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REMITTANCE ADVICE REMARK SEARCH:

 
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Code : M1
Description : X-ray not taken within the past 12 months or near enough to the start of treatment.
Dates : Start: 01/01/1997
Code : M2
Description : Not paid separately when the patient is an inpatient.
Dates : Start: 01/01/1997
Code : M3
Description : Equipment is the same or similar to equipment already being used.
Dates : Start: 01/01/1997
Code : M4
Description : Alert: This is the last monthly installment payment for this durable medical equipment.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : M5
Description : Monthly rental payments can continue until the earlier of the 15th month from the first rental month, or the month when the equipment is no longer needed.
Dates : Start: 01/01/1997
Code : M6
Description : Alert: You must furnish and service this item for any period of medical need for the remainder of the reasonable useful lifetime of the equipment.
Dates : Start: 01/01/1997 | Last Modified: 03/01/2009
Notes: (Modified 4/1/07, 3/1/2009)
Code : M7
Description : No rental payments after the item is purchased, or after the total of issued rental payments equals the purchase price.
Dates : Start: 01/01/1997
Code : M8
Description : We do not accept blood gas tests results when the test was conducted by a medical supplier or taken while the patient is on oxygen.
Dates : Start: 01/01/1997
Code : M9
Description : Alert: This is the tenth rental month. You must offer the patient the choice of changing the rental to a purchase agreement.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : M10
Description : Equipment purchases are limited to the first or the tenth month of medical necessity.
Dates : Start: 01/01/1997
Code : M11
Description : DME, orthotics and prosthetics must be billed to the DME carrier who services the patient's zip code.
Dates : Start: 01/01/1997
Code : M12
Description : Diagnostic tests performed by a physician must indicate whether purchased services are included on the claim.
Dates : Start: 01/01/1997
Code : M13
Description : Only one initial visit is covered per specialty per medical group.
Dates : Start: 01/01/1997 | Last Modified: 06/30/2007
Notes: (Modified 6/30/03)
Code : M14
Description : No separate payment for an injection administered during an office visit, and no payment for a full office visit if the patient only received an injection.
Dates : Start: 01/01/1997
Code : M15
Description : Separately billed services/tests have been bundled as they are considered components of the same procedure. Separate payment is not allowed.
Dates : Start: 01/01/1997
Code : M16
Description : Alert: Please see our web site, mailings, or bulletins for more details concerning this policy/procedure/decision.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Reactivated 4/1/04, Modified 11/18/05, 4/1/07)
Code : M17
Description : Alert: Payment approved as you did not know, and could not reasonably have been expected to know, that this would not normally have been covered for this patient. In the future, you will be liable for charges for the same service(s) under the same or similar conditions.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : M18
Description : Certain services may be approved for home use. Neither a hospital nor a Skilled Nursing Facility (SNF) is considered to be a patient's home.
Dates : Start: 01/01/1997 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : M19
Description : Missing oxygen certification/re-certification.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03) Related to N234
Code : M20
Description : Missing/incomplete/invalid HCPCS.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M21
Description : Missing/incomplete/invalid place of residence for this service/item provided in a home.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M22
Description : Missing/incomplete/invalid number of miles traveled.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M23
Description : Missing invoice.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2005
Notes: (Modified 8/1/05)
Code : M24
Description : Missing/incomplete/invalid number of doses per vial.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M25
Description : The information furnished does not substantiate the need for this level of service. If you believe the service should have been fully covered as billed, or if you did not know and could not reasonably have been expected to know that we would not pay for this level of service, or if you notified the patient in writing in advance that we would not pay for this level of service and he/she agreed in writing to pay, ask us to review your claim within 120 days of the date of this notice. If you do not request an appeal, we will, upon application from the patient, reimburse him/her for the amount you have collected from him/her in excess of any deductible and coinsurance amounts. We will recover the reimbursement from you as an overpayment.
Dates : Start: 01/01/1997 | Last Modified: 11/01/2010
Notes: (Modified 10/1/02, 6/30/03, 8/1/05, 11/5/07, 11/1/10)
Code : M26
Description : The information furnished does not substantiate the need for this level of service. If you have collected any amount from the patient for this level of service /any amount that exceeds the limiting charge for the less extensive service, the law requires you to refund that amount to the patient within 30 days of receiving this notice. The requirements for refund are in 1824(I) of the Social Security Act and 42CFR411.408. The section specifies that physicians who knowingly and willfully fail to make appropriate refunds may be subject to civil monetary penalties and/or exclusion from the program. If you have any questions about this notice, please contact this office.
Dates : Start: 01/01/1997 | Last Modified: 11/05/2007
Notes: (Modified 10/1/02, 6/30/03, 8/1/05, 11/5/07. Also refer to N356)
Code : M27
Description : Alert: The patient has been relieved of liability of payment of these items and services under the limitation of liability provision of the law. The provider is ultimately liable for the patient's waived charges, including any charges for coinsurance, since the items or services were not reasonable and necessary or constituted custodial care, and you knew or could reasonably have been expected to know, that they were not covered. You may appeal this determination. You may ask for an appeal regarding both the coverage determination and the issue of whether you exercised due care. The appeal request must be filed within 120 days of the date you receive this notice. You must make the request through this office.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2007
Notes: (Modified 10/1/02, 8/1/05, 4/1/07, 8/1/07)
Code : M28
Description : This does not qualify for payment under Part B when Part A coverage is exhausted or not otherwise available.
Dates : Start: 01/01/1997
Code : M29
Description : Missing operative note/report.
Dates : Start: 01/01/1997 | Last Modified: 07/01/2008
Notes: (Modified 2/28/03, 7/1/2008) Related to N233
Code : M30
Description : Missing pathology report.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2004
Notes: (Modified 8/1/04, 2/28/03) Related to N236
Code : M31
Description : Missing radiology report.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2004
Notes: (Modified 8/1/04, 2/28/03) Related to N240
Code : M32
Description : Alert: This is a conditional payment made pending a decision on this service by the patient's primary payer. This payment may be subject to refund upon your receipt of any additional payment for this service from another payer. You must contact this office immediately upon receipt of an additional payment for this service.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : M33
Description : Missing/incomplete/invalid UPIN for the ordering/referring/performing provider.
Dates : Start: 01/01/1997 | Stop: 08/01/2004
Notes: Consider using M68
Code : M34
Description : Claim lacks the CLIA certification number.
Dates : Start: 01/01/1997 | Stop: 08/01/2004
Notes: Consider using MA120
Code : M35
Description : Missing/incomplete/invalid pre-operative photos or visual field results.
Dates : Start: 01/01/1997 | Stop: 02/05/2005
Notes: Consider using N178
Code : M36
Description : This is the 11th rental month. We cannot pay for this until you indicate that the patient has been given the option of changing the rental to a purchase.
Dates : Start: 01/01/1997
Code : M37
Description : Not covered when the patient is under age 35.
Dates : Start: 01/01/1997 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
Code : M38
Description : The patient is liable for the charges for this service as you informed the patient in writing before the service was furnished that we would not pay for it, and the patient agreed to pay.
Dates : Start: 01/01/1997
Code : M39
Description : The patient is not liable for payment for this service as the advance notice of non-coverage you provided the patient did not comply with program requirements.
Dates : Start: 01/01/1997 | Last Modified: 11/01/2009
Notes: (Modified 2/1/04, 4/1/07, 11/1/09)
Code : M40
Description : Claim must be assigned and must be filed by the practitioner's employer.
