Medical Yellow Pages Health Care Search

Doctors, Nursing Homes, Home Health, Hospitals, Dialysis

Medicare, Laboratory (CLIA), Drug (NDC) & Billing Codes

download all data from this site    follow us on twitter    be our friend on facebook



REASON SEARCH:

 
Search by Reason Code:
Search by keyword / description :

Reason Codes


Reason codes appear on an explanation of benefits (EOB) to communicate why a claim has been adjusted. If there is no adjustment to a claim/line, then there is no adjustment reason code.

The letters preceding the number codes identify: Contractual Obligation (CO), Correction or reversal to a prior decision (CR), and Patient Responsibility (PR).

Thanks to Janice Humphries of Medical Billing Guide, author of How To Do Medical Billing

You searched for : Reason :

Code : CO10
Description : The diagnosis is inconsistent with the patient's gender.
Code : CO100
Description : Payment made to patient/insured/responsible party.
Code : CO101
Description : Predetermination: anticipated payment upon completion of services or claim adjudication.
Code : CO102
Description : Major Medical Adjustment.
Code : CO103
Description : Provider promotional discount (e.g., Senior citizen discount).
Code : CO104
Description : Managed care withholding.
Code : CO105
Description : Tax withholding.
Code : CO106
Description : Patient payment option/election not in effect.
Code : CO107
Description : Claim/service denied because the related or qualifying claim/service was not previously paid or identified on this claim.
Code : CO108
Description : Payment adjusted because rent/purchase guidelines were not met.
Code : CO109
Description : Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.
Code : CO11
Description : The diagnosis is inconsistent with the procedure.
Code : CO110
Description : Billing date predates service date.
Code : CO111
Description : Not covered unless the provider accepts assignment.
Code : CO112
Description : Payment adjusted as not furnished directly to the patient and/or not documented.
Code : CO113
Description : Payment denied because service/procedure was provided outside the United States or as a result of war.
Code : CO114
Description : Procedure/product not approved by the Food and Drug Administration.
Code : CO115
Description : Payment adjusted as procedure postponed or canceled.
Code : CO116
Description : Payment denied. The advance indemnification notice signed by the patient did not comply with requirements.
Code : CO117
Description : Payment adjusted because transportation is only covered to the closest facility that can provide the necessary care.
Code : CO118
Description : Charges reduced for ESRD network support.
Code : CO119
Description : Benefit maximum for this time period has been reached.
Code : CO12
Description : The diagnosis is inconsistent with the provider type.
Code : CO120
Description : Patient is covered by a managed care plan.
Code : CO121
Description : Indemnification adjustment.
Code : CO122
Description : Psychiatric reduction.
Code : CO123
Description : Payer refund due to overpayment.
Code : CO124
Description : Payer refund amount - not our patient.
Code : CO125
Description : Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.
Code : CO126
Description : Deductible -- Major Medical
Code : CO127
Description : Coinsurance -- Major Medical
Code : CO128
Description : Newborn's services are covered in the mother's Allowance.
Code : CO129
Description : Payment denied - Prior processing information appears incorrect.
Code : CO13
Description : The date of death precedes the date of service.
Code : CO130
Description : Claim submission fee.
Code : CO131
Description : Claim specific negotiated discount.
Code : CO132
Description : Prearranged demonstration project adjustment.
Code : CO133
Description : The disposition of this claim/service is pending further review.
Code : CO134
Description : Technical fees removed from charges.
Code : CO135
Description : Claim denied. Interim bills cannot be processed.
Code : CO136
Description : Claim Adjusted. Plan procedures of a prior payer were not followed.
Code : CO137
Description : Payment/Reduction for Regulatory Surcharges, Assessments, Allowances or Health Related Taxes.
Code : CO138
Description : Claim/service denied. Appeal procedures not followed or time limits not met.
Code : CO139
Description : Contracted funding agreement - Subscriber is employed by the provider of services.
Code : CO14
Description : The date of birth follows the date of service.
Code : CO140
Description : Patient/Insured health identification number and name do not match.
Code : CO141
Description : Claim adjustment because the claim spans eligible and ineligible periods of coverage.
Code : CO142
Description : Claim adjusted by the monthly Medicaid patient liability amount.
Code : CO143
Description : Portion of payment deferred.
Code : CO144
Description : Incentive adjustment, e.g. preferred product/service.
Code : CO145
Description : Premium payment withholding
Code : CO146
Description : Payment denied because the diagnosis was invalid for the date(s) of service reported.
Code : CO147
Description : Provider contracted/negotiated rate expired or not on file.
Code : CO148
Description : Claim/service rejected at this time because information from another provider was not provided or was insufficient/incomplete.
Code : CO149
Description : Lifetime benefit maximum has been reached for this service/benefit category.
Code : CO15
Description : Payment adjusted because the submitted authorization number is missing, invalid, or does not apply to the billed services or provider.
Code : CO150
Description : Payment adjusted because the payer deems the information submitted does not support this level of service.
Code : CO151
Description : Payment adjusted because the payer deems the information submitted does not support this many services.
Code : CO152
Description : Payment adjusted because the payer deems the information submitted does not support this length of service.
Code : CO153
Description : Payment adjusted because the payer deems the information submitted does not support this dosage.
Code : CO154
Description : Payment adjusted because the payer deems the information submitted does not support this day's supply.
Code : CO155
Description : This claim is denied because the patient refused the service/procedure.
Code : CO16
Description : Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate.
Code : CO165
Description : Payment denied/reduced for absence of, or exceeded, referral.
Code : CO167
Description : This (these) diagnosis (es) is (are) not covered.
Code : CO169
Description : Payment adjusted because an alternate benefit has been provided.
Code : CO17
Description : Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever appropriate.
Code : CO170
Description : Payment denied when performed/billed by this type of provider.
Code : CO171
