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HIPAA CLAIM ADJUSTMENT REASON SEARCH:

 
Search by Hipaa Claim Adjustment Reason Code:
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You searched for : Hipaa Claim Adjustment Reason :

Code : 1
Description : Deductible Amount
Dates : Start: 01/01/1995
Code : 2
Description : Coinsurance Amount
Dates : Start: 01/01/1995
Code : 3
Description : Co-payment Amount
Dates : Start: 01/01/1995
Code : 4
Description : The procedure code is inconsistent with the modifier used or a required modifier is missing. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 5
Description : The procedure code/bill type is inconsistent with the place of service. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 6
Description : The procedure/revenue code is inconsistent with the patient's age. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 7
Description : The procedure/revenue code is inconsistent with the patient's gender. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 8
Description : The procedure code is inconsistent with the provider type/specialty (taxonomy). Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 9
Description : The diagnosis is inconsistent with the patient's age. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 10
Description : 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.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 11
Description : The diagnosis is inconsistent with the procedure. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 12
Description : The diagnosis is inconsistent with the provider type. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 13
Description : The date of death precedes the date of service.
Dates : Start: 01/01/1995
Code : 14
Description : The date of birth follows the date of service.
Dates : Start: 01/01/1995
Code : 15
Description : The authorization number is missing, invalid, or does not apply to the billed services or provider.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 16
Description : Claim/service lacks information which is needed for adjudication. 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.)
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 17
Description : Requested information was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code.)
Dates : Start: 01/01/1995 | Last Modified: 09/21/2008 | Stop: 07/01/2009
Code : 18
Description : Duplicate claim/service. This change effective 1/1/2013: Exact duplicate claim/service (Use with Group Code OA).
Dates : Start: 01/01/1995 | Last Modified: 10/02/2011
Code : 19
Description : This is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 20
Description : This injury/illness is covered by the liability carrier.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 21
Description : This injury/illness is the liability of the no-fault carrier.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 22
Description : This care may be covered by another payer per coordination of benefits.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 23
Description : The impact of prior payer(s) adjudication including payments and/or adjustments.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 24
Description : Charges are covered under a capitation agreement/managed care plan.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 25
Description : Payment denied. Your Stop loss deductible has not been met.
Dates : Start: 01/01/1995 | Stop: 04/01/2008
Code : 26
Description : Expenses incurred prior to coverage.
Dates : Start: 01/01/1995
Code : 27
Description : Expenses incurred after coverage terminated.
Dates : Start: 01/01/1995
Code : 28
Description : Coverage not in effect at the time the service was provided.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Redundant to codes 26&27.
Code : 29
Description : The time limit for filing has expired.
Dates : Start: 01/01/1995
Code : 30
Description : Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.
Dates : Start: 01/01/1995 | Stop: 02/01/2006
Code : 31
Description : Patient cannot be identified as our insured.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 32
Description : Our records indicate that this dependent is not an eligible dependent as defined.
Dates : Start: 01/01/1995
Code : 33
Description : Insured has no dependent coverage.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 34
Description : Insured has no coverage for newborns.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 35
Description : Lifetime benefit maximum has been reached.
Dates : Start: 01/01/1995 | Last Modified: 10/31/2002
Code : 36
Description : Balance does not exceed co-payment amount.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 37
Description : Balance does not exceed deductible.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 38
Description : Services not provided or authorized by designated (network/primary care) providers.
Dates : Start: 01/01/1995 | Last Modified: 06/30/2003 | Stop: 01/01/2013
Code : 39
Description : Services denied at the time authorization/pre-certification was requested.
Dates : Start: 01/01/1995
Code : 40
Description : Charges do not meet qualifications for emergent/urgent care. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 41
Description : Discount agreed to in Preferred Provider contract.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 42
Description : Charges exceed our fee schedule or maximum allowable amount. (Use CARC 45)
Dates : Start: 01/01/1995 | Last Modified: 10/31/2006 | Stop: 06/01/2007
Code : 43
Description : Gramm-Rudman reduction.
Dates : Start: 01/01/1995 | Stop: 07/01/2006
Code : 44
Description : Prompt-pay discount.
Dates : Start: 01/01/1995
Code : 45
Description : Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. (Use Group Codes PR or CO depending upon liability).
Dates : Start: 01/01/1995 | Last Modified: 10/31/2006
Code : 46
Description : This (these) service(s) is (are) not covered.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 96.
Code : 47
Description : This (these) diagnosis(es) is (are) not covered, missing, or are invalid.
Dates : Start: 01/01/1995 | Stop: 02/01/2006
Code : 48
Description : This (these) procedure(s) is (are) not covered.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 96.
Code : 49
Description : These are non-covered services because this is a routine exam or screening procedure done in conjunction with a routine exam. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 50
Description : These are non-covered services because this is not deemed a 'medical necessity' by the payer. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 51
Description : These are non-covered services because this is a pre-existing condition. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 52
Description : The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.
Dates : Start: 01/01/1995 | Stop: 02/01/2006
Code : 53
Description : Services by an immediate relative or a member of the same household are not covered.
Dates : Start: 01/01/1995
Code : 54
Description : Multiple physicians/assistants are not covered in this case. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 55
Description : Procedure/treatment is deemed experimental/investigational by the payer. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 56