Dates : Start: 01/01/1997
Code : M41
Description : We do not pay for this as the patient has no legal obligation to pay for this.
Dates : Start: 01/01/1997
Code : M42
Description : The medical necessity form must be personally signed by the attending physician.
Dates : Start: 01/01/1997
Code : M43
Description : Payment for this service previously issued to you or another provider by another carrier/intermediary.
Dates : Start: 01/01/1997 | Stop: 01/31/2004
Notes: Consider using Reason Code 23
Code : M44
Description : Missing/incomplete/invalid condition code.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M45
Description : Missing/incomplete/invalid occurrence code(s).
Dates : Start: 01/01/1997 | Last Modified: 12/02/2004
Notes: (Modified 12/2/04) Related to N299
Code : M46
Description : Missing/incomplete/invalid occurrence span code(s).
Dates : Start: 01/01/1997 | Last Modified: 12/02/2004
Notes: (Modified 12/2/04) Related to N300
Code : M47
Description : Missing/incomplete/invalid internal or document control number.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M48
Description : Payment for services furnished to hospital inpatients (other than professional services of physicians) can only be made to the hospital. You must request payment from the hospital rather than the patient for this service.
Dates : Start: 01/01/1997 | Stop: 01/31/2004
Notes: Consider using M97
Code : M49
Description : Missing/incomplete/invalid value code(s) or amount(s).
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M50
Description : Missing/incomplete/invalid revenue code(s).
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M51
Description : Missing/incomplete/invalid procedure code(s).
Dates : Start: 01/01/1997 | Last Modified: 12/02/2004
Notes: (Modified 12/2/04) Related to N301
Code : M52
Description : Missing/incomplete/invalid “from” date(s) of service.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M53
Description : Missing/incomplete/invalid days or units of service.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M54
Description : Missing/incomplete/invalid total charges.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M55
Description : We do not pay for self-administered anti-emetic drugs that are not administered with a covered oral anti-cancer drug.
Dates : Start: 01/01/1997
Code : M56
Description : Missing/incomplete/invalid payer identifier.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M57
Description : Missing/incomplete/invalid provider identifier.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : M58
Description : Missing/incomplete/invalid claim information. Resubmit claim after corrections.
Dates : Start: 01/01/1997 | Stop: 02/05/2005
Code : M59
Description : Missing/incomplete/invalid “to” date(s) of service.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M60
Description : Missing Certificate of Medical Necessity.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2004
Notes: (Modified 8/1/04, 6/30/03) Related to N227
Code : M61
Description : We cannot pay for this as the approval period for the FDA clinical trial has expired.
Dates : Start: 01/01/1997
Code : M62
Description : Missing/incomplete/invalid treatment authorization code.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M63
Description : We do not pay for more than one of these on the same day.
Dates : Start: 01/01/1997 | Stop: 01/31/2004
Notes: Consider using M86
Code : M64
Description : Missing/incomplete/invalid other diagnosis.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M65
Description : One interpreting physician charge can be submitted per claim when a purchased diagnostic test is indicated. Please submit a separate claim for each interpreting physician.
Dates : Start: 01/01/1997
Code : M66
Description : Our records indicate that you billed diagnostic tests subject to price limitations and the procedure code submitted includes a professional component. Only the technical component is subject to price limitations. Please submit the technical and professional components of this service as separate line items.
Dates : Start: 01/01/1997
Code : M67
Description : Missing/incomplete/invalid other procedure code(s).
Dates : Start: 01/01/1997 | Last Modified: 12/02/2004
Notes: (Modified 12/2/04) Related to N302
Code : M68
Description : Missing/incomplete/invalid attending, ordering, rendering, supervising or referring physician identification.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : M69
Description : Paid at the regular rate as you did not submit documentation to justify the modified procedure code.
Dates : Start: 01/01/1997 | Last Modified: 02/01/2004
Notes: (Modified 2/1/04)
Code : M70
Description : Alert: The NDC code submitted for this service was translated to a HCPCS code for processing, but please continue to submit the NDC on future claims for this item.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2007
Notes: (Modified 4/1/2007, 8/1/07)
Code : M71
Description : Total payment reduced due to overlap of tests billed.
Dates : Start: 01/01/1997
Code : M72
Description : Did not enter full 8-digit date (MM/DD/CCYY).
Dates : Start: 01/01/1997 | Stop: 10/16/2003
Notes: Consider using MA52
Code : M73
Description : The HPSA/Physician Scarcity bonus can only be paid on the professional component of this service. Rebill as separate professional and technical components.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2004
Notes: (Modified 8/1/04)
Code : M74
Description : This service does not qualify for a HPSA/Physician Scarcity bonus payment.
Dates : Start: 01/01/1997 | Last Modified: 12/02/2004
Notes: (Modified 12/2/04)
Code : M75
Description : Multiple automated multichannel tests performed on the same day combined for payment.
Dates : Start: 01/01/1997 | Last Modified: 11/05/2007
Notes: (Modified 11/5/07)
Code : M76
Description : Missing/incomplete/invalid diagnosis or condition.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M77
Description : Missing/incomplete/invalid place of service.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M78
Description : Missing/incomplete/invalid HCPCS modifier.
Dates : Start: 01/01/1997 | Stop: 05/18/2006 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03,) Consider using Reason Code 4
Code : M79
Description : Missing/incomplete/invalid charge.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M80
Description : Not covered when performed during the same session/date as a previously processed service for the patient.
Dates : Start: 01/01/1997 | Last Modified: 10/31/2002
Notes: (Modified 10/31/02)
Code : M81
Description : You are required to code to the highest level of specificity.
Dates : Start: 01/01/1997 | Last Modified: 02/01/2004
Notes: (Modified 2/1/04)
Code : M82
Description : Service is not covered when patient is under age 50.
Dates : Start: 01/01/1997
Code : M83
Description : Service is not covered unless the patient is classified as at high risk.
Dates : Start: 01/01/1997
Code : M84
Description : Medical code sets used must be the codes in effect at the time of service
Dates : Start: 01/01/1997 | Last Modified: 02/01/2004
Notes: (Modified 2/1/04)
Code : M85
Description : Subjected to review of physician evaluation and management services.
Dates : Start: 01/01/1997
Code : M86
Description : Service denied because payment already made for same/similar procedure within set time frame.
Dates : Start: 01/01/1997 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : M87
Description : Claim/service(s) subjected to CFO-CAP prepayment review.
Dates : Start: 01/01/1997
Code : M88
Description : We cannot pay for laboratory tests unless billed by the laboratory that did the work.
Dates : Start: 01/01/1997 | Stop: 08/01/2004
Notes: Consider using Reason Code B20
Code : M89
Description : Not covered more than once under age 40.
Dates : Start: 01/01/1997
Code : M90
Description : Not covered more than once in a 12 month period.
Dates : Start: 01/01/1997
Code : M91
Description : Lab procedures with different CLIA certification numbers must be billed on separate claims.
Dates : Start: 01/01/1997
Code : M92
Description : Services subjected to review under the Home Health Medical Review Initiative.
Dates : Start: 01/01/1997 | Stop: 08/01/2004
Code : M93
Description : Information supplied supports a break in therapy. A new capped rental period began with delivery of this equipment.
Dates : Start: 01/01/1997
Code : M94
Description : Information supplied does not support a break in therapy. A new capped rental period will not begin.
Dates : Start: 01/01/1997
Code : M95
Description : Services subjected to Home Health Initiative medical review/cost report audit.