Description : Payment denied when performed/billed by this type of provider in this type of facility.
Code : CO172
Description : Payment adjusted when performed/billed by a provider of this specialty.
Code : CO177
Description : Payment denied because patient has not met the required eligibility requirements.
Code : CO178
Description : Payment adjusted because the patient has not met the required spend down requirements.
Code : CO18
Description : Duplicate claim/service.
Code : CO181
Description : Payment adjusted because this procedure code was invalid on the date of service.
Code : CO183
Description : The referring provider is not eligible to refer the service billed.
Code : CO185
Description : The rendering provider is not eligible to perform the service billed.
Code : CO19
Description : Claim denied because this is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.
Code : CO2
Description : Coinsurance Amount
Code : CO20
Description : Claim denied because this injury/illness is covered by the liability carrier.
Code : CO21
Description : Claim denied because this injury/illness is the liability of the no-fault carrier.
Code : CO22
Description : Payment adjusted because this care may be covered by another payer per coordination of benefits.
Code : CO23
Description : Payment adjusted because charges have been paid by another payer.
Code : CO24
Description : Payment for charges adjusted. Charges are covered under a capitation agreement/managed care plan.
Code : CO25
Description : Payment denied. Your Stop loss deductible has not been met.
Code : CO26
Description : Expenses incurred prior to coverage.
Code : CO27
Description : Expenses incurred after coverage terminated.
Code : CO28
Description : Coverage not in effect at the time the service was provided.
Code : CO29
Description : The time limit for filing has expired.
Code : CO3
Description : Co-payment Amount
Code : CO30
Description : Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.
Code : CO31
Description : Claim denied as patient cannot be identified as our insured.
Code : CO32
Description : Our records indicate that this dependent is not an eligible dependent as defined.
Code : CO33
Description : Claim denied. Insured has no dependent coverage.
Code : CO34
Description : Claim denied. Insured has no coverage for newborns.
Code : CO35
Description : Lifetime benefit maximum has been reached.
Code : CO36
Description : Balance does not exceed co-payment amount.
Code : CO37
Description : Balance does not exceed deductible.
Code : CO38
Description : Services not provided or authorized by designated (network/primary care) providers.
Code : CO39
Description : Services denied at the time authorization/pre-certification was requested.
Code : CO4
Description : The procedure code is inconsistent with the modifier used or a required modifier is missing.
Code : CO40
Description : Charges do not meet qualifications for emergent/urgent care.
Code : CO41
Description : Discount agreed to in Preferred Provider contract.
Code : CO42
Description : Charges exceed our fee schedule or maximum allowable amount.
Code : CO43
Description : Gramm-Rudman reduction.
Code : CO44
Description : Prompt-pay discount.
Code : CO45
Description : Charges exceed your contracted/ legislated fee arrangement.
Code : CO46
Description : This (these) service(s) is (are) not covered.
Code : CO47
Description : This (these) diagnosis(es) is (are) not covered, missing, or are invalid.
Code : CO48
Description : This (these) procedure(s) is (are) not covered.
Code : CO49
Description : These are non-covered services because this is a routine exam or screening procedure done in conjunction with a routine exam.
Code : CO5
Description : The procedure code/bill type is inconsistent with the place of service.
Code : CO50
Description : These are non-covered services because this is not deemed a `medical necessity' by the payer.
Code : CO51
Description : These are non-covered services because this is a pre-existing condition.
Code : CO52
Description : The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.
Code : CO53
Description : Services by an immediate relative or a member of the same household are not covered.
Code : CO54
Description : Multiple physicians/assistants are not covered in this case.
Code : CO55
Description : Claim/service denied because procedure/treatment is deemed experimental/investigational by the payer.
Code : CO56
Description : Claim/service denied because procedure/treatment has not been deemed `proven to be effective' by the payer.
Code : CO57
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.
Code : CO58
Description : Payment adjusted because treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service.
Code : CO59
Description : Charges are adjusted based on multiple surgery rules or concurrent anesthesia rules.
Code : CO6
Description : The procedure/revenue code is inconsistent with the patient's age.
Code : CO60
Description : Charges for outpatient services with this proximity to inpatient services are not covered.
Code : CO61
Description : Charges adjusted as penalty for failure to obtain second surgical opinion.
Code : CO62
Description : Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.
Code : CO63
Description : Correction to a prior claim.
Code : CO64
Description : Denial reversed per Medical Review.
Code : CO65
Description : Procedure code was incorrect. This payment reflects the correct code.
Code : CO66
Description : Blood Deductible.
Code : CO67
Description : Lifetime reserve days. (Handled in QTY, QTY01=LA)
Code : CO68
Description : DRG weight. (Handled in CLP12)
Code : CO69
Description : Day outlier amount.
Code : CO7
Description : The procedure/revenue code is inconsistent with the patient's gender.
Code : CO70
Description : Cost outlier - Adjustment to compensate for additonal costs.
Code : CO71
Description : Primary Payer amount.
Code : CO72
Description : Coinsurance day. (Handled in QTY, QTY01=CD)
Code : CO73
Description : Administrative days.
Code : CO74
Description : Indirect Medical Education Adjustment.
Code : CO75
Description : Direct Medical Education Adjustment.
Code : CO76
Description : Disproportionate Share Adjustment.
Code : CO77
Description : Covered days. (Handled in QTY, QTY01=CA)
Code : CO78
Description : Non-Covered days/Room charge adjustment.
Code : CO79
Description : Cost Report days. (Handled in MIA15)
Code : CO8
Description : The procedure code is inconsistent with the provider type/specialty (taxonomy).
Code : CO80
Description : Outlier days. (Handled in QTY, QTY01=OU)
Code : CO81
Description : Discharges.
Code : CO82
Description : PIP days.
Code : CO83
Description : Total visits.
Code : CO84
Description : Capital Adjustment. (Handled in MIA)
Code : CO85
Description : Interest amount.
Code : CO86
Description : Statutory Adjustment.
Code : CO87
Description : Transfer amount.
Code : CO88
Description : Adjustment amount represents collection against receivable created in prior overpayment.