Description : Procedure/treatment has not been deemed 'proven to be effective' by the payer. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 57
Description : 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.
Dates : Start: 01/01/1995 | Stop: 06/30/2007
Notes: Split into codes 150, 151, 152, 153 and 154.
Code : 58
Description : Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 59
Description : 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.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 60
Description : Charges for outpatient services are not covered when performed within a period of time prior to or after inpatient services.
Dates : Start: 01/01/1995 | Last Modified: 06/01/2008
Code : 61
Description : Penalty for failure to obtain second surgical opinion. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 62
Description : Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.
Dates : Start: 01/01/1995 | Last Modified: 10/31/2006 | Stop: 04/01/2007
Code : 63
Description : Correction to a prior claim.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 64
Description : Denial reversed per Medical Review.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 65
Description : Procedure code was incorrect. This payment reflects the correct code.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 66
Description : Blood Deductible.
Dates : Start: 01/01/1995
Code : 67
Description : Lifetime reserve days. (Handled in QTY, QTY01=LA)
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 68
Description : DRG weight. (Handled in CLP12)
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 69
Description : Day outlier amount.
Dates : Start: 01/01/1995
Code : 70
Description : Cost outlier - Adjustment to compensate for additional costs.
Dates : Start: 01/01/1995 | Last Modified: 06/30/2001
Code : 71
Description : Primary Payer amount.
Dates : Start: 01/01/1995 | Stop: 06/30/2000
Notes: Use code 23.
Code : 72
Description : Coinsurance day. (Handled in QTY, QTY01=CD)
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 73
Description : Administrative days.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 74
Description : Indirect Medical Education Adjustment.
Dates : Start: 01/01/1995
Code : 75
Description : Direct Medical Education Adjustment.
Dates : Start: 01/01/1995
Code : 76
Description : Disproportionate Share Adjustment.
Dates : Start: 01/01/1995
Code : 77
Description : Covered days. (Handled in QTY, QTY01=CA)
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 78
Description : Non-Covered days/Room charge adjustment.
Dates : Start: 01/01/1995
Code : 79
Description : Cost Report days. (Handled in MIA15)
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 80
Description : Outlier days. (Handled in QTY, QTY01=OU)
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 81
Description : Discharges.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 82
Description : PIP days.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 83
Description : Total visits.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 84
Description : Capital Adjustment. (Handled in MIA)
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 85
Description : Patient Interest Adjustment (Use Only Group code PR)
Dates : Start: 01/01/1995 | Last Modified: 07/09/2007
Notes: Only use when the payment of interest is the responsibility of the patient.
Code : 86
Description : Statutory Adjustment.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Duplicative of code 45.
Code : 87
Description : Transfer amount.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009 | Stop: 01/01/2012
Code : 88
Description : Adjustment amount represents collection against receivable created in prior overpayment.
Dates : Start: 01/01/1995 | Stop: 06/30/2007
Code : 89
Description : Professional fees removed from charges.
Dates : Start: 01/01/1995
Code : 90
Description : Ingredient cost adjustment. Note: To be used for pharmaceuticals only.
Dates : Start: 01/01/1995 | Last Modified: 07/01/2009
Code : 91
Description : Dispensing fee adjustment.
Dates : Start: 01/01/1995
Code : 92
Description : Claim Paid in full.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 93
Description : No Claim level Adjustments.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: As of 004010, CAS at the claim level is optional.
Code : 94
Description : Processed in Excess of charges.
Dates : Start: 01/01/1995
Code : 95
Description : Plan procedures not followed.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 96
Description : Non-covered charge(s). 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: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 97
Description : The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 98
Description : The hospital must file the Medicare claim for this inpatient non-physician service.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 99
Description : Medicare Secondary Payer Adjustment Amount.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : 100
Description : Payment made to patient/insured/responsible party/employer.
Dates : Start: 01/01/1995 | Last Modified: 01/27/2008
Code : 101
Description : Predetermination: anticipated payment upon completion of services or claim adjudication.
Dates : Start: 01/01/1995 | Last Modified: 02/28/1999
Code : 102
Description : Major Medical Adjustment.
Dates : Start: 01/01/1995
Code : 103
Description : Provider promotional discount (e.g., Senior citizen discount).
Dates : Start: 01/01/1995 | Last Modified: 06/30/2001
Code : 104
Description : Managed care withholding.
Dates : Start: 01/01/1995
Code : 105
Description : Tax withholding.
Dates : Start: 01/01/1995
Code : 106
Description : Patient payment option/election not in effect.
Dates : Start: 01/01/1995
Code : 107
Description : The related or qualifying claim/service was not identified on this claim. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 108
Description : Rent/purchase guidelines were not met. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 109
Description : Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor. This change effective 11/1/2012: Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.
Dates : Start: 01/01/1995 | Last Modified: 01/29/2012
Code : 110
Description : Billing date predates service date.
Dates : Start: 01/01/1995
Code : 111
Description : Not covered unless the provider accepts assignment.
Dates : Start: 01/01/1995
Code : 112
Description : Service not furnished directly to the patient and/or not documented.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 113
Description : Payment denied because service/procedure was provided outside the United States or as a result of war.
Dates : Start: 01/01/1995 | Last Modified: 02/28/2001 | Stop: 06/30/2007
Notes: Use Codes 157, 158 or 159.
Code : 114
Description : Procedure/product not approved by the Food and Drug Administration.
Dates : Start: 01/01/1995
Code : 115
Description : Procedure postponed, canceled, or delayed.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 116
Description : The advance indemnification notice signed by the patient did not comply with requirements.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 117
