The diagnosis is inconsistent with the patient's gender. (Use only with Group Code CO). co 256 denial code descriptions . Additional information will be sent following the conclusion of litigation. Referral not authorized by attending physician per regulatory requirement. (For example, multiple surgery or diagnostic imaging, concurrent anesthesia.) CO/200/ CO/26/N30. To be used for Property & Casualty only. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Reason Code 250: Sequestration - reduction in federal payment. (Use only with Group Codes PR or CO depending upon liability). CARCs are used in the RA with group codes that shows the liability for amounts not covered by Medicare for a claim or service. Claim lacks indication that service was supervised or evaluated by a physician. 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.) Fee/Service not payable per patient Care Coordination arrangement. Service/procedure was provided outside of the United States. Usage: To be used for pharmaceuticals only. Reason Code 69: Coinsurance day. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Refund to patient if collected. Reason Code 135: Appeal procedures not followed or time limits not met. This payment reflects the correct code. ), This change effective 7/1/2013: Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete. Information about the X12 organization, its activities, committees & subcommittees, tools, products, and processes. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. JETZT SPENDEN. ), Reason Code 235: Claim spans eligible and ineligible periods of coverage, this is the reduction for the ineligible period (use Group Code PR). Reason Code 142: Premium payment withholding. This (these) diagnosis(es) is (are) not covered. Benefit maximum for this time period or occurrence has been reached. The provider cannot collect this amount from the patient. (Use only with Group Code OA). Revenue code and Procedure code do not match. 'Not otherwise classified' or 'unlisted' procedure code (CPT/HCPCS) was billed when there is a specific procedure code for this procedure/service. Reason Code 126: Prior processing information appears incorrect. Reason/Remark Code Lookup To be used for Workers' Compensation only. Patient/Insured health identification number and name do not match. Another code to be established and/or for 06/2008 meeting for a revised code to replace or strategy to use another existing code, This dual eligible patient is covered by Medicare Part D per Medicare Retro-Eligibility. Usage: Use this code when there are member network limitations. Charges exceed our fee schedule or maximum allowable amount. Note: Refer to the835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Search box will appear then put your adjustment reason code in search box e.g. Reason Code 100: Provider promotional discount (e.g., Senior citizen discount). Usage: To be used for pharmaceuticals only.
Centroid Y Of Region Bounded By Curves Calculator,
Articles C