Code : CO89
Description : Professional fees removed from charges.
Code : CO9
Description : The diagnosis is inconsistent with the patient's age.
Code : CO90
Description : Ingredient cost adjustment.
Code : CO91
Description : Dispensing fee adjustment.
Code : CO92
Description : Claim Paid in full.
Code : CO93
Description : No Claim level Adjustments.
Code : CO94
Description : Processed in Excess of charges.
Code : CO95
Description : Benefits adjusted. Plan procedures not followed.
Code : CO96
Description : Non-covered charge(s).
Code : CO97
Description : Payment is included in the allowance for another service/procedure.
Code : CO98
Description : The hospital must file the Medicare claim for this inpatient non-physician service.
Code : CO99
Description : Medicare Secondary Payer Adjustment Amount.
Code : COA0
Description : Patient refund amount.
Code : COA1
Description : Claim denied charges.
Code : COA2
Description : Contractual adjustment.
Code : COA3
Description : Medicare Secondary Payer liability met.
Code : COA4
Description : Medicare Claim PPS Capital Day Outlier Amount.
Code : COA5
Description : Medicare Claim PPS Capital Cost Outlier Amount.
Code : COA6
Description : Prior hospitalization or 30 day transfer requirement not met.
Code : COA7
Description : Presumptive Payment Adjustment
Code : COA8
Description : Claim denied; ungroupable DRG
Code : COB1
Description : Non-covered visits.
Code : COB10
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.
Code : COB11
Description : The claim/service has been transferred to the proper payer/processor for processing. Claim/service not covered by this payer/processor.
Code : COB12
Description : Services not documented in patients' medical records.
Code : COB13
Description : Previously paid. Payment for this claim/service may have been provided in a previous payment.
Code : COB14
Description : Payment denied because only one visit or consultation per physician per day is covered.
Code : COB15
Description : Payment adjusted because this procedure/service is not paid separately.
Code : COB16
Description : Payment adjusted because `New Patient' qualifications were not met.
Code : COB17
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.
Code : COB18
Description : Payment denied because this procedure code/modifier was invalid on the date of service or claim submission.
Code : COB19
Description : Claim/service adjusted because of the finding of a Review Organization.
Code : COB2
Description : Covered visits.
Code : COB20
Description : Payment adjusted because procedure/service was partially or fully furnished by another provider.
Code : COB21
Description : The charges were reduced because the service/care was partially furnished by another physician.
Code : COB22
Description : This payment is adjused based on the diagnosis.
Code : COB23
Description : Payment denied because this provider has failed an aspect of a proficiency testing program.
Code : COB3
Description : Covered charges.
Code : COB4
Description : Late filing penalty.
Code : COB5
Description : Payment adjusted because coverage/program guidelines were not met or were exceeded.
Code : COB6
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.
Code : COB7
Description : This provider was not certified/eligible to be paid for this procedure/service on this date of service.
Code : COB8
Description : Claim/service not covered/reduced because alternative services were available, and should have been utilized.
Code : COB9
Description : Services not covered because the patient is enrolled in a Hospice.
Code : COD1
Description : Claim/service denied. Level of subluxation is missing or inadequate.
Code : COD10
Description : Claim/service denied. Completed physician financial relationship form not on file.
Code : COD11
Description : Claim lacks completed pacemaker registration form.
Code : COD12
Description : Claim/service denied. Claim does not identify who performed the purchased diagnostic test or the amount you were charged for the test.
Code : COD13
Description : Claim/service denied. Performed by a facility/supplier in which the ordering/referring physician has a financial interest.
Code : COD14
Description : Claim lacks indication that plan of treatment is on file.
Code : COD15
Description : Claim lacks indication that service was supervised or evaluated by a physician.
Code : COD18
Description : Inactive for 4010 as of 2/99.
Code : COD19
Description : Claim service lacks physician/operative or other supporting documentation (inactive as of version 5010; use code 16).
Code : COD2
Description : Claim lacks the name, strength, or dosage of the drug furnished.
Code : COD21
Description : This (these) diagnosis (es) is (are) missing or is (are) invalid.
Code : COD3
Description : Claim/service denied because information to indicate if the patient owns the equipment that requires the part or supply was missing.
Code : COD4
Description : Claim/service does not indicate the period of time for which this will be needed.
Code : COD5
Description : Claim/service denied. Claim lacks individual lab codes included in the test.
Code : COD6
Description : Claim/service denied. Claim did not include patient's medical record for the service.
Code : COD7
Description : Claim/service denied. Claim lacks date of patient's most recent physician visit.
Code : COD8
Description : Claim/service denied. Claim lacks indicator that `x-ray is available for review.'
Code : COD9
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.
Code : COW1
Description : Workers Compensation State Fee Schedule Adjustment
Code : CR A2
Description : Contractual adjustment (inactive for 004060; use code 45 with group code CO).
Code : CR07
Description : The procedure/revenue code is inconsistent with the patients gender.
Code : CR1
Description : Deductible amount.
Code : CR10
Description : The diagnosis is inconsistent with the patients gender.
Code : CR100
Description : Payment made to patient/insured/responsible party.
Code : CR102
Description : Major medical adjustment.
Code : CR104
Description : Managed care withholding.
Code : CR107
Description : Claim/service adjusted because the related or qualifying claim/service was not identified on this claim.
Code : CR109
Description : Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.
Code : CR11
Description : The diagnosis is inconsistent with the patients gender.
Code : CR112
Description : Payment adjusted as not furnished directly to the patient and/or not documented.
Code : CR119
Description : Benefit maximum for this time period or occurrence has been reached.
Code : CR121
Description : Indemnification adjustment.
Code : CR125
Description : Payment adjusted due to a submission/billing error (s). Additional information is supplied using the remittance advice remarks codes whenever possible.
Code : CR127
Description : Coinsurance - major medical.
Code : CR129
