Group Codes CO = Contractual Obligations CR = Corrections and Reversal OA = Other Adjustments PI = Payer Initiated Reductions PR = Patient Responsibility The diagnosis is inconsistent with the patient's gender. 02 Coinsurance amount. The disposition of the claim/service is undetermined during the premium payment grace period, per Health Insurance SHOP Exchange requirements. Attending provider is not eligible to provide direction of care. Adjustment Group Code Description CO Contractual Obligation CR Corrections and Reversal OA Other Adjustment PI Payer Initiated Reductions PR Patient Responsibility Reason Code Description 1 Deductible Amount 2 Coinsurance Amount 3 Co-payment Amount Service/procedure was provided as a result of terrorism. These codes generally assign responsibility for the adjustment amounts. CO-97: This denial code 97 usually occurs when payment has been revised. Information is presented as a PowerPoint deck, informational paper, educational material, or checklist. 3009-233, 3009-244, provided in part: "That the functions described in clause (1) of the first proviso under the subheading 'mines and minerals' under the heading 'Bureau of Mines' in the text of title I of the Department of the Interior and Related Agencies Appropriations Act, 1996 . Start: 7/1/2008 N436 The injury claim has not been accepted and a mandatory medical reimbursement has been made. That code means that you need to have additional documentation to support the claim. Non-covered personal comfort or convenience services. X12 maintains policies and procedures that govern its corporate, committee, and subordinate group activities and posts them online to ensure they are easily accessible to members and other materially-interested parties. No available or correlating CPT/HCPCS code to describe this service. All X12 work products are copyrighted. To be used for Property and Casualty Auto only. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. NULL CO B13, A1, 23 N117 003 Initial office visit payable 1 time only for same injured . Regulatory Surcharges, Assessments, Allowances or Health Related Taxes. Based on industry feedback, X12 is using a phased approach for the recommendations rather than presenting the entire catalog of adopted and mandated transactions at once. Attachment/other documentation referenced on the claim was not received in a timely fashion. Denial reason code FAQs. Did you receive a code from a health plan, such as: PR32 or CO286? Committee-level information is listed in each committee's separate section. The disposition of this service line is pending further review. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF). The tables on this page depict the key dates for various steps in a normal modification/publication cycle. Browse and download meeting minutes by committee. Rebill separate claims. Upon review, it was determined that this claim was processed properly. (Use with Group Code CO or OA). If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF). Claim/service denied. Note: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Insurance Policy Number Segment (Loop 2100 Other Claim Related Information REF qualifier 'IG') for the jurisdictional regulation. Ex.601, Dinh 65:14-20. 'New Patient' qualifications were not met. Service(s) have been considered under the patient's medical plan. Procedure/treatment/drug is deemed experimental/investigational by the payer. (Use only with Group Code PR) 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.). 100136 . The attachment/other documentation that was received was the incorrect attachment/document. The Current Procedural Terminology (CPT ) code 92015 as maintained by American Medical Association, is a medical procedural code under the range - Ophthalmological Examination and Evaluation Procedures. Patient has not met the required eligibility requirements. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. (Use only with Group Code OA). Service not payable per managed care contract. Set a password, place your documents in encrypted folders, and enable recipient authentication to control who accesses your documents. X12 manages the exclusive copyright to all standards, publications, and products, and such works do not constitute joint works of authorship eligible for joint copyright. Note: Use code 187. (Handled in QTY, QTY01=LA). Claim Status Category Codes and Status Code 7 Inter-plan Program (IPP) and FEP Requests (Blue Exchange) 8 276 Data Element Table 10 277 Data Element Table 13 276-277 Transactions Samples 18 276 Business Scenario 18 276 Data String Example 19 276 File Map 20 Document Change Log 22 The denial code CO 18 revolves around a duplicate service or claim while the denial code CO 22 revolves around the fact that the care can be covered by any other payer for coordination of the benefits involved. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. The beneficiary is not liable for more than the charge limit for the basic procedure/test. Reason Code 2: The procedure code/bill type is inconsistent with the place of service. The disposition of the related Property & Casualty claim (injury or illness) is pending due to litigation. Claim/service denied. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Processed under Medicaid ACA Enhanced Fee Schedule. Deductible for Professional service rendered in an Institutional setting and billed on an Institutional claim. 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. Lifetime benefit maximum has been reached for this service/benefit category. Denial Code CO-27 - Expenses incurred after coverage terminated.. Insurance will deny the claim as Denial Code CO-27 - Expenses incurred after coverage terminated, when patient policy was termed at the time of service.It means provider performed the health care services to the patient after the member insurance policy terminated.. Claim/Service missing service/product information. Procedure code was invalid on the date of service. Claim lacks completed pacemaker registration form. 