Description : Transportation is only covered to the closest facility that can provide the necessary care.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 118
Description : ESRD network support adjustment.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 119
Description : Benefit maximum for this time period or occurrence has been reached.
Dates : Start: 01/01/1995 | Last Modified: 02/29/2004
Code : 120
Description : Patient is covered by a managed care plan.
Dates : Start: 01/01/1995 | Stop: 06/30/2007
Notes: Use code 24.
Code : 121
Description : Indemnification adjustment - compensation for outstanding member responsibility.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : 122
Description : Psychiatric reduction.
Dates : Start: 01/01/1995
Code : 123
Description : Payer refund due to overpayment.
Dates : Start: 01/01/1995 | Stop: 06/30/2007
Notes: Refer to implementation guide for proper handling of reversals.
Code : 124
Description : Payer refund amount - not our patient.
Dates : Start: 01/01/1995 | Last Modified: 06/30/1999 | Stop: 06/30/2007
Notes: Refer to implementation guide for proper handling of reversals.
Code : 125
Description : Submission/billing error(s). 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.)
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : 126
Description : Deductible -- Major Medical
Dates : Start: 02/28/1997 | Last Modified: 09/30/2007 | Stop: 04/01/2008
Notes: Use Group Code PR and code 1.
Code : 127
Description : Coinsurance -- Major Medical
Dates : Start: 02/28/1997 | Last Modified: 09/30/2007 | Stop: 04/01/2008
Notes: Use Group Code PR and code 2.
Code : 128
Description : Newborn's services are covered in the mother's Allowance.
Dates : Start: 02/28/1997
Code : 129
Description : Prior processing information appears incorrect. 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.)
Dates : Start: 02/28/1997 | Last Modified: 01/30/2011
Code : 130
Description : Claim submission fee.
Dates : Start: 02/28/1997 | Last Modified: 06/30/2001
Code : 131
Description : Claim specific negotiated discount.
Dates : Start: 02/28/1997
Code : 132
Description : Prearranged demonstration project adjustment.
Dates : Start: 02/28/1997
Code : 133
Description : The disposition of the claim/service is pending further review. This change effective 1/1/2013: The disposition of the claim/service is pending further review. Use Group Code OA.
Dates : Start: 02/28/1997 | Last Modified: 06/03/2012
Code : 134
Description : Technical fees removed from charges.
Dates : Start: 10/31/1998
Code : 135
Description : Interim bills cannot be processed.
Dates : Start: 10/31/1998 | Last Modified: 09/30/2007
Code : 136
Description : Failure to follow prior payer's coverage rules. (Use Group Code OA).
Dates : Start: 10/31/1998 | Last Modified: 09/30/2007
Code : 137
Description : Regulatory Surcharges, Assessments, Allowances or Health Related Taxes.
Dates : Start: 02/28/1999 | Last Modified: 09/30/2007
Code : 138
Description : Appeal procedures not followed or time limits not met.
Dates : Start: 06/30/1999 | Last Modified: 09/30/2007
Code : 139
Description : Contracted funding agreement - Subscriber is employed by the provider of services.
Dates : Start: 06/30/1999
Code : 140
Description : Patient/Insured health identification number and name do not match.
Dates : Start: 06/30/1999
Code : 141
Description : Claim spans eligible and ineligible periods of coverage.
Dates : Start: 06/30/1999 | Last Modified: 09/30/2007 | Stop: 07/01/2012
Code : 142
Description : Monthly Medicaid patient liability amount.
Dates : Start: 06/30/2000 | Last Modified: 09/30/2007
Code : 143
Description : Portion of payment deferred.
Dates : Start: 02/28/2001
Code : 144
Description : Incentive adjustment, e.g. preferred product/service.
Dates : Start: 06/30/2001
Code : 145
Description : Premium payment withholding
Dates : Start: 06/30/2002 | Last Modified: 09/30/2007 | Stop: 04/01/2008
Notes: Use Group Code CO and code 45.
Code : 146
Description : Diagnosis was invalid for the date(s) of service reported.
Dates : Start: 06/30/2002 | Last Modified: 09/30/2007
Code : 147
Description : Provider contracted/negotiated rate expired or not on file.
Dates : Start: 06/30/2002
Code : 148
Description : Information from another provider was not provided or was insufficient/incomplete. 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.)
Dates : Start: 06/30/2002 | Last Modified: 09/20/2009
Code : 149
Description : Lifetime benefit maximum has been reached for this service/benefit category.
Dates : Start: 10/31/2002
Code : 150
Description : Payer deems the information submitted does not support this level of service.
Dates : Start: 10/31/2002 | Last Modified: 09/30/2007
Code : 151
Description : Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.
Dates : Start: 10/31/2002 | Last Modified: 01/27/2008
Code : 152
Description : Payer deems the information submitted does not support this length of service. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 10/31/2002 | Last Modified: 09/20/2009
Code : 153
Description : Payer deems the information submitted does not support this dosage.
Dates : Start: 10/31/2002 | Last Modified: 09/30/2007
Code : 154
Description : Payer deems the information submitted does not support this day's supply.
Dates : Start: 10/31/2002 | Last Modified: 09/30/2007
Code : 155
Description : Patient refused the service/procedure.
Dates : Start: 06/30/2003 | Last Modified: 09/30/2007
Code : 156
Description : Flexible spending account payments. Note: Use code 187.
Dates : Start: 09/30/2003 | Last Modified: 01/25/2009 | Stop: 10/01/2009
Code : 157
Description : Service/procedure was provided as a result of an act of war.
Dates : Start: 09/30/2003 | Last Modified: 09/30/2007
Code : 158
Description : Service/procedure was provided outside of the United States.
Dates : Start: 09/30/2003 | Last Modified: 09/30/2007
Code : 159
Description : Service/procedure was provided as a result of terrorism.
Dates : Start: 09/30/2003 | Last Modified: 09/30/2007
Code : 160
Description : Injury/illness was the result of an activity that is a benefit exclusion.
Dates : Start: 09/30/2003 | Last Modified: 09/30/2007
Code : 161
Description : Provider performance bonus
Dates : Start: 02/29/2004
Code : 162
Description : State-mandated Requirement for Property and Casualty, see Claim Payment Remarks Code for specific explanation.
Dates : Start: 02/29/2004
Code : 163
Description : Attachment referenced on the claim was not received.
Dates : Start: 06/30/2004 | Last Modified: 09/30/2007
Code : 164
Description : Attachment referenced on the claim was not received in a timely fashion.
Dates : Start: 06/30/2004 | Last Modified: 09/30/2007
Code : 165
Description : Referral absent or exceeded.
Dates : Start: 10/31/2004 | Last Modified: 09/30/2007
Code : 166
Description : These services were submitted after this payers responsibility for processing claims under this plan ended.
Dates : Start: 02/28/2005
Code : 167
Description : This (these) diagnosis(es) is (are) not covered. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 06/30/2005 | Last Modified: 09/20/2009
Code : 168
Description : Service(s) have been considered under the patient's medical plan. Benefits are not available under this dental plan.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 169