Description : Payment denied. Prior processing information appears incorrect.
Code : CR13
Description : The date of death precedes the date of service.
Code : CR131
Description : Claim specific negotiated discount.
Code : CR133
Description : The disposition of the claim/service is pending further review.
Code : CR137
Description : Payment/reduction for surcharges, assessments, allowances, or health related taxes.
Code : CR144
Description : Incentive adjustment, e.g., preferred product/service.
Code : CR145
Description : Premium payment withholding.
Code : CR148
Description : Claim/service rejected at this time because information from another provider was not provided or was insufficient/incomplete.
Code : CR149
Description : Lifetime benefit maximum has been reached for this service/benefit category.
Code : CR150
Description : Payment adjusted because the payer deems the information submitted does not support this level of service.
Code : CR151
Description : Payment adjusted because the payer deems the information submitted does not support this many services.
Code : CR16
Description : Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate. This change to be effective 4/1/2007: At least one remark code must be provided (may be comprised of either the remittance advice remark code or NCPDP reject reason code).
Code : CR165
Description : Payment denied/reduced for absence of, or exceeded, referral.
Code : CR17
Description : Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever .appropriate. This change to be effective 4/1/07: at least one remark code
Code : CR170
Description : Payment adjusted when performed/billed by a provider of this type of provider.
Code : CR172
Description : Payment adjusted when performed/billed by a provider of this specialty.
Code : CR179
Description : Payment adjusted because the patient has not met the required waiting requirements.
Code : CR18
Description : Duplicate claim/service.
Code : CR180
Description : Payment adjusted because the patient has not met the required residency requirements.
Code : CR183
Description : The referring provider is not eligible to refer the service billed.
Code : CR185
Description : The rendering provider is not eligible to perform the service billed.
Code : CR187
Description : Health savings account payments.
Code : CR19
Description : Claim denied because this is a work-related injury/illness and thus the liability of the worker's compensation carrier.
Code : CR2
Description : Coinsurance amount.
Code : CR20
Description : Claim denied because this injury/illness is covered by the liability carrier.
Code : CR21
Description : Claim denied because this injury/illness is the liability of the no-fault carrier.
Code : CR22
Description : Payment adjusted because this care may be covered by another payer per coordination of benefits.
Code : CR23
Description : Payment adjusted due to the impact of prior payer(s) adjudication including payments and/or adjustments.
Code : CR24
Description : Payment for charges adjusted. Charges are covered under a capitation agreement/managed care plan.
Code : CR26
Description : Expenses incurred prior to coverage.
Code : CR27
Description : Expenses incurred after coverage terminated.
Code : CR29
Description : The time limit for filing has expired.
Code : CR3
Description : Copayment amount.
Code : CR30
Description : Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.
Code : CR31
Description : Claim denied as patient cannot be identified as our insured.
Code : CR32
Description : Our records indicate that this dependent is not an eligible dependent as defined.
Code : CR33
Description : Claim denied - insured has no dependent coverage.
Code : CR34
Description : Claim denied - insured has no coverage for newborns.
Code : CR35
Description : Lifetime benefit maximum has been reached.
Code : CR38
Description : Services not provided or authorized by designated (network/primary care) providers.
Code : CR39
Description : Services denied at the time authorization/precertification was requested.
Code : CR4
Description : The procedure code is inconsistent with the modifier used or a required modifier is missing.
Code : CR40
Description : Charges do not meet qualifications for emergent/urgent care.
Code : CR42
Description : Charges exceed our fee schedule or maximum allowable amount.
Code : CR45
Description : Charges exceed your contracted/legislated fee arrangement. This change to be effective 6/1/07: Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.
Code : CR46
Description : This (these) service (s) is (are) not covered.
Code : CR47
Description : This (these) diagnosis(es) is (are) not covered, missing, or are invalid.
Code : CR48
Description : This (these) procedure (s) is (are) not covered.
Code : CR49
Description : These are noncovered services because this is a routine exam or screening procedure done in conjunction with a routine exam.
Code : CR5
Description : The procedure code/bill type is inconsistent with the place of service.
Code : CR50
Description : These are noncovered services because this is not deemed a "medical necessity" by the payer.
Code : CR51
Description : These are noncovered services because this is a preexisting condition.
Code : CR52
Description : The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.
Code : CR54
Description : Multiple physicians/assistants are not covered in this case.
Code : CR55
Description : Claim/service denied because procedure/treatment is deemed experimental/investigational by the payer.
Code : CR56
Description : Claim/service denied because procedure/treatment has not been deemed "proven to be effective" by the payer.
Code : CR57
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.
Code : CR58
Description : Payment adjusted because treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service.
Code : CR59
Description : Charges are adjusted based on multiple surgery rules or concurrent anesthesia rules.
Code : CR6
Description : The procedure/revenue code is inconsistent with the patient's age.
Code : CR62
Description : Payment denied/reduced for absence of, or exceeded, precertification/authorization.
Code : CR63
Description : Correction to a prior claim.
Code : CR7
Description : The procedure/revenue code is inconsistent with the patients gender.
Code : CR85
Description : Interest amount.
Code : CR88
Description : Adjustment amount represents collection against receivable created in prior overpayment.
Code : CR9
Description : The diagnosis is inconsistent with the patients age.
Code : CR94
Description : Processed in excess of charges.
Code : CR95
Description : Benefits adjusted. Plan procedures not followed.
Code : CR96
Description : Noncovered charge (s). This change to be effective 4/1/2007: at least one remark code must be provided (may be compromised of either the remittance advice remark code or NCPDP Reject .reason code)
Code : CR97
