCCUR CODE/DATE MIS/INV 7TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1940  7TH OCCUR CODE INVALID 7TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1941  7TH OCCUR SPAN DATE MIS/INV 7TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1942  7TH OCCUR SPAN CD INVALID 7TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1943  8TH OCCUR CODE/DATE MIS/INV 8TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1944  8TH OCCUR CODE INVALID 8TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1945  8TH OCCUR SPAN DATE MIS/INV 8TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1946  8TH OCCUR SPAN CD INVALID 8TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1947  9TH OCCUR CODE/DATE MIS/INV 9TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1948  9TH OCCUR CODE INVALID 9TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1949  9TH OCCUR SPAN DATE MIS/INV 9TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1950  9TH OCCUR SPAN CD INVALID 9TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1951  10TH OCCUR CODE/DATE MIS/INV 10TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1952  10TH OCCUR CODE INVALID 10TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1953  10TH OCCUR SPAN DATE MIS/INV 10TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1954  10TH OCCUR SPAN CD INVALID 10TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1955  11TH OCCUR CODE/DATE MIS/INV 11TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1956  11TH OCCUR CODE INVALID 11TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1957  11TH OCCUR SPAN DATE MIS/INV 11TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1958  11TH OCCUR SPAN CD INVALID 11TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1959  12TH OCCUR CODE/DATE MIS/INV 12TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1960  12TH OCCUR CODE INVALID 12TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1961  12TH OCCUR SPAN DATE MIS/INV 12TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1962  12TH OCCUR SPAN CD INVALID 12TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1963  13TH OCCUR CODE/DATE MIS/INV 13TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1964  13TH OCCUR CODE INVALID 13TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1965  13TH OCCUR SPAN DATE MIS/INV 13TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1966  13TH OCCUR SPAN CD INVALID 13TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1967  14TH OCCUR CODE/DATE MIS/INV 14TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1968  14TH OCCUR CODE INVALID 14TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1969  14TH OCCUR SPAN DATE MIS/INV 14TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1970  14TH OCCUR SPAN CD INVALID 14TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1971  15TH OCCUR CODE/DATE MIS/INV 15TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1972  15TH OCCUR CODE INVALID 15TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1973  15TH OCCUR SPAN DATE MIS/INV 15TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1974  15TH OCCUR SPAN CD INVALID 15TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1975  16TH OCCUR CODE/DATE MIS/INV 16TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1976  16TH OCCUR CODE INVALID 16TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1977  16TH OCCUR SPAN DATE MIS/INV 16TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1978  16TH OCCUR SPAN CD INVALID 16TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1979  17TH OCCUR CODE/DATE MIS/INV 17TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1980  17TH OCCUR CODE INVALID 17TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1981  17TH OCCUR SPAN DATE MIS/INV 17TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1982  17TH OCCUR SPAN CD INVALID 17TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1983  18TH OCCUR CODE/DATE MIS/INV 18TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1984  18TH OCCUR CODE INVALID 18TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1985  18TH OCCUR SPAN DATE MIS/INV 18TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1986  18TH OCCUR SPAN CD INVALID 18TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1987  19TH OCCUR CODE/DATE MIS/INV 19TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1988  19TH OCCUR CODE INVALID 19TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1989  19TH OCCUR SPAN DATE MIS/INV 19TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1990  19TH OCCUR SPAN CD INVALID 19TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1991  20TH OCCUR CODE/DATE MIS/INV 20TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1992  20TH OCCUR CODE INVALID 20TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1993  20TH OCCUR SPAN DATE MIS/INV 20TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1994  20TH OCCUR SPAN CD INVALID 20TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1995  21ST OCCUR CODE/DATE MIS/INV 21ST OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1996  21ST OCCUR CODE INVALID 21ST OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1997  21ST OCCUR SPAN DATE MIS/INV 21ST OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1998  21ST OCCUR SPAN CD INVALID 21ST OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
1999  22ND OCCUR CODE/DATE MIS/INV 22ND OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2000  22ND OCCUR CODE INVALID 22ND OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2001  22ND OCCUR SPAN DATE MIS/INV 22ND OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2002  22ND OCCUR SPAN CD INVALID 22ND OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2003  23RD OCCUR CODE/DATE MIS/INV 23RD OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2004  23RD OCCUR CODE INVALID 23RD OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2005  23RD OCCUR SPAN DATE MIS/INV 23RD OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2006  23RD OCCUR SPAN CD INVALID 23RD OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2007  24TH OCCUR CODE/DATE MIS/INV 24TH OCCURANCE CODE/DATE MISSING OR INVALID N299 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2008  24TH OCCUR CODE INVALID 24TH OCCURANCE CODE INVALID M45 Missing/incomplete/invalid occurrence codes or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2009  24TH OCCUR SPAN DATE MIS/INV 24TH OCCURANCE SPAN DATE MISSING OR INVALID N300 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2010  24TH OCCUR SPAN CD INVALID 24TH OCCURANCE SPAN CODE INVALID M46 Missing/incomplete/invalid occurrence span code or dates. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2011  PRINCIPAL DIAGNOSIS DENIED PRINCIPAL DIAGNOSIS CODE DENIED MA63 Missing/incomplete/invalid principal diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2012  ADMITTING DIAGNOSIS DENIED ADMITTING DIAGNOSIS CODE DENIED MA65 Missing/incomplete/invalid admitting diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2013  1ST DIAGNOSIS CODE DENIED 1ST DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2014  2ND DIAGNOSIS CODE DENIED 2ND DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2015  3RD DIAGNOSIS CODE DENIED 3RD DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2016  4TH DIAGNOSIS CODE DENIED 4TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2017  5TH DIAGNOSIS CODE DENIED 5TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2018  6TH DIAGNOSIS CODE DENIED 6TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2019  7TH DIAGNOSIS CODE DENIED 7TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2020  8TH DIAGNOSIS CODE DENIED 8TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2021  9TH DIAGNOSIS CODE DENIED 9TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2022  10TH DIAGNOSIS CODE DENIED 10TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2023  11TH DIAGNOSIS CODE DENIED 11TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2024  12TH DIAGNOSIS CODE DENIED 12TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2025  13TH DIAGNOSIS CODE DENIED 13TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2026  14TH DIAGNOSIS CODE DENIED 14TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2027  15TH DIAGNOSIS CODE DENIED 15TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2028  16TH DIAGNOSIS CODE DENIED 16TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2029  17TH DIAGNOSIS CODE DENIED 17TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2030  18TH DIAGNOSIS CODE DENIED 18TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2031  19TH DIAGNOSIS CODE DENIED 19TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2032  20TH DIAGNOSIS CODE DENIED 20TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2033  21ST DIAGNOSIS CODE DENIED 21ST DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2034  22ND DIAGNOSIS CODE DENIED 22ND DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2035  23RD DIAGNOSIS CODE DENIED 23RD DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2036  24TH DIAGNOSIS CODE DENIED 24TH DIAGNOSIS CODE DENIED M64 Missing/incomplete/invalid other diagnosis. 146 Diagnosis was invalid for the date(s) of service reported.