Dates : Start: 01/01/1997
Code : M96
Description : The technical component of a service furnished to an inpatient may only be billed by that inpatient facility. You must contact the inpatient facility for technical component reimbursement. If not already billed, you should bill us for the professional component only.
Dates : Start: 01/01/1997
Code : M97
Description : Not paid to practitioner when provided to patient in this place of service. Payment included in the reimbursement issued the facility.
Dates : Start: 01/01/1997
Code : M98
Description : Begin to report the Universal Product Number on claims for items of this type. We will soon begin to deny payment for items of this type if billed without the correct UPN.
Dates : Start: 01/01/1997 | Stop: 01/31/2004
Notes: Consider using M99
Code : M99
Description : Missing/incomplete/invalid Universal Product Number/Serial Number.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M100
Description : We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.
Dates : Start: 01/01/1997
Code : M101
Description : Begin to report a G1-G5 modifier with this HCPCS. We will soon begin to deny payment for this service if billed without a G1-G5 modifier.
Dates : Start: 01/01/1997 | Stop: 01/31/2004
Notes: Consider using M78
Code : M102
Description : Service not performed on equipment approved by the FDA for this purpose.
Dates : Start: 01/01/1997
Code : M103
Description : Information supplied supports a break in therapy. However, the medical information we have for this patient does not support the need for this item as billed. We have approved payment for this item at a reduced level, and a new capped rental period will begin with the delivery of this equipment.
Dates : Start: 01/01/1997
Code : M104
Description : Information supplied supports a break in therapy. A new capped rental period will begin with delivery of the equipment. This is the maximum approved under the fee schedule for this item or service.
Dates : Start: 01/01/1997
Code : M105
Description : Information supplied does not support a break in therapy. The medical information we have for this patient does not support the need for this item as billed. We have approved payment for this item at a reduced level, and a new capped rental period will not begin.
Dates : Start: 01/01/1997
Code : M106
Description : Information supplied does not support a break in therapy. A new capped rental period will not begin. This is the maximum approved under the fee schedule for this item or service.
Dates : Start: 01/01/1997 | Stop: 01/31/2004
Notes: Consider using MA 31
Code : M107
Description : Payment reduced as 90-day rolling average hematocrit for ESRD patient exceeded 36.5%.
Dates : Start: 01/01/1997
Code : M108
Description : Missing/incomplete/invalid provider identifier for the provider who interpreted the diagnostic test.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : M109
Description : We have provided you with a bundled payment for a teleconsultation. You must send 25 percent of the teleconsultation payment to the referring practitioner.
Dates : Start: 01/01/1997
Code : M110
Description : Missing/incomplete/invalid provider identifier for the provider from whom you purchased interpretation services.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : M111
Description : We do not pay for chiropractic manipulative treatment when the patient refuses to have an x-ray taken.
Dates : Start: 01/01/1997
Code : M112
Description : Reimbursement for this item is based on the single payment amount required under the DMEPOS Competitive Bidding Program for the area where the patient resides.
Dates : Start: 01/01/1997 | Last Modified: 11/05/2007
Notes: (Modified 11/5/07)
Code : M113
Description : Our records indicate that this patient began using this item/service prior to the current contract period for the DMEPOS Competitive Bidding Program.
Dates : Start: 01/01/1997 | Last Modified: 11/05/2007
Notes: (Modified 11/5/07)
Code : M114
Description : This service was processed in accordance with rules and guidelines under the DMEPOS Competitive Bidding Program or a Demonstration Project. For more information regarding these projects, contact your local contractor.
Dates : Start: 01/01/1997 | Last Modified: 11/05/2007
Notes: (Modified 8/1/06, 11/5/07)
Code : M115
Description : This item is denied when provided to this patient by a non-contract or non-demonstration supplier.
Dates : Start: 01/01/1997 | Last Modified: 11/05/2007
Notes: (Modified 11/5/2007)
Code : M116
Description : Processed under a demonstration project or program. Project or program is ending and additional services may not be paid under this project or program.
Dates : Start: 01/01/1997 | Last Modified: 03/08/2011
Notes: (Modified 2/1/04, 3/15/11)
Code : M117
Description : Not covered unless submitted via electronic claim.
Dates : Start: 01/01/1997 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : M118
Description : Letter to follow containing further information.
Dates : Start: 01/01/1997 | Stop: 01/01/2011 | Last Modified: 11/01/2009
Notes: Consider using N202
Code : M119
Description : Missing/incomplete/invalid/ deactivated/withdrawn National Drug Code (NDC).
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 2/28/03, 4/1/04)
Code : M120
Description : Missing/incomplete/invalid provider identifier for the substituting physician who furnished the service(s) under a reciprocal billing or locum tenens arrangement.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : M121
Description : We pay for this service only when performed with a covered cryosurgical ablation.
Dates : Start: 01/01/1997
Code : M122
Description : Missing/incomplete/invalid level of subluxation.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2006
Notes: (Modified 2/28/03)
Code : M123
Description : Missing/incomplete/invalid name, strength, or dosage of the drug furnished.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M124
Description : Missing indication of whether the patient owns the equipment that requires the part or supply.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03) Related to N230
Code : M125
Description : Missing/incomplete/invalid information on the period of time for which the service/supply/equipment will be needed.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M126
Description : Missing/incomplete/invalid individual lab codes included in the test.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M127
Description : Missing patient medical record for this service.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03) Related to N237
Code : M128
Description : Missing/incomplete/invalid date of the patient's last physician visit.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : M129
Description : Missing/incomplete/invalid indicator of x-ray availability for review.
Dates : Start: 01/01/1997 | Last Modified: 06/30/2003
Notes: (Modified 2/28/03, 6/30/03)
Code : M130
Description : Missing invoice or statement certifying the actual cost of the lens, less discounts, and/or the type of intraocular lens used.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03) Related to N231
Code : M131
Description : Missing physician financial relationship form.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03) Related to N239
Code : M132
Description : Missing pacemaker registration form.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03) Related to N235
Code : M133
Description : Claim did not identify who performed the purchased diagnostic test or the amount you were charged for the test.
Dates : Start: 01/01/1997
Code : M134
Description : Performed by a facility/supplier in which the provider has a financial interest.
Dates : Start: 01/01/1997 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : M135
Description : Missing/incomplete/invalid plan of treatment.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M136
Description : Missing/incomplete/invalid indication that the service was supervised or evaluated by a physician.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : M137
Description : Part B coinsurance under a demonstration project.
Dates : Start: 01/01/1997
Code : M138
Description : Patient identified as a demonstration participant but the patient was not enrolled in the demonstration at the time services were rendered. Coverage is limited to demonstration participants.
Dates : Start: 01/01/1997
Code : M139
Description : Denied services exceed the coverage limit for the demonstration.
Dates : Start: 01/01/1997
Code : M140
Description : Service not covered until after the patient's 50th birthday, i.e., no coverage prior to the day after the 50th birthday
Dates : Start: 01/01/1997 | Stop: 01/30/2004
Notes: Consider using M82
Code : M141
Description : Missing physician certified plan of care.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03) Related to N238
Code : M142
Description : Missing American Diabetes Association Certificate of Recognition.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03) Related to N226
Code : M143
Description : The provider must update license information with the payer.
Dates : Start: 01/01/1997 | Last Modified: 12/01/2006
Notes: (Modified 12/1/06)
Code : M144
Description : Pre-/post-operative care payment is included in the allowance for the surgery/procedure.