Description : Alternate benefit has been provided.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 170
Description : 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.
Dates : Start: 06/30/2005 | Last Modified: 09/20/2009
Code : 171
Description : 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.
Dates : Start: 06/30/2005 | Last Modified: 09/20/2009
Code : 172
Description : Payment is adjusted when performed/billed by a provider of this specialty. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 06/30/2005 | Last Modified: 09/20/2009
Code : 173
Description : Service was not prescribed by a physician.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 174
Description : Service was not prescribed prior to delivery.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 175
Description : Prescription is incomplete.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 176
Description : Prescription is not current.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 177
Description : Patient has not met the required eligibility requirements.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 178
Description : Patient has not met the required spend down requirements.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 179
Description : Patient has not met the required waiting requirements. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 06/30/2005 | Last Modified: 09/20/2009
Code : 180
Description : Patient has not met the required residency requirements.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 181
Description : Procedure code was invalid on the date of service.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 182
Description : Procedure modifier was invalid on the date of service.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 183
Description : The referring provider is not eligible to refer the service billed. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 06/30/2005 | Last Modified: 09/20/2009
Code : 184
Description : The prescribing/ordering provider is not eligible to prescribe/order the service billed. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 06/30/2005 | Last Modified: 09/20/2009
Code : 185
Description : The rendering provider is not eligible to perform the service billed. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 06/30/2005 | Last Modified: 09/20/2009
Code : 186
Description : Level of care change adjustment.
Dates : Start: 06/30/2005 | Last Modified: 09/30/2007
Code : 187
Description : Consumer Spending Account payments (includes but is not limited to Flexible Spending Account, Health Savings Account, Health Reimbursement Account, etc.)
Dates : Start: 06/30/2005 | Last Modified: 01/25/2009
Code : 188
Description : This product/procedure is only covered when used according to FDA recommendations.
Dates : Start: 06/30/2005
Code : 189
Description : 'Not otherwise classified' or 'unlisted' procedure code (CPT/HCPCS) was billed when there is a specific procedure code for this procedure/service
Dates : Start: 06/30/2005
Code : 190
Description : Payment is included in the allowance for a Skilled Nursing Facility (SNF) qualified stay.
Dates : Start: 10/31/2005
Code : 191
Description : Not a work related injury/illness and thus not the liability of the workers' compensation carrier 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. 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)
Dates : Start: 10/31/2005 | Last Modified: 10/17/2010
Code : 192
Description : Non standard adjustment code from paper remittance. Note: This code is to be used by providers/payers providing Coordination of Benefits information to another payer in the 837 transaction only. 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.
Dates : Start: 10/31/2005 | Last Modified: 09/30/2007
Code : 193
Description : Original payment decision is being maintained. Upon review, it was determined that this claim was processed properly.
Dates : Start: 02/28/2006 | Last Modified: 01/27/2008
Code : 194
Description : Anesthesia performed by the operating physician, the assistant surgeon or the attending physician.
Dates : Start: 02/28/2006 | Last Modified: 09/30/2007
Code : 195
Description : Refund issued to an erroneous priority payer for this claim/service.
Dates : Start: 02/28/2006 | Last Modified: 09/30/2007
Code : 196
Description : Claim/service denied based on prior payer's coverage determination.
Dates : Start: 06/30/2006 | Stop: 02/01/2007
Notes: Use code 136.
Code : 197
Description : Precertification/authorization/notification absent.
Dates : Start: 10/31/2006 | Last Modified: 09/30/2007
Code : 198
Description : Precertification/authorization exceeded.
Dates : Start: 10/31/2006 | Last Modified: 09/30/2007
Code : 199
Description : Revenue code and Procedure code do not match.
Dates : Start: 10/31/2006
Code : 200
Description : Expenses incurred during lapse in coverage
Dates : Start: 10/31/2006
Code : 201
Description : Workers Compensation case settled. Patient is responsible for amount of this claim/service through WC 'Medicare set aside arrangement' or other agreement. (Use group code PR).
Dates : Start: 10/31/2006
Code : 202
Description : Non-covered personal comfort or convenience services.
Dates : Start: 02/28/2007 | Last Modified: 09/30/2007
Code : 203
Description : Discontinued or reduced service.
Dates : Start: 02/28/2007 | Last Modified: 09/30/2007
Code : 204
Description : This service/equipment/drug is not covered under the patient's current benefit plan
Dates : Start: 02/28/2007
Code : 205
Description : Pharmacy discount card processing fee
Dates : Start: 07/09/2007
Code : 206
Description : National Provider Identifier - missing.
Dates : Start: 07/09/2007 | Last Modified: 09/30/2007
Code : 207
Description : National Provider identifier - Invalid format
Dates : Start: 07/09/2007 | Last Modified: 06/01/2008
Code : 208
Description : National Provider Identifier - Not matched.
Dates : Start: 07/09/2007 | Last Modified: 09/30/2007
Code : 209
Description : Per regulatory or other agreement. The provider cannot collect this amount from the patient. However, this amount may be billed to subsequent payer. Refund to patient if collected. (Use Group code OA)
Dates : Start: 07/09/2007
Code : 210
Description : Payment adjusted because pre-certification/authorization not received in a timely fashion
Dates : Start: 07/09/2007
Code : 211
Description : National Drug Codes (NDC) not eligible for rebate, are not covered.
Dates : Start: 07/09/2007
Code : 212
Description : Administrative surcharges are not covered
Dates : Start: 11/05/2007
Code : 213
Description : Non-compliance with the physician self referral prohibition legislation or payer policy.
Dates : Start: 01/27/2008
Code : 214
Description : Workers' Compensation claim adjudicated as non-compensable. This Payer not liable for claim or service/treatment. 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. 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). To be used for Workers' Compensation only
Dates : Start: 01/27/2008 | Last Modified: 10/17/2010
Code : 215
Description : Based on subrogation of a third party settlement
Dates : Start: 01/27/2008
Code : 216
Description : Based on the findings of a review organization