Description : Payment adjusted because the benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.
Code : CRA1
Description : Claim/service denied. At least one remark code must be provided; may be comprised of either the remittance advice remark code or NCPDP reject reason code.
Code : CRA2
Description : Contractual adjustment (inactive for 004060; use code 45 with group code CO).
Code : CRA6
Description : Prior hospitalization or 30-day transfer requirement not met.
Code : CRB1
Description : Noncovered visits.
Code : CRB10
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.
Code : CRB11
Description : Claim/service has been transferred to the proper payer/processor for processing. Claim/service not covered by this payer/processor.
Code : CRB12
Description : Services not documented in patient's medical records.
Code : CRB13
Description : Previously paid. Payment for this claim/service may have been provided in a previous payment.
Code : CRB14
Description : Payment denied because only one visit or consultation per physician per day is covered.
Code : CRB15
Description : Payment adjusted because this procedure/service requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure/has not been received/ .adjudicated.
Code : CRB16
Description : Payment adjusted because "new patient" qualifications were not met.
Code : CRB18
Description : Payment denied because this procedure code/modifier was invalid on the date of service or claim submission.
Code : CRB20
Description : Payment adjusted because procedure/service was partially or fully furnished by another provider.
Code : CRB22
Description : This payment is adjusted based on the diagnosis.
Code : CRB3
Description : Covered charges.
Code : CRB5
Description : Payment adjusted because coverage/program guidelines were not met or were exceeded.CRB6 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.
Code : CRB7
Description : This provider was not certified/eligible to be paid for this procedure/service on this date of service.
Code : CRB9
Description : Services not covered because the patient is enrolled in hospice.
Code : CRD19
Description : Claim/service lacks physician/operative or other supporting documentation.
Code : CRD21
Description : This (these) diagnosis(es) is (are) not covered, missing, or are invalid.
Code : NC
Description : Precert not obtained.
Code : PR02
Description : Coinsurance amount.
Code : PR07
Description : The procedure/revenue code is inconsistent with the patients gender.
Code : PR1
Description : Deductible amount.
Code : PR10
Description : The diagnosis is inconsistent with the patients gender.
Code : PR100
Description : Payment made to patient/insured/responsible party.
Code : PR104
Description : Managed care withholding.
Code : PR107
Description : Claim/service adjusted because the related or qualifying claim/service was not identified on this claim.
Code : PR109
Description : Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.
Code : PR11
Description : The diagnosis is inconsistent with the procedure.
Code : PR111
Description : Not covered unless the provider accepts assignment.
Code : PR112
Description : Payment adjusted as not furnished directly to the patient and/or not documented.
Code : PR117
Description : Payment adjusted because transportation is only covered to the closest facility that can provide the necessary care.
Code : PR119
Description : Benefit maximum for this time period or occurrence has been reached.
Code : PR125
Description : Payment adjusted due to a submission/billing error (s). Additional information is supplied using the remittance advice remarks codes whenever possible.
Code : PR126
Description : Deductible - major medical.
Code : PR127
Description : Coinsurance - major medical.
Code : PR129
Description : Payment denied. Prior processing information appears incorrect.
Code : PR13
Description : The date of death precedes the date of service.
Code : PR131
Description : Claim specific negotiated discount.
Code : PR133
Description : The disposition of the claim/service is pending further review.
Code : PR136
Description : Claim adjusted based on failure to follow prior payer's coverage rules.
Code : PR137
Description : Payment/reduction for regulatory surcharges, assessments, allowances, or health related taxes.
Code : PR138
Description : Claim/service denied. Appeal procedures not followed or time limits not met.
Code : PR140
Description : Patient/insured health identification number and name do not match.
Code : PR141
Description : Claim adjustment because the claim spans eligible and ineligible periods of coverage.
Code : PR145
Description : Premium payment withholding.
Code : PR147
Description : Provider contracted/negotiated rate expired or not on file.
Code : PR149
Description : Lifetime benefit maximum has been reached for this service/benefit category.
Code : PR15
Description : Payment adjusted because the submitted authorization number is missing, invalid, or does not apply to the billed services or provider.
Code : PR150
Description : Payment adjusted because the payer deems the information submitted does not support this level of service.
Code : PR151
Description : Payment adjusted because the payer deems the information submitted does not support this many services.
Code : PR156
Description : Flexible spending account payments.
Code : PR16
Description : Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate. This change to be effective 4/1/2007: At least one remark code must be provided (may be comprised of either the remittance advice remark code or NCPDP reject reason code).
Code : PR167
Description : This (these) diagnosis (es) is (are) not covered.
Code : PR17
Description : Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever appropriate. This change to be effective 4/1/07: at least one remark code
Code : PR170
Description : Payment denied when performed/billed by this type of provider.
Code : PR171
Description : Payment denied when performed/billed by this type of provider in this type of facility.
Code : PR172
Description : Payment adjusted when performed/billed by a provider of this specialty.
Code : PR177
Description : Payment denied because the patient has not met the required eligibility requirements.
Code : PR179
Description : Payment adjusted because the patient has not met the required waiting requirements.
Code : PR18
Description : Duplicate claim/service.
Code : PR180
Description : Payment adjusted because the patient has not met the required residency requirements.
Code : PR183
Description : The referring provider is not eligible to refer the service billed.
Code : PR184
Description : The prescribing/ordering provider is not eligible to prescribe/order the service billed.
Code : PR185
Description : The rendering provider is not eligible to perform the service billed.
Code : PR19
Description : Claim denied because this is a work-related injury/illness and thus the liability of the worker's compensation carrier.
Code : PR2