2037  PRINCIPAL ICD PROC CODE DENIED PRINCIPAL ICD PROCEDURE CODE DENIED MA66 Missing/incomplete/invalid principal procedure code or date. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2038  1ST ICD PROC CODE DENIED 1ST ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2039  2ND ICD PROC CODE DENIED 2ND ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2040  3RD ICD PROC CODE DENIED 3RD ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2041  4TH ICD PROC CODE DENIED 4TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2042  5TH ICD PROC CODE DENIED 5TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2043  6TH ICD PROC CODE DENIED 6TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2044  7TH ICD PROC CODE DENIED 7TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2045  8TH ICD PROC CODE DENIED 8TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2046  9TH ICD PROC CODE DENIED 9TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2047  10TH ICD PROC CODE DENIED 10TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2048  11TH ICD PROC CODE DENIED 11TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2049  12TH ICD PROC CODE DENIED 12TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2050  13TH ICD PROC CODE DENIED 13TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2051  14TH ICD PROC CODE DENIED 14TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2052  15TH ICD PROC CODE DENIED 15TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2053  16TH ICD PROC CODE DENIED 16TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2054  17TH ICD PROC CODE DENIED 17TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2055  18TH ICD PROC CODE DENIED 18TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2056  19TH ICD PROC CODE DENIED 19TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2057  20TH ICD PROC CODE DENIED 20TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2058  21ST ICD PROC CODE DENIED 21ST ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2059  22ND ICD PROC CODE DENIED 22ND ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2060  23RD ICD PROC CODE DENIED 23RD ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
2061  24TH ICD PROC CODE DENIED 24TH ICD PROCEDURE CODE DENIED M67 Missing/incomplete/invalid other procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3005  RECEIPT DATE > CURRENT DATE RECEIPT DATE IS GREATER THAN CURRENT DATE N10 Payment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
3017  >ONE UNIT BILL FOR DELIV PROC GREATER THAN ONE UNIT WAS BILLED FOR DELIVER PROCEDURE N640 Exceeds number/frequency approved/allowed within time period. 119 Benefit maximum for this time period or occurence has been reached.
3024  DED NOT BILL W/TOB 111 OR 112 DEDUCTIBLE AMT. NOT BILLED WITH TYPE OF BILL 111 OR 112 MA30 Missing/incomplete/invalid type of bill. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3029  FP VISITS SL EXCEEDED FAMILY PLANNING VISITS SERVICE LIMIT EXCEEDED N640 Exceeds number/frequency approved/allowed within time period. 119 Benefit maximum for this time period or occurence has been reached.
3031  INVALID REV CODE PROVIDER SUBMITTED WITH 3 DIGIT REVENUE CODE M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3041  ACCOM REV CODES NOT ALLOWED ACCOMMODATION REVENUE CODES NOT ALLOWED M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3042  INVALID REVENUE CHARGE INVALID REVENUE CHARGE M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3043  REV CODE NOT COVERED REVENUE CODE NOT COVERED M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3044  PROCEDURE NOT COVERED PROCEDURE CODE NOT COVERED M51 Missing/incomplete/invalid procedure code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3047  CVD DAYS INV DUE TO INV VAL CD COVERED DAYS ARE NOT VALID DUE TO INVALID VALUE CODE MA32 Missing/incomplete/invalid number of covered days during the billing period. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3053  DATE OF DISCHARGE IS INV/MIS DATE OF DISCHARGE IS INVALID/MISSING N50 Missing/incomplete/invalid discharge information. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3063  PINTS OF BLOOD REPLACED INV PINTS OF BLOOD REPLACED INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3064  PINTS OF BLOOD NOT RPLCD INV PINTS OF BLOOD NOT REPLACED INVALID M49 Missing/incomplete/invalid value code(s) or amount(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3070  PRIVATE ROOM CHARGES INVALID PRIVATE ROOM CHARGES INVALID
3075  SVCS NOT CVD FOR SLMN/QI1/QI2 SERVICES NOT COVERED FOR SLMB/QI1/QI2 BENEFICIARIES N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
3091  DATE OF ADMISSION > LDOS DATE OF ADMISSION > LDOS MA40 Missing/incomplete/invalid admission date. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3098  NWBRN SVCS BID FOR MALE PARENT NEWBORN SERVICES BILLED FOR MALE PARENT N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
3099  NEWBORN - 21 DAY RECYCLE NEWBORN - PEND FOR BENEFICIARY ELIGIBILITY - RECYCLE FOR 21 DAYS 34 Claim denied. Insured has no coverage for newborns.