Dates : Start: 01/27/2008
Code : 217
Description : Based on payer reasonable and customary fees. No maximum allowable defined by legislated fee arrangement. (Note: To be used for Workers' Compensation only)
Dates : Start: 01/27/2008
Code : 218
Description : Based on entitlement to benefits. 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. 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). To be used for Workers' Compensation only
Dates : Start: 01/27/2008 | Last Modified: 10/17/2010
Code : 219
Description : Based on extent of injury. 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. 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).
Dates : Start: 01/27/2008 | Last Modified: 10/17/2010
Code : 220
Description : The applicable fee schedule does not contain the billed code. Please resubmit a bill with the appropriate fee schedule code(s) that best describe the service(s) provided and supporting documentation if required. (Note: To be used for Workers' Compensation only)
Dates : Start: 01/27/2008
Code : 221
Description : Workers' Compensation claim is under investigation. 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. 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).
Dates : Start: 01/27/2008 | Last Modified: 10/17/2010
Code : 222
Description : Exceeds the contracted maximum number of hours/days/units by this provider for this period. This is not patient specific. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 06/01/2008 | Last Modified: 09/20/2009
Code : 223
Description : 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.
Dates : Start: 06/01/2008
Code : 224
Description : Patient identification compromised by identity theft. Identity verification required for processing this and future claims.
Dates : Start: 06/01/2008
Code : 225
Description : Penalty or Interest Payment by Payer (Only used for plan to plan encounter reporting within the 837)
Dates : Start: 06/01/2008
Code : 226
Description : Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete. 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.)
Dates : Start: 09/21/2008 | Last Modified: 09/20/2009
Code : 227
Description : Information requested from the patient/insured/responsible party was not provided or was insufficient/incomplete. 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.)
Dates : Start: 09/21/2008 | Last Modified: 09/20/2009
Code : 228
Description : Denied for failure of this provider, another provider or the subscriber to supply requested information to a previous payer for their adjudication
Dates : Start: 09/21/2008
Code : 229
Description : Partial charge amount not considered by Medicare due to the initial claim Type of Bill being 12X. Note: This code can only be used in the 837 transaction to convey Coordination of Benefits information when the secondary payer's cost avoidance policy allows providers to bypass claim submission to a prior payer. Use Group Code PR.
Dates : Start: 01/25/2009
Code : 230
Description : No available or correlating CPT/HCPCS code to describe this service. Note: Used only by Property and Casualty.
Dates : Start: 01/25/2009
Code : 231
Description : Mutually exclusive procedures cannot be done in the same day/setting. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 07/01/2009 | Last Modified: 09/20/2009
Code : 232
Description : Institutional Transfer Amount. Note - Applies to institutional claims only and explains the DRG amount difference when the patient care crosses multiple institutions.
Dates : Start: 11/01/2009
Code : 233
Description : Services/charges related to the treatment of a hospital-acquired condition or preventable medical error.
Dates : Start: 01/24/2010
Code : 234
Description : This procedure is not paid separately. 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.)
Dates : Start: 01/24/2010
Code : 235
Description : Sales Tax
Dates : Start: 06/06/2010
Code : 236
Description : 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.
Dates : Start: 01/30/2011
Code : 237
Description : Legislated/Regulatory Penalty. 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.)
Dates : Start: 06/05/2011
Code : 238
Description : Claim spans eligible and ineligible periods of coverage, this is the reduction for the ineligible period (use Group Code PR).
Dates : Start: 03/01/2012
Code : 239
Description : Claim spans eligible and ineligible periods of coverage. Rebill separate claims (use Group Code OA). This change effective 11/1/2012: Claim spans eligible and ineligible periods of coverage. Rebill separate claims.
Dates : Start: 03/01/2012 | Last Modified: 01/29/2012
Code : 240
Description : The diagnosis is inconsistent with the patient's birth weight. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 06/03/2012
Code : 241
Description : Low Income Subsidy (LIS) Co-payment Amount
Dates : Start: 06/03/2012
Code : 242
Description : Services not provided by network/primary care providers.
Dates : Start: 06/03/2012
Code : 243
Description : Services not authorized by network/primary care providers.
Dates : Start: 06/03/2012
Code : A0
Description : Patient refund amount.
Dates : Start: 01/01/1995
Code : A1
Description : Claim/Service denied. 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.)
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : A2
Description : Contractual adjustment.
Dates : Start: 01/01/1995 | Last Modified: 02/28/2007 | Stop: 01/01/2008
Notes: Use Code 45 with Group Code 'CO' or use another appropriate specific adjustment code.
Code : A3
Description : Medicare Secondary Payer liability met.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : A4
Description : Medicare Claim PPS Capital Day Outlier Amount.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007 | Stop: 04/01/2008
Code : A5
Description : Medicare Claim PPS Capital Cost Outlier Amount.
Dates : Start: 01/01/1995
Code : A6
Description : Prior hospitalization or 30 day transfer requirement not met.
Dates : Start: 01/01/1995
Code : A7
Description : Presumptive Payment Adjustment
Dates : Start: 01/01/1995
Code : A8
Description : Ungroupable DRG.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : B1
Description : Non-covered visits.
Dates : Start: 01/01/1995
Code : B2
Description : Covered visits.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : B3
Description : Covered charges.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : B4
Description : Late filing penalty.
Dates : Start: 01/01/1995
Code : B5
Description : Coverage/program guidelines were not met or were exceeded.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : B6
Description : 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.
Dates : Start: 01/01/1995 | Stop: 02/01/2006
Code : B7
Description : This provider was not certified/eligible to be paid for this procedure/service on this date of service. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : B8
Description : Alternative services were available, and should have been utilized. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : B9
Description : Patient is enrolled in a Hospice.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : B10
Description : Allowed amount has been reduced because a component of the basic procedure/test was paid. The beneficiary is not liable for more than the charge limit for the basic procedure/test.