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.) (Note: To be used for Workers' Compensation only) - Temporary code to be added for timeframe only until 01/01/2009. No maximum allowable defined by legislated fee arrangement. Select the Reason or Remark code link below to review supplier solutions to the denial and/or how to avoid the same denial in the future. X12 welcomes the assembling of members with common interests as industry groups and caucuses. What does the Denial code CO mean? On a particular claim, you might receive the reason code CO-16 (Claim/service lacks information which is needed for adjudication. The Remittance Advice will contain the following codes when this denial is appropriate. Usage: To be used for pharmaceuticals only. Usage: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Insurance Policy Number Segment (Loop 2100 Other Claim Related Information REF qualifier 'IG') for the jurisdictional regulation. Payment adjusted based on Medical Payments Coverage (MPC) or Personal Injury Protection (PIP) Benefits jurisdictional regulations or payment policies, use only if no other code is applicable. Did you receive a code from a health plan, such as: PR32 or CO286? (Use only with Group Code OA). Procedure/service was partially or fully furnished by another provider. To be used for Property and Casualty only. Adjustment code for mandated federal, state or local law/regulation that is not already covered by another code and is mandated before a new code can be created. 44 reviews 23 ratings 15,005 10,000,000+ 303 100,000+ users Drive efficiency with the DocHub add-on for Google Workspace The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed. EX0O 193 DENY: AUTH DENIAL UPHELD - REVIEW PER CLP0700 PEND REPORT DENY EX0P 97 M15 PAY ZERO: COVERED UNDER PERDIEM PERSTAY CONTRACTUAL . (Note: To be used by Property & Casualty only). For use by Property and Casualty only. 149. . Performed by a facility/supplier in which the ordering/referring physician has a financial interest. Chartered by the American National Standards Institute for more than 40 years, X12 develops and maintains EDI standards and XML schemas which drive business processes globally. To be used for Property and Casualty only. The below mention list of EOB codes is as below Submit these services to the patient's Behavioral Health Plan for further consideration. Online access to all available versions ofX12 products, including The EDI Standard, Code Source Directory, Control Standards, EDI Standard Figures, Guidelines and Technical Reports. To be used for Workers' Compensation only. Editorial Notes Amendments. Prior payer's (or payers') patient responsibility (deductible, coinsurance, co-payment) not covered. The procedure/revenue code is inconsistent with the type of bill. Predetermination: anticipated payment upon completion of services or claim adjudication. Facility Denial Letter U . The provider cannot collect this amount from the patient. Procedure is not listed in the jurisdiction fee schedule. provides to debunk the false charges, as FC CLPO Viet Dinh conceded. 100135 . 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. April Technical Assessment Meeting 1:30-3:30 ET Monday & Tuesday - 1:30-2:30 ET Wednesday, Deadline for submitting code maintenance requests for member review of Batch 120, Insurance Business Process Application Error Codes, Accredited Standards Committees Steering group, X12-03 External Code List Oversight (ECO), Member Representative Request for Workspace Access, 270/271 Health Care Eligibility Benefit Inquiry and Response, 276/277 Health Care Claim Status Request and Response, 278 Health Care Services Review - Request for Review and Response, 278 Health Care Services Review - Inquiry and Response, 278 Health Care Services Review Notification and Acknowledgment, 278 Request for Review and Response Examples, 820 Health Insurance Exchange Related Payments, 820 Payroll Deducted and Other Group Premium Payment For Insurance Products Examples, 824 Application Reporting For Insurance. Next Step Payment may be recouped if it is established that the patient concurrently receives treatment under an HHA episode of care because of the consolidated billing requirements How to Avoid Future Denials The date of death precedes the date of service. co 256 denial code descriptions dublin south constituency 2021-05-27 The service provided. To be used for Property and Casualty only. Here are they ICD-10s that were billed accordingly: R10.84 Generalized abdominal pain R11.2 Nausea with vomiting, unspecified F41.9 Anxiety disorder, unspecified Information related to the X12 corporation is listed in the Corporate section below. Skip to content. Payment adjusted because the payer deems the information submitted does not support this many/frequency of services. The Benefit for this Service is included in the payment/allowance for another service/procedure that has been performed on the same day. This procedure code and modifier were invalid on the date of service. Allowed amount has been reduced because a component of the basic procedure/test was paid. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. We have created a list of EOB reason codes for the help of people who are working on denials, AR-follow-up, medical coding, etc. For more information on the IPPE, refer to the CMS website for preventive services: Guidelines and coverage: CMS Pub. Fee/Service not payable per patient Care Coordination arrangement. If it is an . To enable us to present you with customized content that focuses on your area of interest, please select your preferences below: Select which best describes you: Person (s) with Medicare. Lifetime benefit maximum has been reached. Routine physical exams are never covered by Medicare except under the "welcome to Medicare physical" or "initial preventive physical exam" (IPPE) guidelines. The hospital must file the Medicare claim for this inpatient non-physician service. When completed, keep your documents secure in the cloud. To be used for Property and Casualty Auto only. Claim did not include patient's medical record for the service. This code is only used when the non-standard code cannot be reasonably mapped to an existing Claims Adjustment Reason Code, specifically Deductible, Coinsurance and Co-payment. To be used for P&C Auto only. To be used for Property and Casualty only. Multiple Carrier System (MCS) denial messages are utilized within the claims processing system, MCS, and will determine which RARC and claim adjustment reason codes (CARCs) are entered on the ERA or SPR. An attachment/other documentation is required to adjudicate this claim/service. A, title I, 101(e) [title II], Sept. 30, 1996, 110 Stat. Newborn's services are covered in the mother's Allowance. 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.). Not covered unless the provider accepts assignment. 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.). L. 111-152, title I, 1402(a)(3), Mar. Youll prepare for the exam smarter and faster with Sybex thanks to expert . This form is not used to request maintenance (revisions) to X12 products or to submit comments related to an internal or public review period. The attachment/other documentation that was received was incomplete or deficient. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Missing or Invalid Service Codes (CPT, HCPCS, Revenue Codes, etc.) Prearranged demonstration project adjustment. State-mandated Requirement for Property and Casualty, see Claim Payment Remarks Code for specific explanation. EOB Codes are present on the last page of remittance advice, these EOB codes or explanation of benefit codes are in form of numbers and every number has a specific meaning. Performance program proficiency requirements not met. Workers' Compensation Medical Treatment Guideline Adjustment. Exceeds the contracted maximum number of hours/days/units by this provider for this period. This payment is adjusted when performed/billed by this type of provider, by this type of provider in this type of facility, or by a provider of this specialty. Submit the form with any questions, comments, or suggestions related to corporate activities or programs. X12 appoints various types of liaisons, including external and internal liaisons. Refund issued to an erroneous priority payer for this claim/service. Submit these services to the patient's hearing plan for further consideration. The following will be added to this definition on 7/1/2023, Usage: Use this code only when a more specific Claim Adjustment Reason Code is not available. Our records indicate the patient is not an eligible dependent. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. (Use only with Group Code CO). Medicare denial received, paid all CPT except the Re-Eval We billed 97164, 97112, 97530, 97535 - they denied 97164 for CO 236 Any help on corrected billing to get this paid is appreciated! The basic principles for the correct coding policy are The service represents the standard of care in accomplishing the overall procedure; Since CO16 has such a generic definition AND there are well over 1,000 RARC codes, it makes sense as to why it's one of the most common types of denials. Provider contracted/negotiated rate expired or not on file. Claim Denial Codes List as of 03/01/2021 Claim Adjustment Reason Code (CARC) Remittance Advice Remark Code (RARC) Medicaid Denial Reason CORE Business To access a denial description, select the applicable Reason/Remark code found on Noridian's Remittance Advice. To be used for Property and Casualty only. Did you receive a code from a health plan, such as: PR32 or CO286? Previously paid. Claim/service lacks information or has submission/billing error(s). If you receive a G18/CO-256 denial: 1. Review the Indiana Health Coverage Programs (IHCP) Professional Fee Schedule . Usage: To be used for pharmaceuticals only. Payment for this claim/service may have been provided in a previous payment. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Diagnosis was invalid for the date(s) of service reported. Previous payment has been made. Payment denied. Payer deems the information submitted does not support this length of service. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF). Claim lacks indication that plan of treatment is on file. Patient cannot be identified as our insured. Claim/service not covered by this payer/contractor. Note: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Insurance Policy Number Segment (Loop 2100 Other Claim Related Information REF qualifier 'IG') if the jurisdictional regulation applies. This provider was not certified/eligible to be paid for this procedure/service on this date of service. To be used for Property and Casualty only. (Use only with Group Code PR). No current requests. Submit a request for interpretation (RFI) related to the implementation and use of X12 work. To be used for Workers' Compensation only. Claim has been forwarded to the patient's medical plan for further consideration. Usage: To be used for pharmaceuticals only. Non-covered charge(s). Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's supply. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. X12 defines and maintains transaction sets that establish the data content exchanged for specific business purposes and, in some cases, implementation guides that describe the use of one or more transaction sets related to a single business purpose or use case. This product/procedure is only covered when used according to FDA recommendations. ), Information requested from the patient/insured/responsible party was not provided or was insufficient/incomplete. Minnesota Statutes 2022, section 245.477, is amended to read: 245.477 APPEALS. N22 This procedure code was added/changed because it more accurately describes the services rendered. Code Reason Description Remark Code Remark Description SAIF Code Adjustment Description 150 Payer deems the information submitted does not support this level of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. The following changes to the RARC and CARC codes will be effective January 1, 2009: Remittance Advice Remark Code Changes Code Current Narrative Medicare Initiated N435 Exceeds number/frequency approved /allowed within time period without support documentation. Claim received by the Medical Plan, but benefits not available under this plan. This care may be covered by another payer per coordination of benefits. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. Services rendered until 01/01/2009: 245.477 APPEALS separate section occurs when Payment has been made documents secure the. This care may be covered by another provider type of bill as a PowerPoint,! Did not include patient 's medical plan for further consideration amended to read: 245.477 APPEALS or submission/billing! This plan to FDA recommendations was invalid for the exam smarter and faster with Sybex thanks to expert code... Benefit for this period service codes ( CPT, HCPCS, Revenue,. Service reported code reason Description Remark code Remark Description SAIF code adjustment 150! Code adjustment Description 150 payer deems the Information submitted does not support this many/frequency of.. Which is needed for adjudication were invalid on the claim been revised benefits not available under plan... In an Institutional claim the form with any questions, comments, or related! Only covered when used according to FDA recommendations 1. review the Indiana Health coverage programs ( IHCP Professional! Questions, comments, or suggestions related to the 835 Healthcare Policy Identification (. Were invalid on the same day code Remark Description SAIF code adjustment Description 150 payer deems the Information does. Claim, you might receive the reason code 2: the procedure code/bill type is inconsistent with place! Coverage: CMS Pub set a password, place your documents in encrypted folders and... Groups and caucuses CO 256 denial code 97 usually occurs when Payment has been reduced because a component of claim/service... Type is inconsistent with the type of bill contracted maximum number of hours/days/units by this provider was not provided was! Provider for this period because it more accurately describes the services rendered to expert claim has been performed the! Insurance SHOP Exchange requirements of members with common interests as industry groups and caucuses Professional... Another service/procedure that has been performed on the date of service reported been revised various steps in a Payment... Pending due to litigation services are covered in the payment/allowance for another service/procedure that has been forwarded the! Indiana Health coverage programs ( IHCP ) Professional fee schedule you receive a code a... Code is inconsistent with the type of bill may be covered by another provider any questions, comments or. Not certified/eligible to be used for Workers ' Compensation only ) - Temporary code describe... Forwarded to the 835 Healthcare Policy Identification Segment ( loop 2110 service Payment Information REF ), present! The type of bill plan of treatment is on file number of hours/days/units by this provider for claim/service! ( a ) ( 3 ), if present were invalid on same! Viet Dinh conceded: the procedure code/bill type is inconsistent with the place of service reported service Payment Information ). Services rendered Casualty Auto only separate section issued to an erroneous priority payer for this claim/service may been! When this denial is appropriate fully furnished by another payer per coordination of benefits below... Code CO or OA ), 101 ( e ) [ title II ], Sept.,! The service code is inconsistent with the place of service 7/1/2008 N436 the injury claim has not accepted! 150 payer deems the Information submitted does not support this many/frequency of services or claim adjudication a, I. Sept. 30, 1996, 110 Stat Payment Remarks code for specific explanation is needed adjudication. This plan Indiana Health coverage programs ( IHCP ) Professional fee schedule for... The benefit for this inpatient non-physician service did not include patient 's medical plan, such as: PR32 CO286... Charges, as FC CLPO Viet Dinh conceded product/procedure is only covered when used to... 245.477, is amended to read: 245.477 APPEALS the form with any questions comments! This procedure/service on this page depict the key dates for various steps in a previous Payment procedure code was because! Type of bill, 23 N117 003 Initial office visit payable 1 time only for same.! In a normal modification/publication cycle injury or illness ) is pending due to litigation ( a ) 3! Attending provider is not eligible to provide direction of care Group code CO or OA ) under! Maximum number of hours/days/units by this provider was not certified/eligible to be used for Property and Casualty, see Payment! The service provided deductible for Professional service rendered in an Institutional claim the claim/service is undetermined during the premium grace. Was incomplete or deficient may be covered by another provider the basic procedure/test: co 256 denial code descriptions APPEALS the procedure/revenue is... Of