3105  ANNL PHYEXM NCOVRD FOR LTC,ETC ANNUAL PHYSICAL EXAM NOT COVERED FOR LTC BENES, COE 88, COE 29 OR IF IN AN ICF/MR FACILITY N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
3108  PRC NCVRD FOR 1STYR OF MC ELIG PROCEDURE NOT COVERED FOR 1ST YEAR OF MEDICARE ELIGIBILITY N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
3112  NET TRANSACTION ID MISSING DOMNT + 12 DIGIT NET TRANSACTION NUMBER REQUIRED. APPLICABLE TO J03 PROVIDERS ONLY. N382 Missing/incomplete/invalid patient identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3130  RESPITE CARE > 5 CONSEC DAYS RESPITE CARE IS GREATER THAN 5 CONSECUTIVE DAYS M53 Missing/incomplete/invalid days or units of service. 119 Benefit maximum for this time period or occurence has been reached.
3135  UNAUTHORIZED SCHOOL PROVIDER UNAUTHORIZED SCHOOL PROVIDER N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
3157  LEAVE DAYS > TOTAL DAYS BILLED LEAVE DAYS ARE GREATER THAN TOTAL DAYS BILLED N43 Bed hold or leave days exceeded. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
3158  REV CDS INVLD FOR AFTER EFF DT AFTER EFFECTIVE DATE REVENUE CODES ARE INVALID M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3159  PATIENT HAS NO APPROV LTC DAYS PATIENT HAS NO APPROVED LONG TERM CARE DAYS MA32 Missing/incomplete/invalid number of covered days during the billing period. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3164  NURSING FACILITY NUM MISSING NURSING FACILITY NUMBER MISSING MA134 Missing/incomplete/invalid provider number of the facility where the patient resides. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3169  LEAVE OF ABSENCE HOSPITAL/HOME LEAVE OF ABSENCE HOSPITAL/HOME THERAPEUTIC N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3173  INV COPAY IND 'P' BENE IS MALE INVALID COPAY INDICATOR 'P', BENEFICIARY IS MALE N517 Resubmit a new claim with the requested information. 7 The procedure/revenue code is inconsistent with the patient's gender.
3175  INVALID COVERED DAYS INVALID COVERED DAYS MA32 Missing/incomplete/invalid number of covered days during the billing period. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3188  NF XOVERS CVD DAYS < 21 NURSING FACILITY CROSSOVERS COVERED DAYS ARE LESS THAN 21 N381 Consult our contractual agreement for restrictions/billing/payment information related to these charges. 109 Claim/Service not cobered by this payer/contractor. You mustsend the claim/service to the correc pyer/contractor.
3189  ENCOUNTER CLAIM - ZERO PAID ENCOUNTER CLAIM - ZERO PAID 24 Payment for charges adjusted. Charges are covered under a capitation agreement/managed care plan.
3194  ASSISTANT SURGEON NOT COVERED ASSISTANT SURGEON NOT COVERED FOR NURSE PRACTITIONOR PHYSICIAN ASSISTANT N646 Reimbursement has been adjusted based on the guidelines for an assistant. 54 Multiple physicians/assistants are not covered in this case .
3195  ASST SURG NOT ALWD ON THE PROC ASSISTANT SURGEON NOT ALLOWED ON THE PROCEDURE N90 Covered only when performed by the attending physician. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
3196  ANNUAL ASSES/EXAM EPSDT ONLY ANNUAL PHYSICAL ASSESSMENT/EXAM TO BE PERFORMED BY EPSDT PROVIDER N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
3199  ASC CANNOT BILL ANESTH SVCS ASC CLAIM TYPE CANNOT BILL ANESTHESIA SERVICES N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
3214  PROV NOT CERTIFIED FOR PROC PROVIDER NOT CERTIFIED FOR THIS PROCEDURE N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
3216  PROV TYPE/ANESTHESIA CLM CNFL PROVIDER TYPE / ANESTHESIA CLAIM CONFLICT N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
3218  ENCTR PROC IN HIST; SAME DOS ENCOUNTER PROCEDURE FOUND IN HISTORY FOR SAME DOS M86 Service denied because payment already made for similar procedure within set time frame. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
3222  PROVIDER NAME/NUMBER MISMATCH PROVIDER NAME/NUMBER MISMATCH N256 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3226  PROV TY NOT AUTH FOR HCBS BENE CLAIM BILLED BY X05 PROVIDER AND HAVING HCBS OR MYPAC LOCKIN. N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
3227  BENE NOT CERTIFIED FOR HCBS BENEFICIARY NOT CERTIFIED FOR HCBS N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
3228  EPSDT PROV MUST BE SCR/CSE MGR EPSDT PROVIDER MUST BE SCREENER OR CASE MANAGER N570 Missing/incomplete/invalid credentialing data B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service.
3230  NO EPSDT LOCKIN FOR DOS NO EPSDT LOCKIN SEGMENT FOUND FOR DATES OF SERVICE N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
3231  PROC/FORM PROV TYPE RESTR PROCEDURE/FORMULARY PROVIDER TYPE RESTRICTIONS N95 This provider type/provider specialty may not bill this service. 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
3234  PROC/EPSDT AGE RESTRICTION PROCEDURE CODE/EPSDT AGE RESTRICTION (IN DAYS OR MONTHS) N129 This amount represents the dollar amount not eligible due to the patient's age. 6 The procedure/revenue code is inconsistent with the patient's age.