Dates : Start: 01/01/1997
Code : MA01
Description : Alert: If you do not agree with what we approved for these services, you may appeal our decision. To make sure that we are fair to you, we require another individual that did not process your initial claim to conduct the appeal. However, in order to be eligible for an appeal, you must write to us within 120 days of the date you received this notice, unless you have a good reason for being late.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 10/31/02, 6/30/03, 8/1/05, 4/1/07)
Code : MA02
Description : Alert: If you do not agree with this determination, you have the right to appeal. You must file a written request for an appeal within 180 days of the date you receive this notice.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 10/31/02, 6/30/03, 8/1/05, 12/29/05, 8/1/06, 4/1/07)
Code : MA03
Description : If you do not agree with the approved amounts and $100 or more is in dispute (less deductible and coinsurance), you may ask for a hearing within six months of the date of this notice. To meet the $100, you may combine amounts on other claims that have been denied, including reopened appeals if you received a revised decision. You must appeal each claim on time.
Dates : Start: 01/01/1997 | Stop: 10/01/2006 | Last Modified: 11/18/2005
Notes: Consider using MA02 (Modified 10/31/02, 6/30/03, 8/1/05, 11/18/05)
Code : MA04
Description : Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible.
Dates : Start: 01/01/1997
Code : MA05
Description : Incorrect admission date patient status or type of bill entry on claim.
Dates : Start: 01/01/1997 | Stop: 10/16/2003
Notes: Consider using MA30, MA40 or MA43
Code : MA06
Description : Missing/incomplete/invalid beginning and/or ending date(s).
Dates : Start: 01/01/1997 | Stop: 08/01/2004
Notes: Consider using MA31
Code : MA07
Description : Alert: The claim information has also been forwarded to Medicaid for review.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA08
Description : Alert: Claim information was not forwarded because the supplemental coverage is not with a Medigap plan, or you do not participate in Medicare.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA09
Description : Claim submitted as unassigned but processed as assigned. You agreed to accept assignment for all claims.
Dates : Start: 01/01/1997
Code : MA10
Description : Alert: The patient's payment was in excess of the amount owed. You must refund the overpayment to the patient.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA11
Description : Payment is being issued on a conditional basis. If no-fault insurance, liability insurance, Workers' Compensation, Department of Veterans Affairs, or a group health plan for employees and dependents also covers this claim, a refund may be due us. Please contact us if the patient is covered by any of these sources.
Dates : Start: 01/01/1997 | Stop: 01/31/2004
Notes: Consider using M32
Code : MA12
Description : You have not established that you have the right under the law to bill for services furnished by the person(s) that furnished this (these) service(s).
Dates : Start: 01/01/1997
Code : MA13
Description : Alert: You may be subject to penalties if you bill the patient for amounts not reported with the PR (patient responsibility) group code.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA14
Description : Alert: The patient is a member of an employer-sponsored prepaid health plan. Services from outside that health plan are not covered. However, as you were not previously notified of this, we are paying this time. In the future, we will not pay you for non-plan services.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2007
Notes: (Modified 4/1/07, 8/1/07)
Code : MA15
Description : Alert: Your claim has been separated to expedite handling. You will receive a separate notice for the other services reported.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA16
Description : The patient is covered by the Black Lung Program. Send this claim to the Department of Labor, Federal Black Lung Program, P.O. Box 828, Lanham-Seabrook MD 20703.
Dates : Start: 01/01/1997
Code : MA17
Description : We are the primary payer and have paid at the primary rate. You must contact the patient's other insurer to refund any excess it may have paid due to its erroneous primary payment.
Dates : Start: 01/01/1997
Code : MA18
Description : Alert: The claim information is also being forwarded to the patient's supplemental insurer. Send any questions regarding supplemental benefits to them.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA19
Description : Alert: Information was not sent to the Medigap insurer due to incorrect/invalid information you submitted concerning that insurer. Please verify your information and submit your secondary claim directly to that insurer.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA20
Description : Skilled Nursing Facility (SNF) stay not covered when care is primarily related to the use of an urethral catheter for convenience or the control of incontinence.
Dates : Start: 01/01/1997 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : MA21
Description : SSA records indicate mismatch with name and sex.
Dates : Start: 01/01/1997
Code : MA22
Description : Payment of less than $1.00 suppressed.
Dates : Start: 01/01/1997
Code : MA23
Description : Demand bill approved as result of medical review.
Dates : Start: 01/01/1997
Code : MA24
Description : Christian Science Sanitarium/ Skilled Nursing Facility (SNF) bill in the same benefit period.
Dates : Start: 01/01/1997 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : MA25
Description : A patient may not elect to change a hospice provider more than once in a benefit period.
Dates : Start: 01/01/1997
Code : MA26
Description : Alert: Our records indicate that you were previously informed of this rule.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA27
Description : Missing/incomplete/invalid entitlement number or name shown on the claim.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA28
Description : Alert: Receipt of this notice by a physician or supplier who did not accept assignment is for information only and does not make the physician or supplier a party to the determination. No additional rights to appeal this decision, above those rights already provided for by regulation/instruction, are conferred by receipt of this notice.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA29
Description : Missing/incomplete/invalid provider name, city, state, or zip code.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : MA30
Description : Missing/incomplete/invalid type of bill.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA31
Description : Missing/incomplete/invalid beginning and ending dates of the period billed.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA32
Description : Missing/incomplete/invalid number of covered days during the billing period.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA33
Description : Missing/incomplete/invalid noncovered days during the billing period.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA34
Description : Missing/incomplete/invalid number of coinsurance days during the billing period.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA35
Description : Missing/incomplete/invalid number of lifetime reserve days.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA36
Description : Missing/incomplete/invalid patient name.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA37
Description : Missing/incomplete/invalid patient's address.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA38
Description : Missing/incomplete/invalid birth date.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : MA39
Description : Missing/incomplete/invalid gender.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA40
Description : Missing/incomplete/invalid admission date.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA41
Description : Missing/incomplete/invalid admission type.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA42
Description : Missing/incomplete/invalid admission source.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA43
Description : Missing/incomplete/invalid patient status.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA44
Description : Alert: No appeal rights. Adjudicative decision based on law.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA45
Description : Alert: As previously advised, a portion or all of your payment is being held in a special account.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA46
Description : The new information was considered but additional payment will not be issued.
Dates : Start: 01/01/1997 | Last Modified: 03/01/2009
Notes: (Modified 3/1/2009)
Code : MA47
Description : Our records show you have opted out of Medicare, agreeing with the patient not to bill Medicare for services/tests/supplies furnished. As result, we cannot pay this claim. The patient is responsible for payment.
Dates : Start: 01/01/1997
Code : MA48
Description : Missing/incomplete/invalid name or address of responsible party or primary payer.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA49
Description : Missing/incomplete/invalid six-digit provider identifier for home health agency or hospice for physician(s) performing care plan oversight services.
Dates : Start: 01/01/1997 | Stop: 08/01/2004
Notes: Consider using MA76
Code : MA50
Description : Missing/incomplete/invalid Investigational Device Exemption number for FDA-approved clinical trial services.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA51
Description : Missing/incomplete/invalid CLIA certification number for laboratory services billed by physician office laboratory.
Dates : Start: 01/01/1997 | Stop: 02/05/2005
Notes: Consider using MA120
Code : MA52
Description : Missing/incomplete/invalid date.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : MA53
Description : Missing/incomplete/invalid Competitive Bidding Demonstration Project identification.
Dates : Start: 01/01/1997 | Last Modified: 02/01/2004
Notes: (Modified 2/1/04)
Code : MA54
Description : Physician certification or election consent for hospice care not received timely.