Dates : Start: 01/01/1995
Code : B11
Description : The claim/service has been transferred to the proper payer/processor for processing. Claim/service not covered by this payer/processor.
Dates : Start: 01/01/1995
Code : B12
Description : Services not documented in patients' medical records.
Dates : Start: 01/01/1995
Code : B13
Description : Previously paid. Payment for this claim/service may have been provided in a previous payment.
Dates : Start: 01/01/1995
Code : B14
Description : Only one visit or consultation per physician per day is covered.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : B15
Description : This service/procedure requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Dates : Start: 01/01/1995 | Last Modified: 09/20/2009
Code : B16
Description : 'New Patient' qualifications were not met.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : B17
Description : Payment adjusted because this service was not prescribed by a physician, not prescribed prior to delivery, the prescription is incomplete, or the prescription is not current.
Dates : Start: 01/01/1995 | Stop: 02/01/2006
Code : B18
Description : This procedure code and modifier were invalid on the date of service.
Dates : Start: 01/01/1995 | Last Modified: 09/21/2008 | Stop: 03/01/2009
Code : B19
Description : Claim/service adjusted because of the finding of a Review Organization.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : B20
Description : Procedure/service was partially or fully furnished by another provider.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : B21
Description : The charges were reduced because the service/care was partially furnished by another physician.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Code : B22
Description : This payment is adjusted based on the diagnosis.
Dates : Start: 01/01/1995 | Last Modified: 02/28/2001
Code : B23
Description : Procedure billed is not authorized per your Clinical Laboratory Improvement Amendment (CLIA) proficiency test.
Dates : Start: 01/01/1995 | Last Modified: 09/30/2007
Code : D1
Description : Claim/service denied. Level of subluxation is missing or inadequate.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 16 and remark codes if necessary.
Code : D2
Description : Claim lacks the name, strength, or dosage of the drug furnished.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 16 and remark codes if necessary.
Code : D3
Description : Claim/service denied because information to indicate if the patient owns the equipment that requires the part or supply was missing.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 16 and remark codes if necessary.
Code : D4
Description : Claim/service does not indicate the period of time for which this will be needed.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 16 and remark codes if necessary.
Code : D5
Description : Claim/service denied. Claim lacks individual lab codes included in the test.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 16 and remark codes if necessary.
Code : D6
Description : Claim/service denied. Claim did not include patient's medical record for the service.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 16 and remark codes if necessary.
Code : D7
Description : Claim/service denied. Claim lacks date of patient's most recent physician visit.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 16 and remark codes if necessary.
Code : D8
Description : Claim/service denied. Claim lacks indicator that 'x-ray is available for review.'
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 16 and remark codes if necessary.
Code : D9
Description : Claim/service denied. Claim lacks invoice or statement certifying the actual cost of the lens, less discounts or the type of intraocular lens used.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 16 and remark codes if necessary.
Code : D10
Description : Claim/service denied. Completed physician financial relationship form not on file.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 17.
Code : D11
Description : Claim lacks completed pacemaker registration form.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 17.
Code : D12
Description : Claim/service denied. Claim does not identify who performed the purchased diagnostic test or the amount you were charged for the test.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 17.
Code : D13
Description : Claim/service denied. Performed by a facility/supplier in which the ordering/referring physician has a financial interest.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 17.
Code : D14
Description : Claim lacks indication that plan of treatment is on file.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 17.
Code : D15
Description : Claim lacks indication that service was supervised or evaluated by a physician.
Dates : Start: 01/01/1995 | Stop: 10/16/2003
Notes: Use code 17.
Code : D16
Description : Claim lacks prior payer payment information.
Dates : Start: 01/01/1995 | Stop: 06/30/2007
Notes: Use code 16 with appropriate claim payment remark code [N4].
Code : D17
Description : Claim/Service has invalid non-covered days.
Dates : Start: 01/01/1995 | Stop: 06/30/2007
Notes: Use code 16 with appropriate claim payment remark code.
Code : D18
Description : Claim/Service has missing diagnosis information.
Dates : Start: 01/01/1995 | Stop: 06/30/2007
Notes: Use code 16 with appropriate claim payment remark code.
Code : D19
Description : Claim/Service lacks Physician/Operative or other supporting documentation
Dates : Start: 01/01/1995 | Stop: 06/30/2007
Notes: Use code 16 with appropriate claim payment remark code.
Code : D20
Description : Claim/Service missing service/product information.
Dates : Start: 01/01/1995 | Stop: 06/30/2007
Notes: Use code 16 with appropriate claim payment remark code.
Code : D21
Description : This (these) diagnosis(es) is (are) missing or are invalid
Dates : Start: 01/01/1995 | Stop: 06/30/2007
Code : D22
Description : Reimbursement was adjusted for the reasons to be provided in separate correspondence. (Note: To be used for Workers' Compensation only) - Temporary code to be added for timeframe only until 01/01/2009. Another code to be established and/or for 06/2008 meeting for a revised code to replace or strategy to use another existing code
Dates : Start: 01/27/2008 | Stop: 01/01/2009
Code : D23
Description : This dual eligible patient is covered by Medicare Part D per Medicare Retro-Eligibility. 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.)
Dates : Start: 11/01/2009 | Stop: 01/01/2012
Code : W1
Description : Workers' compensation jurisdictional fee schedule adjustment. Note: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Class of Contract Code Identification Segment (Loop 2100 Other Claim Related Information REF). 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).
Dates : Start: 02/29/2000 | Last Modified: 10/17/2010
Code : W2
Description : Payment reduced or denied based on workers' compensation jurisdictional regulations or payment policies, use only if no other code is applicable. 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. 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). To be used for Workers' Compensation only.
Dates : Start: 10/17/2010