3237  ADDON BILLED W/O PRIMARY PROC ADD-ON CODES BILLED WITHOUT THE PRIMARY PROCEDURE CODE N122 Mammography add-on code cannot be billed by itself. B15 Payment adjusted because this procedure/service is not paid separately.
3240  PROC/FORMULARY DX RESTRIC PROCEDURE/FORMULARY DIAGNOSIS RESTRICTION N657 This should be billed with the appropriate code for these services 11 The diagnosis is inconsistent with the procedure.
3242  DOS PART OUTSIDE PROC EFF DTS CLAIM DATES OF SERVICE ARE PARTIALLY OUTSIDE THE RANGE OF THE PROCEDURE CODE PRICING SPAN EFFECTIVE DATES M20 Missing/incomplete/invalid HCPCS. 181
3250  INVLD CLIA CERT TYPE FOR PROCS TYPE OF CLIA CERTIFICATION DOES NOT PERMIT THIS PROCEDURE MA120 Missing/incomplete/invalid CLIA certification number. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3251  SCNDRY SRGRY REQUIRES MOD 51 BILLING OF A SECONDARY SURGERY REQUIRES THE SURGERY PROCEDURE CODE TO BE SUBMITTED WITH MODIFIER 51 59 Processed based on multiple or concurrent procedure rules.(For example multiple surgery or diagnostic imaging, concurrent anesthesia.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
3256  DIAG PROCEDURE RESTR DIAGNOSIS FILE PROCEDURE RESTRICTIONS N657 This should be billed with the appropriate code for these services 11 The diagnosis is inconsistent with the procedure.
3259  CLAIM EXCEEDS FILING TIME LMT CLAIM ECEEDS FILING TIME LIMIT 29 The time limit for filing has expired.
3268  CLM EXCDS FTL-RESUB WITH PROOF CLAIMS EXCEED FILING TIME LIMIT - RESUBMIT WITH PROOF OF TIMELY FILING 29 The time limit for filing has expired.
3269  TIMELY FILING TCN < SVC DATE TIMELY FILING TCN IS BEFORE SERVICE DATE 29 The time limit for filing has expired.
3271  INVALID TIMELY FILING TCN TIMELY FILING TCN IS BEFORE SERVICE DATE 29 The time limit for filing has expired.
3272  DOS>1 YR-NO TIMELY FILING TCN DATE OF SERVICE OLDER THAN ONE YEAR AND NO TIMELY FILING TCN ON CLAIM 29 The time limit for filing has expired.
3273  DOS>2 YRS FROM CURRENT TCN DT DATE OF SERVICE IS OLDER THAN TWO YEARS FROM CURRENT TCN DATE 29 The time limit for filing has expired.
3278  THRU DOS> 1 YR FROM TF TCN THRU DOS > ONE YEAR FROM TIMELY FILING TCN 29 The time limit for filing has expired.
3279  TCN > 2 YRS FROM TF TCN TCN > 2 YEARS FROM TIMELY FILING TCN 29 The time limit for filing has expired.
3280  THRU DOS>12 MTHS FROM TF TCN THRU DOS > 12 MONTHS FROM TIMELY FILING TCN 29 The time limit for filing has expired.
3299  CPT PROC NO LONGER VALID CPT PROCEDURE CODES NO LONGER VALID M20 Missing/incomplete/invalid HCPCS. 181
3301  FRI/SAT/SUN ADMISSION DENIED FRI/SAT/SUN ADMISSION DENIED MA40 Missing/incomplete/invalid admission date. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3304  BILL 1 DIAL CD/1 UNT/1 MTH NONE N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3305  PROV MUST BILL DIAL REV CODE PROVIDER MUST BILL DIALYSIS REVENUE CODE M50 Missing/incomplete/invalid revenue code(s). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3310  IP PSYCHIATRIC AGE RESTRICTION "INPATIENT PSYCHIATRIC AGE RESTRICTION" N129 This amount represents the dollar amount not eligible due to the patient's age. 6 The procedure/revenue code is inconsistent with the patient's age.
3314  POS 11,21-23,32,50,51,71,72,81 INDEPENDENT LAB PLACE OF SERVICE 11, 21, 22, 23, 32,50,51,71,72 AND 81. M77 Missing/incomplete/invalid/inappropriate place of service. 5 The procedure code/bill type is inconsistent with the place of service.
3319  PROF COMP N/A FOR THIS PROC PROFESSIONAL COMPONENT NOT APPLICABLE FOR THIS PROCEDURE N519 Invalid combination of HCPCS modifiers 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
3320  TECH COMP N/A FOR THIS PROC "TECHNICAL COMPONENT NOT APPLICABLE FOR THIS PROCEDURE" N519 Invalid combination of HCPCS modifiers 4 The procedure code is inconsistent with the modifier used or a required modifier is missing.