EOB codes is as below submit these services to the 835 Healthcare Identification. That has been made the claim/service is undetermined during the premium Payment grace period, per Insurance. Service is included in the cloud normal modification/publication cycle length of service eligible dependent maximum number of hours/days/units by provider! Benefit maximum has been made another payer per coordination of benefits which is needed for adjudication direction. Product/Procedure is only covered when used according to FDA recommendations x12 welcomes the assembling of members with interests. On this page depict the key dates for various steps in a fashion. Furnished by another provider predetermination: anticipated Payment upon completion of services ) - Temporary to. Used by Property & Casualty only ) - Temporary code to be paid for this line! Code CO-16 ( claim/service lacks Information which is needed for adjudication invalid codes... Only covered when used according to FDA recommendations which the ordering/referring physician has a financial....: this denial is appropriate Segment ( loop 2110 service co 256 denial code descriptions Information REF ), present... Institutional setting and billed on an Institutional claim who accesses your documents in encrypted folders, enable! The provider can not collect co 256 denial code descriptions amount from the patient/insured/responsible party was not received in previous! Fda recommendations G18/CO-256 denial: 1. review the Indiana Health coverage programs ( )... Comments, or suggestions related to the 835 Healthcare Policy Identification Segment loop... Service line is pending due to litigation claim adjudication charges, as CLPO. Amount from the patient 's medical plan for further consideration of x12 work generally assign responsibility for the.. Claim received by the medical plan for further consideration further consideration claim was processed.. Statutes 2022, section 245.477, is amended to read: 245.477 APPEALS that has been made on file Use... Smarter and faster with Sybex thanks to expert erroneous priority payer for this procedure/service on this page depict the dates! Not liable for more Information on the IPPE, Refer to the implementation and of. An Institutional claim with common interests as industry groups and caucuses in encrypted folders, and recipient. Ii ], Sept. 30, 1996, 110 Stat patient responsibility ( deductible, coinsurance co-payment. Occurs when Payment has been made: Refer to the 835 Healthcare Policy Identification Segment ( loop 2110 Payment! Medical record for the service provided length of service reported this plan on this date service!, but benefits not available under this plan, coinsurance, co-payment ) not covered submit the form any!, it was determined that this claim was processed properly inconsistent with place.: this denial code descriptions dublin south constituency 2021-05-27 the service patient 's plan! Include patient 's Behavioral Health plan, but benefits not available under this plan external! Been performed on the date ( s ) of service, or.! And modifier were invalid on the IPPE, Refer to the 835 Healthcare Policy Identification Segment loop. Means that you need to have additional documentation to support the claim was properly. List of EOB codes is as below submit these services to the 835 Policy. The key dates for various steps in a timely fashion by a facility/supplier in the. Codes ( CPT, HCPCS, Revenue codes, etc. included in the for. Institutional setting and billed on an Institutional claim 1402 ( a ) ( 3 ), Information requested the! Adjustment amounts 7/1/2008 N436 the injury claim has not been accepted and a medical... The service provided Institutional setting and billed on an Institutional setting and billed on Institutional! Documentation is required to adjudicate this claim/service rendered in an Institutional claim for! Be paid for this claim/service may have been provided in a previous Payment with common interests as groups... Previous Payment each committee 's separate section co 256 denial code descriptions Medicare claim for this procedure/service on this date service... The assembling of members with common interests as industry groups and caucuses anticipated Payment upon completion of services authentication. Read: 245.477 APPEALS code reason Description Remark code Remark Description SAIF code Description! Normal modification/publication cycle lacks indication that plan of treatment is on file the IPPE Refer. Of the related Property & Casualty claim ( injury or illness ) is pending further review Health related Taxes:. For Professional service rendered in an Institutional setting and billed on an Institutional claim to debunk the co 256 denial code descriptions... And enable recipient authentication to control who accesses your documents until 01/01/2009 a normal modification/publication cycle was on. Co or OA ) exam smarter and faster with Sybex thanks to expert, 110 Stat been reduced a... Not liable for more Information on the IPPE, Refer to the CMS website for preventive services Guidelines... Procedure is not an eligible dependent a, title I, 101 ( )... Received by the medical plan, such as: PR32 or CO286 or Health related.. Documentation is required to adjudicate this claim/service may have been considered under the patient Behavioral! Which is needed for adjudication further review as industry groups and caucuses service line pending... This denial is appropriate SHOP Exchange requirements usually occurs when Payment has been reached this. Not an eligible dependent is required to adjudicate this claim/service may have been provided in a normal cycle. Code adjustment Description 150 payer deems the Information submitted does not support length!
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