Dates : Start: 01/01/1997
Code : MA55
Description : Not covered as patient received medical health care services, automatically revoking his/her election to receive religious non-medical health care services.
Dates : Start: 01/01/1997
Code : MA56
Description : Our records show you have opted out of Medicare, agreeing with the patient not to bill Medicare for services/tests/supplies furnished. As result, we cannot pay this claim. The patient is responsible for payment, but under Federal law, you cannot charge the patient more than the limiting charge amount.
Dates : Start: 01/01/1997
Code : MA57
Description : Patient submitted written request to revoke his/her election for religious non-medical health care services.
Dates : Start: 01/01/1997
Code : MA58
Description : Missing/incomplete/invalid release of information indicator.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA59
Description : Alert: The patient overpaid you for these services. You must issue the patient a refund within 30 days for the difference between his/her payment and the total amount shown as patient responsibility on this notice.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA60
Description : Missing/incomplete/invalid patient relationship to insured.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA61
Description : Missing/incomplete/invalid social security number or health insurance claim number.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA62
Description : Alert: This is a telephone review decision.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2007
Notes: (Modified 4/1/07, 8/1/07)
Code : MA63
Description : Missing/incomplete/invalid principal diagnosis.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA64
Description : Our records indicate that we should be the third payer for this claim. We cannot process this claim until we have received payment information from the primary and secondary payers.
Dates : Start: 01/01/1997
Code : MA65
Description : Missing/incomplete/invalid admitting diagnosis.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA66
Description : Missing/incomplete/invalid principal procedure code.
Dates : Start: 01/01/1997 | Last Modified: 12/02/2004
Notes: (Modified 12/2/04) Related to N303
Code : MA67
Description : Correction to a prior claim.
Dates : Start: 01/01/1997
Code : MA68
Description : Alert: We did not crossover this claim because the secondary insurance information on the claim was incomplete. Please supply complete information or use the PLANID of the insurer to assure correct and timely routing of the claim.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA69
Description : Missing/incomplete/invalid remarks.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA70
Description : Missing/incomplete/invalid provider representative signature.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA71
Description : Missing/incomplete/invalid provider representative signature date.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA72
Description : Alert: The patient overpaid you for these assigned services. You must issue the patient a refund within 30 days for the difference between his/her payment to you and the total of the amount shown as patient responsibility and as paid to the patient on this notice.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA73
Description : Informational remittance associated with a Medicare demonstration. No payment issued under fee-for-service Medicare as patient has elected managed care.
Dates : Start: 01/01/1997
Code : MA74
Description : This payment replaces an earlier payment for this claim that was either lost, damaged or returned.
Dates : Start: 01/01/1997
Code : MA75
Description : Missing/incomplete/invalid patient or authorized representative signature.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA76
Description : Missing/incomplete/invalid provider identifier for home health agency or hospice when physician is performing care plan oversight services.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03, 2/1/04)
Code : MA77
Description : Alert: The patient overpaid you. You must issue the patient a refund within 30 days for the difference between the patient's payment less the total of our and other payer payments and the amount shown as patient responsibility on this notice.
Dates : Start: 01/01/1997 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : MA78
Description : The patient overpaid you. You must issue the patient a refund within 30 days for the difference between our allowed amount total and the amount paid by the patient.
Dates : Start: 01/01/1997 | Stop: 01/31/2004
Notes: Consider using MA59
Code : MA79
Description : Billed in excess of interim rate.
Dates : Start: 01/01/1997
Code : MA80
Description : Informational notice. No payment issued for this claim with this notice. Payment issued to the hospital by its intermediary for all services for this encounter under a demonstration project.
Dates : Start: 01/01/1997
Code : MA81
Description : Missing/incomplete/invalid provider/supplier signature.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA82
Description : Missing/incomplete/invalid provider/supplier billing number/identifier or billing name, address, city, state, zip code, or phone number.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : MA83
Description : Did not indicate whether we are the primary or secondary payer.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2005
Notes: (Modified 8/1/05)
Code : MA84
Description : Patient identified as participating in the National Emphysema Treatment Trial but our records indicate that this patient is either not a participant, or has not yet been approved for this phase of the study. Contact Johns Hopkins University, the study coordinator, to resolve if there was a discrepancy.
Dates : Start: 01/01/1997
Code : MA85
Description : Our records indicate that a primary payer exists (other than ourselves); however, you did not complete or enter accurately the insurance plan/group/program name or identification number. Enter the PlanID when effective.
Dates : Start: 01/01/1997 | Stop: 08/01/2004
Notes: Consider using MA92
Code : MA86
Description : Missing/incomplete/invalid group or policy number of the insured for the primary coverage.
Dates : Start: 01/01/1997 | Stop: 08/01/2004
Notes: Consider using MA92
Code : MA87
Description : Missing/incomplete/invalid insured's name for the primary payer.
Dates : Start: 01/01/1997 | Stop: 08/01/2004
Notes: Consider using MA92
Code : MA88
Description : Missing/incomplete/invalid insured's address and/or telephone number for the primary payer.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA89
Description : Missing/incomplete/invalid patient's relationship to the insured for the primary payer.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA90
Description : Missing/incomplete/invalid employment status code for the primary insured.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03).
Code : MA91
Description : This determination is the result of the appeal you filed.
Dates : Start: 01/01/1997
Code : MA92
Description : Missing plan information for other insurance.
Dates : Start: 01/01/1997 | Last Modified: 02/01/2004
Notes: (Modified 2/1/04) Related to N245
Code : MA93
Description : Non-PIP (Periodic Interim Payment) claim.
Dates : Start: 01/01/1997 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : MA94
Description : Did not enter the statement “Attending physician not hospice employee” on the claim form to certify that the rendering physician is not an employee of the hospice.
Dates : Start: 01/01/1997 | Last Modified: 08/01/2005
Notes: (Reactivated 4/1/04, Modified 8/1/05)
Code : MA95
Description : A not otherwise classified or unlisted procedure code(s) was billed but a narrative description of the procedure was not entered on the claim. Refer to item 19 on the HCFA-1500.
Dates : Start: 01/01/1997 | Stop: 01/01/2004 | Last Modified: 02/28/2003
Notes: (Deactivated 2/28/2003) (Erroneous description corrected 9/2/2008) Consider using M51
Code : MA96
Description : Claim rejected. Coded as a Medicare Managed Care Demonstration but patient is not enrolled in a Medicare managed care plan.
Dates : Start: 01/01/1997
Code : MA97
Description : Missing/incomplete/invalid Medicare Managed Care Demonstration contract number or clinical trial registry number.
Dates : Start: 01/01/1997 | Last Modified: 02/29/2008
Notes: (Modified 2/29/08)
Code : MA98
Description : Claim Rejected. Does not contain the correct Medicare Managed Care Demonstration contract number for this beneficiary.
Dates : Start: 01/01/1997 | Stop: 10/16/2003
Notes: Consider using MA97
Code : MA99
Description : Missing/incomplete/invalid Medigap information.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA100
Description : Missing/incomplete/invalid date of current illness or symptoms
Dates : Start: 01/01/1997 | Last Modified: 03/30/2005
Notes: (Modified 2/28/03, 3/30/05)
Code : MA101
Description : A Skilled Nursing Facility (SNF) is responsible for payment of outside providers who furnish these services/supplies to residents.