3329  PROC CANT BE BILL WITH 84443 84436, 84439, 84479, OR 84480 CANNOT BE BILLED ON SAME DATE OF SERVICE AS 84443
3331  AWAITING PRIOR AUTH AWAITING PRIOR AUTHORIZATION 197
3334  NO PTNT LIAB IN EFF FOR DOS NO PATIENT LIABILITY IN EFFECT FOR DATES OF SERVICE N58 Missing/incomplete/invalid patient liability amount. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3341  CLM REQS PA OR APPROPRIATE MOD CLAIM REQUIRES PRIOR AUTHORIZATION OR APPROPRIATE MODIFIER N517 Resubmit a new claim with the requested information. 15 The authorization number is missing, invalid, or does not apply to the billed services or provider
3344  NO PTLIAB ON DOS-VER W/REG OFC NO PATIENT LIABILITY FOR DATES OF SERVICE - VERIFY WITH REGIONAL OFFICE N141 The patient was not residing in a long-term care facility during all or part of the service dates billed. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
3364  EXTRACT TOOTH CNT LESS THAN 3 EXTRACT TOOTH CODE COUNT OR SPACE COUNT (MISSING TEETH) IS <3 FOR THE SAME QUADRANT N37 Missing/incomplete/invalid tooth number/letter. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3365  PROC REQ PRIM TOOTH CODE(S) PROCEDURE REQUIRES PRIMARY TOOTH CODE(S) N37 Missing/incomplete/invalid tooth number/letter. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3366  PROC REQ PERM TOOTH CODE(S) PROCEDURE REQUIRES PERMANENT TOOTH CODE(S) N37 Missing/incomplete/invalid tooth number/letter. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3400  CC-GLOBAL SYSTEM ERRORS CLAIM CHECK - GLOBAL SYSTEM ERRORS
3431  CC-EXCEEDS LIFETIME LIMITATION CLAIM CHECK - EXCEEDS LIFETIME LIMITATION
3432  CC-NO PROF/TECH COMP FOR CD CLAIM CHECK - NO PROFESSIONAL/TECHNICAL COMPONENT FOR THIS CODE
3433  CR-PEND FOR DUP COMP BILLING CLAIM REVIEW - PEND FOR DUPLICATE/MULTIPLE COMPONENT BILLING
3434  CC-CD REPL TO MOST COMP CD CLAIM CHECK - CODE REPLACED TO MOST COMPREHENSIVE CODE
3435  CC-PROC INC/INT TO OTHER PROC CLAIM CHECK - PROCEDURE INCIDENTAL/INTEGRAL TO ANOTHER PROCEDURE CODE
3436  CC-MED VISIT VS. PROC-SAME DOS CLAIM CHECK - MEDICAL VISIT VS. PROCEDURE - SAME DATE OF SERVICE
3437  CC-CD RBNDLED TO MOST COMP CD CLAIM CHECK - CODE REBUNDLED TO MOST COMPREHENSIVE CODE
3442  CC-CD IS MUT EXCL TO OTHER CD CLAIM CHECK - CODE IS MUTUALLY EXCLUSIVE TO ANOTHER CODE
3443  CC-VISIT WITHIN OPER PERIOD CLAIM CHECK - VISIT IS WITHIN PRE/POST OPERATIVE PERIOD
3444  CC-ASST SURGEON NOT ALLOWED CLAIM CHECK - ASSISTANT SURGEON IS NOT ALLOWED
3445  CC-UNILAT REPLACED W/BILATERAL CLAIM CHECK - UNILATERAL CODES REPLACE WITH MORE COMPREHENSIVE BILATERAL CODES
3446  CR-PEND FOR DUP COMP BILLING CLAIM REVIEW - PROCEDURE NOT EXPECTED FOR DIAGNOSIS
3447  CR-1 OFFICE VST PER RECIP/PROV CLAIM REVIEW - ONE NEW OFFICE VISIT ALLOWED PER RECIPIENT PER PROVIDER PER 3 YEARS
3448  CR-VISIT VS DIAG; RPLCED W/VST CLAIM REVIEW - VISIT VS. DIAGNOSIS; REPLACED WITH THE EXPECTED LEVEL VISIT CODE
3449  CC-CURR CODE REBUNDLED TO PREV CLAIM CHECK - CURRENT CODE REBUNDLED TO PREVIOUSLY PAID CODE
3453  UNITS BILLED > CVRD DAYS UNITS BILLED ARE GREATER THAN COVERED DAYS M53 Missing/incomplete/invalid days or units of service. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3456  GLOBAL PACKAGE APPLIES GLOBAL PACKAGE APPLIES TO SERVICES REPORTED M144 Pre-/post-operative care payment is included in the allowance for the surgery/procedure. 97 Payment is included in the allowance for another service/procedure.
3457  GLOBAL CLM REND TXNMY NO MATCH GLOBAL PACKAGE CLAIM, RENDERING TAXON CODE DOES NOT MATCH PROV RECORD N288 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
3458  GLOBAL CLM REND TXNMY REQUIRED GLOBAL PACKAGE CLAIM, RENDERING TAXONOMY CODE IS REQUIRED N288 8 The procedure code is inconsistent with the provider type/specialty (taxonomy).
3502  MAX DOLLAR AMT EXCEEDED MAXIMUM DOLLAR AMOUNT EXCEEDED FOR FISCAL YEAR N587 Policy benefits have been exhausted. 119 Benefit maximum for this time period or occurence has been reached.
3504  MENT HLTH SVC MAX ALW EXC MENTAL HEALTH SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3506  PAYMENT ALW EXC BILLED AMT PAYMENT ALLOWED EXCEEDS BILLED AMOUNT M139 Denied services exceed the coverage limit for the demonstration. 119 Benefit maximum for this time period or occurence has been reached.
3509  DAYS SVC EXC 7 OR UNT EXC 100 NUMBER OF DAYS SERVICED EXCEEDED 7 OR UNITS EXCEEDED 100 N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3576  SL UNT ALW FOR WVR 0282 EXC SERVICE LIMIT UNITS ALLOWED FOR WAIVER 0282 ARE EXCEEDED N587 Policy benefits have been exhausted. 35 Lifetime benefit maximum has been reached.
3603  COMP ORAL EVAL LIMIT EXC COMPREHENSIVE ORAL EVALUATION SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3643  HOME LEAVE DAYS EXC FOR FY HOME LEAVE DAYS EXCEEDED FOR FISCAL YEAR N435 Exceeds number/frequency approved /allowed within time period without support documentation 119 Benefit maximum for this time period or occurence has been reached.