Description : Coinsurance amount.
Code : PR20
Description : Claim denied because this injury/illness is covered by the liability carrier.
Code : PR21
Description : Claim denied because this injury/illness is the liability of the no-fault carrier.
Code : PR22
Description : Payment adjusted because this care may be covered by another payer per coordination of benefits.
Code : PR23
Description : Payment adjusted due to the impact of prior payer's) adjudication including payments and/or adjustments.
Code : PR24
Description : Payment for charges adjusted. Charges are covered under a capitation agreement/managed care plan.
Code : PR26
Description : Expenses incurred prior to coverage.
Code : PR27
Description : Expenses incurred after coverage terminated.
Code : PR28
Description : Coverage not in effect at the time the service was provided.
Code : PR29
Description : The time limit for filing has expired.
Code : PR3
Description : Copayment amount.
Code : PR30
Description : Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.
Code : PR31
Description : Claim denied as patient cannot be identified as our insured.
Code : PR32
Description : Our records indicate that this dependent is not an eligible dependent as defined.
Code : PR33
Description : Claim denied - insured has no dependent coverage.
Code : PR34
Description : Claim denied - insured has no coverage for newborns.
Code : PR35
Description : Lifetime benefit maximum has been reached.
Code : PR38
Description : Services not provided or authorized by designated (network/primary care) providers.
Code : PR39
Description : Services denied at the time authorization/precertification was requested.
Code : PR4
Description : The procedure code is inconsistent with the modifier used or a required modifier is missing.
Code : PR40
Description : Charges do not meet qualifications for emergent/urgent care.
Code : PR42
Description : Charges exceed our fee schedule or maximum allowable amount.
Code : PR45
Description : Charges exceed your contracted/legislated fee arrangement. This change to be effective 6/1/07: Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.
Code : PR46
Description : This (these) service (s) is (are) not covered.
Code : PR47
Description : This (these) diagnosis(es) is (are) not covered, missing, or are invalid.
Code : PR48
Description : This (these) procedure (s) is (are) not covered.
Code : PR49
Description : These are noncovered services because this is a routine exam or screening procedure done in conjunction with a routine exam.
Code : PR5
Description : Procedure code/bill type is inconsistent with the place of service.
Code : PR50
Description : These are noncovered services because this is not deemed a "medical necessity" by the payer.
Code : PR51
Description : These are noncovered services because this is a preexisting condition.
Code : PR52
Description : The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.
Code : PR54
Description : Multiple physicians/assistants are not covered in this case.
Code : PR55
Description : Claim/service denied because procedure/treatment is deemed experimental/investigational by the payer.
Code : PR56
Description : Claim/service denied because procedure/treatment has not been deemed "proven to be effective" by the payer.
Code : PR57
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.
Code : PR58
Description : Payment adjusted because treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service.
Code : PR59
Description : Charges are adjusted based on multiple surgery rules or concurrent anesthesia rules.
Code : PR6
Description : The procedure/revenue code is inconsistent with the patient's age.
Code : PR62
Description : Payment denied/reduced for absence of, or exceeded, precertification/authorization.
Code : PR63
Description : Correction to a prior claim.
Code : PR7
Description : The procedure/revenue code is inconsistent with the patients gender.
Code : PR8
Description : The procedure code is inconsistent with the provider type/specialty (taxonomy).
Code : PR87
Description : Transfer amount.
Code : PR9
Description : The diagnosis is inconsistent with the patients age.
Code : PR92
Description : Claim paid in full.
Code : PR94
Description : Processed in excess of charges.
Code : PR95
Description : Benefits adjusted. Plan procedures not followed.
Code : PR96
Description : Noncovered charge (s). This change to be effective 4/1/2007: at least one remark code must be provided (may be compromised of either the remittance advice remark code or NCPDP Reject .reason code)
Code : PR97
Description : Payment adjusted because the benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.
Code : PRA1
Description : Claim/service denied. At least one remark code must be provided; may be comprised of either the remittance advice remark code or NCPDP reject reason code.
Code : PRA2
Description : Contractual adjustment (inactive for 004060; use code 45 with group code CO).
Code : PRA6
Description : Prior hospitalization or 30-day transfer requirement not met.
Code : PRB1
Description : Noncovered visits.
Code : PRB11
Description : Claim/service has been transferred to the proper payer/processor for processing. Claim/service not covered by this payer/processor.
Code : PRB12
Description : Services not documented in patient's medical records.
Code : PRB13
Description : Previously paid. Payment for this claim/service may have been provided in a previous payment.
Code : PRB14
Description : Payment denied because only one visit or consultation per physician per day is covered.
Code : PRB15
Description : Payment adjusted because this procedure/service requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure/has not been received/ .adjudicated.
Code : PRB16
Description : Payment adjusted because "new patient" qualifications were not met.
Code : PRB18
Description : Payment denied because this procedure code/modifier was invalid on the date of service or claim submission.
Code : PRB20
Description : Payment adjusted because procedure/service was partially or fully furnished by another provider.
Code : PRB22
Description : This payment is adjusted based on the diagnosis.
Code : PRB5
Description : Payment adjusted because coverage/program guidelines were not met or were exceeded.
Code : PRB6
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.
Code : PRB7
Description : This provider was not certified/eligible to be paid for this procedure/service on this date of service.
Code : PRB8
Description : Claim/service not covered/reduced because alternative services were available and should have been utilized.
Code : PRB9
Description : Services not covered because the patient is enrolled in hospice.
Code : PRD19
Description : Claim/service lacks physician/operative or other supporting documentation.
Code : PRD21
Description : This (these) diagnosis(es) is (are) not covered, missing, or are invalid.
Code : WB
Description : Paid at wrong benefit amount.