Dates : Start: 01/01/1997 | Stop: 01/01/2011 | Last Modified: 06/30/2003
Notes: Consider using N538
Code : MA102
Description : Missing/incomplete/invalid name or provider identifier for the rendering/referring/ ordering/ supervising provider.
Dates : Start: 01/01/1997 | Stop: 08/01/2004
Notes: Consider using M68
Code : MA103
Description : Hemophilia Add On.
Dates : Start: 01/01/1997
Code : MA104
Description : Missing/incomplete/invalid date the patient was last seen or the provider identifier of the attending physician.
Dates : Start: 01/01/1997 | Stop: 01/31/2004
Notes: Consider using M128 or M57
Code : MA105
Description : Missing/incomplete/invalid provider number for this place of service.
Dates : Start: 01/01/1997 | Stop: 06/02/2005
Code : MA106
Description : PIP (Periodic Interim Payment) claim.
Dates : Start: 01/01/1997 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : MA107
Description : Paper claim contains more than three separate data items in field 19.
Dates : Start: 01/01/1997
Code : MA108
Description : Paper claim contains more than one data item in field 23.
Dates : Start: 01/01/1997
Code : MA109
Description : Claim processed in accordance with ambulatory surgical guidelines.
Dates : Start: 01/01/1997
Code : MA110
Description : Missing/incomplete/invalid information on whether the diagnostic test(s) were performed by an outside entity or if no purchased tests are included on the claim.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA111
Description : Missing/incomplete/invalid purchase price of the test(s) and/or the performing laboratory's name and address.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA112
Description : Missing/incomplete/invalid group practice information.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA113
Description : Incomplete/invalid taxpayer identification number (TIN) submitted by you per the Internal Revenue Service. Your claims cannot be processed without your correct TIN, and you may not bill the patient pending correction of your TIN. There are no appeal rights for unprocessable claims, but you may resubmit this claim after you have notified this office of your correct TIN.
Dates : Start: 01/01/1997
Code : MA114
Description : Missing/incomplete/invalid information on where the services were furnished.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA115
Description : Missing/incomplete/invalid physical location (name and address, or PIN) where the service(s) were rendered in a Health Professional Shortage Area (HPSA).
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA116
Description : Did not complete the statement 'Homebound' on the claim to validate whether laboratory services were performed at home or in an institution.
Dates : Start: 01/01/1997
Notes: (Reactivated 4/1/04)
Code : MA117
Description : This claim has been assessed a $1.00 user fee.
Dates : Start: 01/01/1997
Code : MA118
Description : Coinsurance and/or deductible amounts apply to a claim for services or supplies furnished to a Medicare-eligible veteran through a facility of the Department of Veterans Affairs. No Medicare payment issued.
Dates : Start: 01/01/1997
Code : MA119
Description : Provider level adjustment for late claim filing applies to this claim.
Dates : Start: 01/01/1997 | Stop: 05/01/2008 | Last Modified: 11/05/2007
Notes: Consider using Reason Code B4
Code : MA120
Description : Missing/incomplete/invalid CLIA certification number.
Dates : Start: 01/01/1997 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : MA121
Description : Missing/incomplete/invalid x-ray date.
Dates : Start: 01/01/1997 | Last Modified: 12/02/2004
Notes: (Modified 12/2/04)
Code : MA122
Description : Missing/incomplete/invalid initial treatment date.
Dates : Start: 01/01/1997 | Last Modified: 12/02/2004
Notes: (Modified 12/2/04)
Code : MA123
Description : Your center was not selected to participate in this study, therefore, we cannot pay for these services.
Dates : Start: 01/01/1997
Code : MA124
Description : Processed for IME only.
Dates : Start: 01/01/1997 | Stop: 01/31/2004
Notes: Consider using Reason Code 74
Code : MA125
Description : Per legislation governing this program, payment constitutes payment in full.
Dates : Start: 01/01/1997
Code : MA126
Description : Pancreas transplant not covered unless kidney transplant performed.
Dates : Start: 10/12/2001
Code : MA127
Description : Reserved for future use.
Dates : Start: 10/12/2001 | Stop: 06/02/2005
Code : MA128
Description : Missing/incomplete/invalid FDA approval number.
Dates : Start: 10/12/2001 | Last Modified: 03/30/2005
Notes: (Modified 2/28/03, 3/30/05)
Code : MA129
Description : This provider was not certified for this procedure on this date of service.
Dates : Start: 10/12/2001 | Stop: 01/31/2004 | Last Modified: 01/31/2004
Notes: Consider using MA120 and Reason Code B7
Code : MA130
Description : Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable. Please submit a new claim with the complete/correct information.
Dates : Start: 10/12/2001
Code : MA131
Description : Physician already paid for services in conjunction with this demonstration claim. You must have the physician withdraw that claim and refund the payment before we can process your claim.
Dates : Start: 10/12/2001
Code : MA132
Description : Adjustment to the pre-demonstration rate.
Dates : Start: 10/12/2001
Code : MA133
Description : Claim overlaps inpatient stay. Rebill only those services rendered outside the inpatient stay.
Dates : Start: 10/12/2001
Code : MA134
Description : Missing/incomplete/invalid provider number of the facility where the patient resides.
Dates : Start: 10/12/2001
Code : N1
Description : Alert: You may appeal this decision in writing within the required time limits following receipt of this notice by following the instructions included in your contract or plan benefit documents.
Dates : Start: 01/01/2000 | Last Modified: 04/01/2007
Notes: (Modified 2/28/03, 4/1/07)
Code : N2
Description : This allowance has been made in accordance with the most appropriate course of treatment provision of the plan.
Dates : Start: 01/01/2000
Code : N3
Description : Missing consent form.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03) Related to N228
Code : N4
Description : Missing/Incomplete/Invalid prior Insurance Carrier(s) EOB.
Dates : Start: 01/01/2000 | Last Modified: 03/06/2012
Notes: (Modified 2/28/03, 3/6/2012)
Code : N5
Description : EOB received from previous payer. Claim not on file.
Dates : Start: 01/01/2000
Code : N6
Description : Under FEHB law (U.S.C. 8904(b)), we cannot pay more for covered care than the amount Medicare would have allowed if the patient were enrolled in Medicare Part A and/or Medicare Part B.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N7
Description : Processing of this claim/service has included consideration under Major Medical provisions.
Dates : Start: 01/01/2000
Code : N8
Description : Crossover claim denied by previous payer and complete claim data not forwarded. Resubmit this claim to this payer to provide adequate data for adjudication.
Dates : Start: 01/01/2000
Code : N9
Description : Adjustment represents the estimated amount a previous payer may pay.
Dates : Start: 01/01/2000 | Last Modified: 11/18/2005
Notes: (Modified 11/18/05)
Code : N10
Description : Payment based on the findings of a review organization/professional consult/manual adjudication/medical or dental advisor.
Dates : Start: 01/01/2000 | Last Modified: 07/01/2008
Notes: (Modified 10/31/02, 7/1/08)
Code : N11
Description : Denial reversed because of medical review.
Dates : Start: 01/01/2000
Code : N12
Description : Policy provides coverage supplemental to Medicare. As the member does not appear to be enrolled in the applicable part of Medicare, the member is responsible for payment of the portion of the charge that would have been covered by Medicare.
Dates : Start: 01/01/2000 | Last Modified: 08/01/2007
Notes: (Modified 8/1/07)
Code : N13
Description : Payment based on professional/technical component modifier(s).
Dates : Start: 01/01/2000
Code : N14
Description : Payment based on a contractual amount or agreement, fee schedule, or maximum allowable amount.