3646  MAX INP DAYS EXCEEDED-NO COINS MAXIMUM INPATIENT DAYS EXHAUSTED - NO COINSURANCE DUE N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3647  INVALID SERVICE LIMIT ADJ INVALID SERVICE LIMIT ADJUSTMENT B5 Coverage/program guidelines were not met or were exceeded.
3648  MAX IP DAYS EXCEEDED MAXIMUM INPATIENT DAYS EXCEEDED FOR FISCAL YEAR N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3649  MAX 6 BLOOD UNITS EXCEEDED MAXIMUM OF 6 BLOOD UNITS EXCEEDED FOR FISCAL YEAR N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3653  SL CASH ALW FOR CHIRO BENE EXC SERVICE LIMIT CASH ALLOWED PER BENEFICIARY FOR A CHIROPRACTOR CLAIM HAS BEEN EXCEEDED N587 Policy benefits have been exhausted. 35 Lifetime benefit maximum has been reached.
3671  NO SPACE MAINT PROC BILLED NO SPACE MAINTENANCE PROCEDURE BILLED
3682  LIMITED ORAL EVAL LIMIT EXC LIMITED ORAL EVALUATION SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3683  INVALID TIMELY FILING TCN INVALID TIMELY FILING TCN 29 The time limit for filing has expired.
3684  PSYCH THERA LVE DYS EXCEEDED PSYCHIATRIC THERAPEUTIC LEAVE DAYS SERVICE LIMIT EXCEEDED N435 Exceeds number/frequency approved /allowed within time period without support documentation 119 Benefit maximum for this time period or occurence has been reached.
3688  PERIODONTAL SL EXCEEDED PERIODONTAL SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3689  DENT PROPHYLAXIS SL EXCEEDED DENTAL PROPHYLAXIS SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3690  DENT FLRD SL EXCEED EPSDT ONLY DENT FLUORIDE SL EXCEEDED (EPSDT BENEFIT ONLY) N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3694  HOSPITAL LEAVE DAYS EXCEEDED HOSPITAL LEAVE DAYS EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3700  PROC EXCEEDS LIFETIME LIMIT PROCEDURE EXCEEDS LIFETIME LIMITATION N117 This service is paid only once in a lifetime per beneficiary. 35 Lifetime benefit maximum has been reached.
3701  EYEGLASS LENS SL EXCEEDED EYEGLASS LENS SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3704  EYEGLASS FRAMES SL EXCEEDED EYEGLASS FRAMES SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3705  HH VISITS SL EXCEEDED HOME HEALTH VISITS SERVICE LIMIT EXCEEDED N435 Exceeds number/frequency approved /allowed within time period without support documentation 119 Benefit maximum for this time period or occurence has been reached.
3706  OUTPATIENT VISITS SL EXCEEDED OUTPATIENT VISITS SERVICE LIMIT EXCEEDED N435 Exceeds number/frequency approved /allowed within time period without support documentation 119 Benefit maximum for this time period or occurence has been reached.
3707  EPSDT VIS/HEAR/COUNSEL EXCEED EPSDT VISION/HEARING/COUNSELING SERVICE LIMIT EXCEEDED M90 Not covered more than once in a 12 month period. 119 Benefit maximum for this time period or occurence has been reached.
3708  PHY OFC VISIT EXCEEDED PHYSICIAN OFFICE VISIT SERVICE LIMIT EXCEEDED N435 Exceeds number/frequency approved /allowed within time period without support documentation 119 Benefit maximum for this time period or occurence has been reached.
3711  PHYS ASSESS PREV PD EPSDT ONLY PHYS ASSESS PREV PAID (EPSDT BENEFIT ONLY) M86 Service denied because payment already made for similar procedure within set time frame. B13 Previously paid. Payment for this claim/service may have been provided in a previous payment.
3715  PHYS INPATIENT SVC LMT EXCEED PHYS INPATIENT SVC LMT EXCEED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3716  INPATIENT PSYCH SL EXCEEDED INPATIENT PSYCHIATRIC SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3721  PHYS NF VISITS SL EXCEEDED PHYSICIAN NURSING FACILITY VISITS SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3723  HEARING AID SL EXCEEDED HEARING AID SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3724  HEARING SCREENING SL EXCEEDED HEARING SCREENING SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3740  PHARM DISEASE MGMT SL EXCEEDED PHARMACY DISEASE MANAGEMENT SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3741  MYPAC SVC LMT EXCEEDED MYPAC RESPITE EXCEEDS 45 DAYS FOR THE FISCAL YEAR N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3742  CVR DAYS>LONG STAY THRESHOLD CVR DAYS>LONG STAY THRESHOLD MA32 Missing/incomplete/invalid number of covered days during the billing period. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3743  CVR DAYS>LONG STAY MH THRESHOL CVR DAYS>LONG STAY MH THRESHOLD AND THERE IS NO PA ON FILE AUTHORIZING THE STAY. MA32 Missing/incomplete/invalid number of covered days during the billing period. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3744  FUTURE EDIT FUTURE EDIT
3745  B2I PROGRAM SL EXCEEDED B2I PROGRAM SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3746  MH ASMT (H0031) SL EXCEEDED MH ASSESMENT SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3747  MH ACT SL EXCEEDED MH ACT SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3748  MH CRISIS SRVCS SL EXCEEDED MH CRISIS SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3749  MH COMM SUPPORT SL EXCEEDED MH COMUNTY SUPRT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3750  MH PEER SUPPORT SL EXCEEDED MH PEER SUPPORT SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3751  MH WRAPAROUND SRVCS SL EXCEDED MH WRAPAROUND SERVICES LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3752  MH TX PLAN REV SL EXCEEDED MH TX PLAN REV(H0032) SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3753  MH EVAL(96101) SL EXCEEDED MH EVAL (96101) SERVICE LIMIT EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3754  MH CRISIS RES SL EXCEEDED MH CRISIS RES SL EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3755  MH IOP SL EXCEEDED MH IOP PSYCH SL EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3756  MH TX FOSTER CARE SL EXCEEDED MH TX FOSTER CARE SL EXCEEDED N362 The number of Days or Units of Service exceeds our acceptable maximum. 119 Benefit maximum for this time period or occurence has been reached.