JOBS - Page 1

1 Appointment Coordinator Appleton, WI, USA Appointment Coordinator About us: At Apple Creek Orthodontics of Appleton, we love creating healthy, beautiful smiles for our patients, a person at a time. Our goal is to deliver the highest quality ...... Apply Now>>

2 SPED Driver Fairbanks, AK, USA Now Hiring Part-Time SPED Drivers in Fairbanks! At First Student, our SPED Drivers are an integral part of the communities they serve. They are committed to safety, customer service and have genuine ...... Apply Now>>

3 CDL A Dedicated Flatbed Truck Driver - Local Home Daily La Mirada, CA, USA CDL-A Drivers - Get Home Daily On Local Runs With Hub Group! At Hub Group, we believe in employing the best drivers on the road, and we do so by ensuring that our professional drivers feel supported ...... Apply Now>>

4 Customer Service and Sales Fairbanks, AK, USA Are you good at: * Communicating with people? * Providing advice? * Answering client or customer questions about properly using or accessing a product or service? * Listening to customers and their ...... Apply Now>>

5 Owner Operator CDL Flatbed Truck Driver Earn $58k+ OTR Seattle, WA, USA OWNER OPERATOR CDL-A FLATBED DRIVERS WANTED! When our country needs it most, we're Driving America Forward! System Transport has been hauling what builds America since 1972, keeping the country ...... Apply Now>>

6 Amazon Package Sorter (Columbus) Galloway, OH, USA Warehouse Team Members (Seasonal, Part-Time, Full-Time, Flex) Shifts: Overnight, Sunrise, Day, Evening, Weekend Location: Columbus, Lockbourne Job opportunities vary by location. We update postings ...... Apply Now>>

7 Amazon Online Order Shopper (Part-Time) San Jose, CA, USA Schedule: Reduced Time Seasonal, Part-Time Seasonal Shifts: Morning, Day, Evening, Weekend Flexible Shift Requirements All flexible shift associates will start on a standard training schedule for 1 ...... Apply Now>>

8 CDL Class-A Tractor-Trailer Drivers San Ramon, CA, USA CDL Class - A Tractor-Trailer Drivers San Ramon, CA HOME DAILY * $68,000 FIRST YEAR! (est. and based on route assignment) * Paid Orientation & Training * Annual Safety & Performance Rewards DHL ...... Apply Now>>

9 CDL Class A Delivery Driver - MB Mason City, IA, USA Position Summary: Responsible for the safe operation of company equipment and timely, courteous delivery of product to our customers. Position Responsibilities may include, but not limited to... Apply Now>>

10 CDL A Dedicated Truck Driver - Local Home Daily Tracy, CA, USA Be home daily while enjoying top earnings! Enjoy daily home time, higher pay, a predictable schedule and more with local truck driving jobs at Hub Group. Leave those over-the-road miles behind and ...... Apply Now>>

11 Seasonal Personal Vehicle Package Driver Sunnyvale, CA, USA Candidates must have a personal vehicle that meets UPS standards. Personal Vehicle Drivers must have proof of a registered vehicle for use, minimum state required auto insurance, and must be 21 years ...... Apply Now>>

12 Sales Lead - Valley River Center Eugene, OR, USA Overview : The Sales Lead supports the management team in achieving store sales and profitability goals by creating a positive and energetic store environment. The primary focus is to ensure a ...... Apply Now>>

13 CDL Class A Delivery Driver - MB Whitewater, WI, USA Position Summary: Responsible for the safe operation of company equipment and timely, courteous delivery of product to our customers. Position Responsibilities may include, but not limited to... Apply Now>>

14 Class A CDL Truck Driver Tigard, OR, USA Job Code: 2020-01-710-295 Local Truck Driver - Class A CDL Chain Experience Required Doubles Endorsement/Experience Preferred and Hazmat Preferred BLACK HORSE CARRIERS,the 13thlargest Dedicated Fleet ...... Apply Now>>

15 Van Driver-Non CDL Portland, OR, USA Now Hiring Part-Time Van Drivers In Portland! At First Student, our Van Drivers are an integral part of the communities they serve. They are committed to safety, customer service and have genuine ...... Apply Now>>

16 Research Remediation Analyst 2, Everyday Customer Advocacy Group San Antonio, TX, USA Important Note: During the application process, ensure your contact information (email and phone number) is up to date and upload your current resume when submitting your application for ...... Apply Now>>

17 FedEx - Package Handler, Warehouse Fremont, CA, USA Auto req ID: 239361BR Job Summary FedEx Ground is hiring part-time and full-time individuals to load and unload packages in our fast-paced warehouse environment. Part-time employees typically work a ...... Apply Now>>

18 Amazon Order Packer - Full and Part Time Tualatin, OR, USA Warehouse Team Member Shifts: Day, Night, Weekdays, Weekends Location: Troutdale, OR Job opportunities vary by location. We update postings daily with open positions. Hourly pay rate : Earn $15.10 to ...... Apply Now>>

19 Contact Center Representative (Bilingual) Spokane, WA, USA Company Description STCU is a growing regional credit union that is consistently rated one of the top-performing credit unions in the nation, and we have been named as one of Fortune Magazine's Great ...... Apply Now>>

20 CDL A Truck Driver Portland, OR, USA Drive for the largest intermodal fleet in the industry in the Portland area. * Hiring for dedicated and intermodal positions. * At least 3 months of CDL-A driving experience is required. Frequent ...... Apply Now>>

21 Entry Level Sales Salem, OR, USA Start your career in an Allstate agency to serve all customers including our growing customer base. Are you looking for a meaningful career in a local business that has national brand support that ...... Apply Now>>