Dates : Start: 01/01/2000 | Stop: 10/01/2007
Notes: Consider using Reason Code 45
Code : N15
Description : Services for a newborn must be billed separately.
Dates : Start: 01/01/2000
Code : N16
Description : Family/member Out-of-Pocket maximum has been met. Payment based on a higher percentage.
Dates : Start: 01/01/2000
Code : N17
Description : Per admission deductible.
Dates : Start: 01/01/2000 | Stop: 08/01/2004
Notes: Consider using Reason Code 1
Code : N18
Description : Payment based on the Medicare allowed amount.
Dates : Start: 01/01/2000 | Stop: 01/31/2004
Notes: Consider using N14
Code : N19
Description : Procedure code incidental to primary procedure.
Dates : Start: 01/01/2000
Code : N20
Description : Service not payable with other service rendered on the same date.
Dates : Start: 01/01/2000
Code : N21
Description : Alert: Your line item has been separated into multiple lines to expedite handling.
Dates : Start: 01/01/2000 | Last Modified: 04/01/2007
Notes: (Modified 8/1/05, 4/1/07)
Code : N22
Description : This procedure code was added/changed because it more accurately describes the services rendered.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 10/31/02, 2/28/03)
Code : N23
Description : Alert: Patient liability may be affected due to coordination of benefits with other carriers and/or maximum benefit provisions.
Dates : Start: 01/01/2000 | Last Modified: 04/01/2007
Notes: (Modified 8/13/01, 4/1/07)
Code : N24
Description : Missing/incomplete/invalid Electronic Funds Transfer (EFT) banking information.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N25
Description : This company has been contracted by your benefit plan to provide administrative claims payment services only. This company does not assume financial risk or obligation with respect to claims processed on behalf of your benefit plan.
Dates : Start: 01/01/2000
Code : N26
Description : Missing itemized bill/statement.
Dates : Start: 01/01/2000 | Last Modified: 07/01/2008
Notes: (Modified 2/28/03, 7/1/2008) Related to N232
Code : N27
Description : Missing/incomplete/invalid treatment number.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N28
Description : Consent form requirements not fulfilled.
Dates : Start: 01/01/2000
Code : N29
Description : Missing documentation/orders/notes/summary/report/chart.
Dates : Start: 01/01/2000 | Last Modified: 08/01/2005
Notes: (Modified 2/28/03, 8/1/05) Related to N225
Code : N30
Description : Patient ineligible for this service.
Dates : Start: 01/01/2000 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : N31
Description : Missing/incomplete/invalid prescribing provider identifier.
Dates : Start: 01/01/2000 | Last Modified: 12/02/2004
Notes: (Modified 12/2/04)
Code : N32
Description : Claim must be submitted by the provider who rendered the service.
Dates : Start: 01/01/2000 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : N33
Description : No record of health check prior to initiation of treatment.
Dates : Start: 01/01/2000
Code : N34
Description : Incorrect claim form/format for this service.
Dates : Start: 01/01/2000 | Last Modified: 11/18/2005
Notes: (Modified 11/18/05)
Code : N35
Description : Program integrity/utilization review decision.
Dates : Start: 01/01/2000
Code : N36
Description : Claim must meet primary payer's processing requirements before we can consider payment.
Dates : Start: 01/01/2000
Code : N37
Description : Missing/incomplete/invalid tooth number/letter.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N38
Description : Missing/incomplete/invalid place of service.
Dates : Start: 01/01/2000 | Stop: 02/05/2005
Notes: Consider using M77
Code : N39
Description : Procedure code is not compatible with tooth number/letter.
Dates : Start: 01/01/2000
Code : N40
Description : Missing radiology film(s)/image(s).
Dates : Start: 01/01/2000 | Last Modified: 07/01/2008
Notes: (Modified 2/1/04, 7/1/08) Related to N242
Code : N41
Description : Authorization request denied.
Dates : Start: 01/01/2000 | Stop: 10/16/2003
Notes: Consider using Reason Code 39
Code : N42
Description : No record of mental health assessment.
Dates : Start: 01/01/2000
Code : N43
Description : Bed hold or leave days exceeded.
Dates : Start: 01/01/2000
Code : N44
Description : Payer's share of regulatory surcharges, assessments, allowances or health care-related taxes paid directly to the regulatory authority.
Dates : Start: 01/01/2000 | Stop: 10/16/2003
Notes: Consider using Reason Code 137
Code : N45
Description : Payment based on authorized amount.
Dates : Start: 01/01/2000
Code : N46
Description : Missing/incomplete/invalid admission hour.
Dates : Start: 01/01/2000
Code : N47
Description : Claim conflicts with another inpatient stay.
Dates : Start: 01/01/2000
Code : N48
Description : Claim information does not agree with information received from other insurance carrier.
Dates : Start: 01/01/2000
Code : N49
Description : Court ordered coverage information needs validation.
Dates : Start: 01/01/2000
Code : N50
Description : Missing/incomplete/invalid discharge information.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N51
Description : Electronic interchange agreement not on file for provider/submitter.
Dates : Start: 01/01/2000
Code : N52
Description : Patient not enrolled in the billing provider's managed care plan on the date of service.
Dates : Start: 01/01/2000
Code : N53
Description : Missing/incomplete/invalid point of pick-up address.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N54
Description : Claim information is inconsistent with pre-certified/authorized services.
Dates : Start: 01/01/2000
Code : N55
Description : Procedures for billing with group/referring/performing providers were not followed.
Dates : Start: 01/01/2000
Code : N56
Description : Procedure code billed is not correct/valid for the services billed or the date of service billed.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N57
Description : Missing/incomplete/invalid prescribing date.
Dates : Start: 01/01/2000 | Last Modified: 12/02/2004
Notes: (Modified 12/2/04) Related to N304
Code : N58
Description : Missing/incomplete/invalid patient liability amount.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N59
Description : Please refer to your provider manual for additional program and provider information.
Dates : Start: 01/01/2000 | Last Modified: 11/01/2009
Notes: (Modified 4/1/07, 11/1/09)
Code : N60
Description : A valid NDC is required for payment of drug claims effective October 02.
Dates : Start: 01/01/2000 | Stop: 01/31/2004
Notes: Consider using M119
Code : N61
Description : Rebill services on separate claims.
Dates : Start: 01/01/2000
Code : N62
Description : Dates of service span multiple rate periods. Resubmit separate claims.
Dates : Start: 01/01/2000 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
Code : N63
Description : Rebill services on separate claim lines.
Dates : Start: 01/01/2000
Code : N64
Description : The “from” and “to” dates must be different.
Dates : Start: 01/01/2000
Code : N65
Description : Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N66
Description : Missing/incomplete/invalid documentation.
Dates : Start: 01/01/2000 | Stop: 02/05/2005
Notes: Consider using N29 or N225.
Code : N67
Description : Professional provider services not paid separately. Included in facility payment under a demonstration project. Apply to that facility for payment, or resubmit your claim if: the facility notifies you the patient was excluded from this demonstration; or if you furnished these services in another location on the date of the patient's admission or discharge from a demonstration hospital. If services were furnished in a facility not involved in the demonstration on the same date the patient was discharged from or admitted to a demonstration facility, you must report the provider ID number for the non-demonstration facility on the new claim.
Dates : Start: 01/01/2000
Code : N68
Description : Prior payment being cancelled as we were subsequently notified this patient was covered by a demonstration project in this site of service. Professional services were included in the payment made to the facility. You must contact the facility for your payment. Prior payment made to you by the patient or another insurer for this claim must be refunded to the payer within 30 days.