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16 Account Coordinator - Ad Sales Honolulu, HI, USA Spectrum Reach is currently searching for a dynamic Account Coordinator to support our Ad Sales team in Honolulu, HI. Spectrum Reach (www.spectrumreach.com) grows businesses of all sizes with custom ...... Apply Now>>

17 Customer Service Representative Lake Oswego, United States Description: Immediately hiring for Customer Service Representatives in Portland! Continuum Global Solutions is a leading customer care provider. Our clients are brand name Fortune 500 companies ...... Apply Now>>

18 Sales Representative University Place, WA, USA Are you looking to reinvigorate your career and regain work/life balance? Whether your career is just getting started or you are looking to change professions, Bankers Life offers continuous support ...... Apply Now>>

19 Entry Level Sales University Place, WA, USA Bankers Life is recruiting, intelligent and passionate professionals to meet the needs of our exploding market where 10,000 Baby Boomers turn 65 every day. Our successful agents are motivated to make ...... Apply Now>>

20 Customer Service/Operations Representative us About SEKO Logistics: As a customer-centric organization with over 120 offices in 40 countries, we are powered by the expertise of our people and our in-house developed, best in class, customizable ...... Apply Now>>

21 Strategic Account Manager, Healthcare - Spectrum Enterprise Cerritos, CA, USA At a glance: * Are you a motivated client-focused sales expert familiar with the needs of healthcare organizations? * Can you commit to a consultative sales position growing existing accounts by ...... Apply Now>>