3913  INV LTR RTR ELIG-DENIED FOR TF INVALID LETTER OF RETROACTIVE ELIGIBILITY - DENIED FOR TIMELY FILING 29 The time limit for filing has expired.
3948  CC-REBILL ITEM SVCS ON SEP LI CLAIM CHECK - REBILL ITEMIZING SERVICES ON SEPARATE LINES
3950  BABY DATE OF BIRTH MISS BABY'S DATE OF BIRTH IS MISSING/INVALID N329 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3951  BABY BIRTH NAME MISSING BABY'S BIRTH NAME IS MISSING/INVALID MA36 Missing/incomplete/invalid patient name. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3952  REBILL UNDER BABY'S ID&DETAILS REBILL UNDER BABY'S PERMANENT MEDICAID NUMBER WITH NAME,GENDER AND DOB N382 Missing/incomplete/invalid patient identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3953  SEX OF BABY MISSING SEX OF BABY MISSING/INVALID MA39 Missing/incomplete/invalid gender. 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
3954  MOTHER NOT ELIGIBLE MOTHER NOT ELIGIBLE ON BABY'S DATE OF BIRTH N30 Recipient ineligible for this service. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
3955  SERVICE NOT COVERED FOR BENE SERVICE NOT COVERED FOR BENEFICIARY N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
3956  DATES FALL WITHIN COST SETTLE THE BILLING PROVIDER HAS A COST SETTLEMENT SEGMENT THAT FALLS WITHIN THE DATES OF SERVICE B13 Previously paid. Payment for this claim/service may have been provided in a previous payment.
3957  PROV COST SETTLEMENT SPLITBILL THE SERVICE BEGINNING OR END DATE FALLS WITHIN THE PROVIDERS COST SETTLEMENT SEGMENT. THE PROVIDER NEEDS TO SPLIT BILL THE CLAIM. N61 Rebill services on separate claims. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
3958  IP PSYCH AND AGE RESTRICTION IP PSYCH AND BENE AGE RESTRICTION N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
3960  CC-REBILL USING SPEC PROC CD CLAIM CHECK - REBILL USING SPECIFIC PROCEDURE CODE
3991  ASST SURG/SURG MUST FILE SEP ASSISTANT SURGEON/SURGEON MUST FILE SEPARATELY N61 Rebill services on separate claims. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
3995  "FUTURE EDIT" "FUTURE EDIT" N130 Consult plan benefit documents for information about restrictions for this service. 204 This service/equipment/drug is not covered under the patient's current benefit plan.
5000  ENCTR CLM RECVD FOR NON-MSCAN ENCTR CLM RECVD FOR NON-MSCAN RECPIENT N52 Patient not enrolled in the billing provider's managed care plan on the date of service. 32 Our records indicate that this dependent is not an eligible dependent as defined.
5001  CCO ON CLM DIFF THAN LCKN CCO CCO ON CLM DIFFERENT THAN CCO ON LOCKIN N52 Patient not enrolled in the billing provider's managed care plan on the date of service. 32 Our records indicate that this dependent is not an eligible dependent as defined.
5002  ENCTR CLM RCVD FOR NON-COV SVC ENCTR CLM RECVD FOR NON-COVERED SERVICE N216 We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package 109 Claim/Service not cobered by this payer/contractor. You mustsend the claim/service to the correc pyer/contractor.
5003  CCO BILL PROV NOT IN AFFL FILE CCO BILLING PROVIDER NOT FOUND ON AFFILIATION FILE N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
5004  CCO SERV PROV NOT IN AFFL FILE CCO SERVICING PROVIDER NOT FOUND ON AFFILIATION FILE N198 Rendering provider must be affiliated with the pay-to provider. 96 Non-covered charge(s). At least one Remark Code must be provided(may be comprised of either the NCPDP Reject Reason İsic¨ Code,or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
5005  DUP MSCAN ENCTR CLAIM DUPLICATE MSCAN ENCOUNTER CLAIM M86 Service denied because payment already made for similar procedure within set time frame. 97 Payment is included in the allowance for another service/procedure.
5006  ENCTR CLAIM EXCEEDS TF LIMIT ENCTR CLAIM EXCEEDS TF LIMIT 29 The time limit for filing has expired.
5007  CORR ENCTR CLAIM RCVD > 60 DAY CORRECTED ENCNTR CLAIM RECEIVED PAST 60 DAYS 29 The time limit for filing has expired.
5008  CCO DENIED ENCTR ON CAS RSN CD CCO DENIED ENCOUNTERS BASED ON THE CAS REASON CODES N36 Claim must meet primary payer¿s processing requirements before we can consider payment. 109 Claim/Service not cobered by this payer/contractor. You mustsend the claim/service to the correc pyer/contractor.
5009  NO CAS REPRTD AND CCO AMT = 0 NO CAS REPORTED FOR CAN ENCOUNTER CLAIMS AND CCO PAID AMOUNT IS ZERO N480 Incomplete/invalid Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
5010  ENCTR CLM RECVD FOR NON-MSCHP ENCTR CLM RECVD FOR NON-MSCHP RECPIENT N52 Patient not enrolled in the billing provider's managed care plan on the date of service. 32 Our records indicate that this dependent is not an eligible dependent as defined.