22 Bilingual Customer Service Coordinator - Work from home Hawaii County, HI, USA Position Description Turn on the news on any night of the week and you're likely to hear about the changes that are sweeping through our health care system. It's dramatic. It's positive. And it ...... Apply Now>>

23 CDL-A Regional Truck Driver - Walmart Transportation Battle Ground, WA, USA LOCATION SPANAWAY, WACAREER AREA Drivers & TransportationJOB FUNCTION DriverEMPLOYMENT TYPE Full TimePOSITION TYPE -REQUISITION 1425421BRWhat you'll doWALMART TRANSPORTATION is Hiring CDL-A Drivers ...... Apply Now>>

24 Service Manager San Francisco, CA, USA Company Overview: Our mission is to create products we love and take care of our customers. We value our team, making sure the best is on the field. We also appreciate new ideas from anywhere ...... Apply Now>>

25 Local Class A CDL Driver Lima, OH, USA Martin Transportation Systems (MTS) is committed to offering our drivers the best working environment with more home time, dedicated runs and a consistent schedule. We are a family run business and ...... Apply Now>>

26 Class A CDL Truck Driver Wilsonville, OR, USA Job Code: 2020-01-790-229 Truck Drivers Class A CDL - Immediate Openings! Straight truck route! Class A with Hazmat and Doubles Endorsements Preferred Straight truck route ! Great route for the right ...... Apply Now>>

27 Sales Coordinator for Hattori Hanzo Shears Sacramento, CA, USA Best. Job. Ever. Okay maybe we're biased but it's seriously an awesome position at an amazing company. Full Time, on-the-job training, 401k, Medical, Dental,Vision, Life plus more. Hattori Hanzo is ...... Apply Now>>

28 Customer Service Representative Hayward, CA, USA Function & Responsibility Receives (by telephone, email or fax) requests for quotations, orders, and lead times from customers. Makes quotations on standard items, enter orders, and relays pertinent ...... Apply Now>>

29 Class A CDL - Dedicated Flatbed Truck Driver Vacaville, CA, USA This Dedicated Flatbed Truck Driver position features daily home time and up to $63,100 per year.* Dedicated Flatbed truckers will haul multi-stop freight and be equipped with a flatbed with moffett ...... Apply Now>>

30 CDL A Truck Driver Dublin, CA, USA Company Driver | Local | $27/hr, Dry Van/No Touch, Benefits after 30 days Requisition ID: 731 For More Information, Contact a Recruiter @ 1.800.935.3131 Pay & Benefits Full-time CDL-A truck drivers ...... Apply Now>>

31 CDL A Truck Driver Concord, CA, USA Company Driver | Local | $24/hr, Benefits after 30 days Requisition ID: 811 For More Information, Contact a Recruiter @ 1.800.935.3131 Pay & Benefits Full-time CDL-A local truck drivers are eligible ...... Apply Now>>

32 Truck Driver - 1st Shit Bakersfield, CA, USA THE ROLE: * This position will report to the: Manager - Maintenance * Travel Requirement: None * FLSA Status : Non-Exempt. * Shift: 1st Shift * Employment Category: Full time - Regular STRONG HISTORY... Apply Now>>

33 CDL-A Team Drivers - 3 mo EXP & Doubles Required Santa Cruz, CA, USA DRIVE DEDICATED & HOME WEEKLY: TEAMS OR SOLOS THAT WANT TO TEAM! TEAMS EARN $24,000 BONUS/SPLIT IN FIRST YEAR!Teams for Immediate Seating or we will find you a Team Partner $24,000 Sign On Bonus ...... Apply Now>>

34 Shipt Shopper - Temporary or part-time work Tracy, CA, USA Shipt is a membership-based marketplace that helps people get the things they need, like fresh produce and household essentials, from stores they trust. Help people save time and have fun while you ...... Apply Now>>

35 Customer Service Agent Phoenix, AZ, USA Williams-Sonoma Inc. Customer Service Agents - Work from Home in Phoenix! Training starts Monday July 13th!! Job Description: Why you and why us? Who are our Customer Service Agents? They are people ...... Apply Now>>

36 Customer Service Representative Portland, OR, USA We are looking for a Customer Service Representative to provide an exemplary customer experience through phone calls and email communication which support our team. The successful candidate will ...... Apply Now>>

37 Customer Service Apple Valley, MN, USA Overview The Crewmember - At Raising Cane's, "What We Do" is serve the Perfect Box, Fast, Friendly, Clean & Have Fun! A Crewmember has the primary responsibility of providing a positive Customer ...... Apply Now>>

38 Class A CDL Driver - Home Daily - Recent Grads Welcome -Yuba City, CA Yuba City, CA, USA : Home daily drivers needed! RECENT GRADS! Consistent Miles & Hourly Pay! Helena is currently seeking qualified CDL drivers that get home daily. Helena Agri-Enterprises, LLC is one of the nation s ...... Apply Now>>

39 Lyft Driver (Full-Time) Bolinas, CA, USA What is Lyft? Lyft is a platform that connects drivers with individuals and organizations that need rides. In addition to helping passengers get from A to B, in select markets drivers may also opt in ...... Apply Now>>

40 Customer Service Representativ Portland, OR, USA This is a long-term temporary opportunity working as a Customer Service Representative . This opportunity will last until September 2020 or further. This role is perfect for those who have experience ...... Apply Now>>

2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10    Next »


TO CORRECT ERRORS ON THIS SITE CLICK HERE
© Coconut Island Software -- Go Mobile Today!
     contact      copyright stuff      privacy policy           Job Search by

Mobile Websites reach people who are On The Move!    >>  Call Now 805.225.4509