22 Delivery Service Representative Milton, WA, USA id0:portId:jid72jid0:portId:jid72 00NF000000CFqt6 div" class="sfdc_richtext"> Warehouse Team Member (Seasonal, Part-Time, Flexible Hours) Shifts: Over-night, Early Morning, Day, Evening, Weekend ...... Apply Now>>

23 CDL-A Dedicated Team Driver Job: Tracy, California Fort Bragg, United States TRACY TEAMS OR SOLOS THAT WANT TO TEAM!Teams for Immediate Seating or we will find you a Team Partner$12K sign on bonus for each driver paid out $1,000.00 per month5000 mile weekly average$1500.00 ...... Apply Now>>

24 MERCHANDISING Tumwater, United States Merchandising Execution Associates: All Merchandising Execution Associates (MEAs) perform in-store merchandising service activities such as merchandising projects, planogram maintenance, overhead ...... Apply Now>>

25 Client Service Associate - Registered/Licensed Preferred Burlingame, CA, USA About the Role We are an established Investment and Financial Planning firm serving the Bay Area for the past 37 years. We cater to pre and post retirees helping them manage and maintain their assets ...... Apply Now>>

26 Sales Account Executive Maple Grove, MN, USA Join One of the Fastest Growing Privately Held Media Companies in North America. We Are Recognized Year After Year for our Outstanding Growth, Positive Culture and Opportunity. * Rated 2019 Best ...... Apply Now>>

27 Customer Service Associate Honolulu, United States Position Purpose: Customer Service/Sales associates provide fast, friendly service by actively seeking out customers to assess their needs and provide assistance. These associates learn about ...... Apply Now>>

28 Named Account Executive Lansing, United States Konica Minolta Business Solutions U.S.A., Inc., a global Fortune 1000 company and one of Forbes 2017 America's Best Large Employers, is transforming the way we all do business. From smart office ...... Apply Now>>

29 CDL-A Dedicated Team Driver Job: Portland, OR Mountlake Terrace, United States PORTLAND TEAMS OR SOLOS THAT WANT TO TEAM!Teams for Immediate Seating or we will find you a Team Partner$12K sign on bonus for each driver paid out $1,000.00 per month5,000 mile weekly average$1,500 ...... Apply Now>>

30 Call Center Manager Las Vegas, NV, USA Consumer Attorney Marketing Group (CAMG), an advertising agency that combines media buying expertise, industry experience and intensive analytics to deliver the most effective TV & radio campaigns ...... Apply Now>>

31 CDL-A Dedicated Flat Bed Drivers needed - WEEKLY or DAILY home-time depending on location! Morgantown, KY, USA Dedicated Flatbed Needed - Home on WEEKENDS or DAILY depending on home location! CT delivers the flexibility, pay and benefits you need to make your job a balanced, satisfying part of your life! This ...... Apply Now>>

32 CDL - A Hazmat, Tanker & TWIC Drivers Needed - Angleton, TX - Local - CTL! Angleton, TX, USA New Grads and Experienced Class A CDL Drivers Needed w/Hazmat, Tanker & TWIC (Reimbursement provided for Hazmat and TWIC) CTL delivers the flexibility, pay and benefits you need to make your job a ...... Apply Now>>

33 Class A Delivery Driver Clackamas, United States Class A Delivery Driver FULL-TIME $22/hr Duties include driving company truck to deliver produce to customers. Assisting warehouse in storing incoming produce, returning produce to coolers, fueling ...... Apply Now>>

34 CDL-A Dedicated Truck Driver - DSH Louisville KY Trenton, USA Dedicated/supply chain drivers enjoy the many privileges that come with having consistent customers. Unlike some driver positions, this one gives you a better idea of the number of miles and hours ...... Apply Now>>

35 Outside Sales Consultant Tacoma, WA, USA Can you make $100K in your first year? Absolutely. You can also make zero. You just have to go to work and be awesome. Full-time is 40-50 hours a week. We help with appointment scheduling. Stick to ...... Apply Now>>

36 Outside Sales Representative Outside Sales - Interviewing Experienced and Entry Level If you're exploring sales careers, you already know sales is the way to get ahead. You can sell just about anywhere, but the key is knowing ...... Apply Now>>

37 Customer Service Representative Bellevue, WA, USA Hours: Monday-Friday 8:30 a.m. to 5:15 p.m. We are Farmers! Join a team of diverse professionals at Farmers to acquire skills on the job and apply your learned knowledge to future roles at Farmers... Apply Now>>

38 Driver - Dedicated Truck Driver - Dollar General - Class A CDL San Francisco, CA, USA This Dedicated truck driver position on the Dollar General account features earnings up to $0.39 per mile* with a weekly performance pay up to $0.04 per mile, weekly time at home and a predictable ...... Apply Now>>

39 Roadside Technician - Side Gig San Mateo, CA, USA Description: Be your own boss and help stranded drivers in need as a Roadside Rescuer for Allstate's Good Hands Rescue Network (GHRN)! The Good Hands Rescue Network is the world's first fully ...... Apply Now>>

40 Member Services Associate Long Beach, California, USA We are actively seeking to hire a Member Services Advocate to serve members by being an advocate and point of contact for member questions and concerns regarding benefits, eligibility, referrals ...... Apply Now>>

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