5011  CCO ON CLM DIFF THAN CHP CCO CCO ON CLM DIFFERENT THAN CCO ON LOCKIN N52 Patient not enrolled in the billing provider's managed care plan on the date of service. 32 Our records indicate that this dependent is not an eligible dependent as defined.
5013  CHP BILL PROV NOT IN AFFL FILE CCO CHP BLN PROVIDER NOT FOUND ON AFFILIATION FILE N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
5014  CHP SERV PROV NOT IN AFFL FILE CCO CHP SRVC PROVIDER NOT FOUND ON AFFILIATION FILE M86 Service denied because payment already made for similar procedure within set time frame. 208 National Provider Identifier - Not matched
5015  DUPLICATE CHIP ENCTR CLAIM DUPLICATE CHIP ENCOUNTER CLAIM FOUND M86 Service denied because payment already made for similar procedure within set time frame. 97 Payment is included in the allowance for another service/procedure.
5016  CHP ENCTR CLAIM EXCEEDS TF LMT CHIP ENCTR CLAIM EXCEEDS TF LIMIT 29 The time limit for filing has expired.
5017  CHP CORR ENCTR CLM RCVD>60 DAY CHIP CORRECTED ENCNTR CLAIM RECEIVED PAST 60 DAYS 29 The time limit for filing has expired.
5018  CCO DENY CHIP ENCNTR ON CAS CD CCO DENIED CHIP ENCOUNTERS BASED ON CAS RSN CODES N36 Claim must meet primary payer¿s processing requirements before we can consider payment. 109 Claim/Service not cobered by this payer/contractor. You mustsend the claim/service to the correc pyer/contractor.
5019  NO CAS REPRTD AND CCO AMT = 0 NO CAS REPORTED FOR CHIP ENCOUNTER CLAIMS AND CCO PAID AMOUNT IS ZERO N480 Incomplete/invalid Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
5020  OUT NTWRK CHP BILPROVDR UNAFFL OUT OF NETWRK CHP BILING PROV NOT AFFILIATED N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
5021  OUT NTWRK BILPROV NOT CHPPROV OUT OF NETWRK BILING PROV NOT CHIP PROVDR N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
5022  OUT NTWRK CHP SRVPROVDR UNAFFL OUT OF NETWRK CHP SRVCING PROV NOT AFFILIATED N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
5023  NPI BILLED IS NOT CHP PROVIDER BILLING NPI SUBMITTED ON CLAIM IS NOT CHIP PROVIDER NPI N257 Missing/incomplete/invalid billing provider/supplier primary identifier 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
5024  SUSPECT DUP ENCTR CLM SUSPECT DUPLICATE ENCOUNTER CLAIM M86 Service denied because payment already made for similar procedure within set time frame. 97 Payment is included in the allowance for another service/procedure.
5025  DUPLICATE NET ENCTR CLAIM DUPLICATE NET ENCOUNTER CLAIM FOUND M86 Service denied because payment already made for similar procedure within set time frame. 97 Payment is included in the allowance for another service/procedure.
5026  NET ENCTR CLAIM EXCEEDS TF LMT NET ENCTR CLAIM EXCEEDS TIMELY FILING LIMIT 29 The time limit for filing has expired.
5027  NET CORR ENCTR CLM RCVD>60 DAY NET CORRECTED ENCNTR CLAIM RECEIVED PAST 60 DAYS 29 The time limit for filing has expired.
5028  NET DENY ENCNTR ON CAS CD NET PROVIDER DENIED CLAIM BASED ON CAS RSN CODES N36 Claim must meet primary payer¿s processing requirements before we can consider payment. 109 Claim/Service not cobered by this payer/contractor. You mustsend the claim/service to the correc pyer/contractor.
5029  CAS REQ NET ENC PD AMT ZERO DENY ENCOUNTERS FOR NET PROVIDER AMT ZERO AND EMPTY CAS N480 Incomplete/invalid Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer). 16 Claim/service lacks information or has submission/billing errors which is needed for adjudication.Additional information is supplied using remittance advice remarks codes whenever appropriate
5030  DRG CODE NOT SUB ON ENC CLAIM DRG CODE NOT SUBMITTED ON MSCAN ENCOUNTER CLAIM M86 Service denied because payment already made for similar procedure within set time frame. 97 Payment is included in the allowance for another service/procedure.
6111  MLGE CHG MUST HAVE EMG BR PROC MILEAGE CHARGE MUST HAVE EMERGENCY BASE RATE PROCEDURE ON CLAIM 107 The related or qualifying claim/service was not identifiedon this claim. Note: Refer to the 835 Healthcare PolicyIdentification Segment (loop 2110 Service Payment Information REF), if present.
6500  MENTAL HEALTH MEDS CHECK (LCL) FOR PROC W3000 - CAN ONLY BILL 36 UNITS FOR THE REMAINDER OF THIS FISCAL YEAR
6501  MENTAL HEALTH MEDS CHECK(NATL) FOR PROC 90862 - CAN ONLY BILL 54 UNITS FOR THE REMAINDER OF THIS FISCAL YEAR (NORMAL FY LIMIT IS 72 UNITS)
6502  MENTAL HLTH-INDIV THERAPY(LCL) FOR PROCEDURE CODES W3005-W3007 - CAN ONLY BILL 36 UNITS FOR THIS FISCAL YEAR (NORMAL FY LIMIT IS 144 UNITS)
6503  MENTAL HLTH-INDIV THERAPY(NATL FOR PROCEDURE CODES H0031-H0032, 90804, 90806, 90808 - CAN ONLY BILL 27 UNITS FOR THE REMAINDER OF THIS FY (NORMAL UNITS PER FY = 36)
6504  MENTAL HLTH-FAMILY THERPY(LCL)