Dates : Start: 01/01/2000
Code : N69
Description : PPS (Prospective Payment System) code changed by claims processing system.
Dates : Start: 01/01/2000 | Last Modified: 07/01/2012
Notes: (Modified 6/30/03, 7/1/12)
Code : N70
Description : Consolidated billing and payment applies.
Dates : Start: 01/01/2000 | Last Modified: 11/05/2007
Notes: (Modified 2/28/02, 11/5/07)
Code : N71
Description : Your unassigned claim for a drug or biological, clinical diagnostic laboratory services or ambulance service was processed as an assigned claim. You are required by law to accept assignment for these types of claims.
Dates : Start: 01/01/2000 | Last Modified: 06/30/2003
Notes: (Modified 2/21/02, 6/30/03)
Code : N72
Description : PPS (Prospective Payment System) code changed by medical reviewers. Not supported by clinical records.
Dates : Start: 01/01/2000 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : N73
Description : A Skilled Nursing Facility is responsible for payment of outside providers who furnish these services/supplies under arrangement to its residents.
Dates : Start: 01/01/2000 | Stop: 01/31/2004
Notes: Consider using MA101 or N200
Code : N74
Description : Resubmit with multiple claims, each claim covering services provided in only one calendar month.
Dates : Start: 01/01/2000
Code : N75
Description : Missing/incomplete/invalid tooth surface information.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N76
Description : Missing/incomplete/invalid number of riders.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N77
Description : Missing/incomplete/invalid designated provider number.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N78
Description : The necessary components of the child and teen checkup (EPSDT) were not completed.
Dates : Start: 01/01/2000
Code : N79
Description : Service billed is not compatible with patient location information.
Dates : Start: 01/01/2000
Code : N80
Description : Missing/incomplete/invalid prenatal screening information.
Dates : Start: 01/01/2000 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N81
Description : Procedure billed is not compatible with tooth surface code.
Dates : Start: 01/01/2000
Code : N82
Description : Provider must accept insurance payment as payment in full when a third party payer contract specifies full reimbursement.
Dates : Start: 01/01/2000
Code : N83
Description : No appeal rights. Adjudicative decision based on the provisions of a demonstration project.
Dates : Start: 01/01/2000
Code : N84
Description : Alert: Further installment payments are forthcoming.
Dates : Start: 01/01/2000 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07, 8/1/07)
Code : N85
Description : Alert: This is the final installment payment.
Dates : Start: 01/01/2000 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07, 8/1/07)
Code : N86
Description : A failed trial of pelvic muscle exercise training is required in order for biofeedback training for the treatment of urinary incontinence to be covered.
Dates : Start: 01/01/2000
Code : N87
Description : Home use of biofeedback therapy is not covered.
Dates : Start: 01/01/2000
Code : N88
Description : Alert: This payment is being made conditionally. An HHA episode of care notice has been filed for this patient. When a patient is treated under a HHA episode of care, consolidated billing requires that certain therapy services and supplies, such as this, be included in the HHA's payment. This payment will need to be recouped from you if we establish that the patient is concurrently receiving treatment under a HHA episode of care.
Dates : Start: 01/01/2000 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N89
Description : Alert: Payment information for this claim has been forwarded to more than one other payer, but format limitations permit only one of the secondary payers to be identified in this remittance advice.
Dates : Start: 01/01/2000 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N90
Description : Covered only when performed by the attending physician.
Dates : Start: 01/01/2000
Code : N91
Description : Services not included in the appeal review.
Dates : Start: 01/01/2000
Code : N92
Description : This facility is not certified for digital mammography.
Dates : Start: 01/01/2000
Code : N93
Description : A separate claim must be submitted for each place of service. Services furnished at multiple sites may not be billed in the same claim.
Dates : Start: 01/01/2000
Code : N94
Description : Claim/Service denied because a more specific taxonomy code is required for adjudication.
Dates : Start: 01/01/2000
Code : N95
Description : This provider type/provider specialty may not bill this service.
Dates : Start: 07/31/2001 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N96
Description : Patient must be refractory to conventional therapy (documented behavioral, pharmacologic and/or surgical corrective therapy) and be an appropriate surgical candidate such that implantation with anesthesia can occur.
Dates : Start: 08/24/2001
Code : N97
Description : Patients with stress incontinence, urinary obstruction, and specific neurologic diseases (e.g., diabetes with peripheral nerve involvement) which are associated with secondary manifestations of the above three indications are excluded.
Dates : Start: 08/24/2001
Code : N98
Description : Patient must have had a successful test stimulation in order to support subsequent implantation. Before a patient is eligible for permanent implantation, he/she must demonstrate a 50 percent or greater improvement through test stimulation. Improvement is measured through voiding diaries.
Dates : Start: 08/24/2001
Code : N99
Description : Patient must be able to demonstrate adequate ability to record voiding diary data such that clinical results of the implant procedure can be properly evaluated.
Dates : Start: 08/24/2001
Code : N100
Description : PPS (Prospect Payment System) code corrected during adjudication.
Dates : Start: 09/14/2001 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : N101
Description : Additional information is needed in order to process this claim. Please resubmit the claim with the identification number of the provider where this service took place. The Medicare number of the site of service provider should be preceded with the letters 'HSP' and entered into item #32 on the claim form. You may bill only one site of service provider number per claim.
Dates : Start: 10/31/2001 | Stop: 01/31/2004
Notes: Consider uisng MA105
Code : N102
Description : This claim has been denied without reviewing the medical record because the requested records were not received or were not received timely.
Dates : Start: 10/31/2001
Code : N103
Description : Social Security records indicate that this patient was a prisoner when the service was rendered. This payer does not cover items and services furnished to an individual while he or she is in a Federal facility, or while he or she is in State or local custody under a penal authority, unless under State or local law, the individual is personally liable for the cost of his or her health care while incarcerated and the State or local government pursues such debt in the same way and with the same vigor as any other debt.
Dates : Start: 10/31/2001 | Last Modified: 07/01/2012
Notes: (Modified 6/30/03, 7/1/12)
Code : N104
Description : This claim/service is not payable under our claims jurisdiction area. You can identify the correct Medicare contractor to process this claim/service through the CMS website at www.cms.gov.
Dates : Start: 01/29/2002 | Last Modified: 07/01/2010
Notes: (Modified 10/31/02, 7/1/10)
Code : N105
Description : This is a misdirected claim/service for an RRB beneficiary. Submit paper claims to the RRB carrier: Palmetto GBA, P.O. Box 10066, Augusta, GA 30999. Call 866-749-4301 for RRB EDI information for electronic claims processing.
Dates : Start: 01/29/2002
Code : N106
Description : Payment for services furnished to Skilled Nursing Facility (SNF) inpatients (except for excluded services) can only be made to the SNF. You must request payment from the SNF rather than the patient for this service.
Dates : Start: 01/31/2002
Code : N107
Description : Services furnished to Skilled Nursing Facility (SNF) inpatients must be billed on the inpatient claim. They cannot be billed separately as outpatient services.
Dates : Start: 01/31/2002
Code : N108
Description : Missing/incomplete/invalid upgrade information.
Dates : Start: 01/31/2002 | Last Modified: 02/28/2003
Notes: (Modified 2/28/03)
Code : N109
Description : This claim/service was chosen for complex review and was denied after reviewing the medical records.
Dates : Start: 02/28/2002 | Last Modified: 03/01/2009
Notes: (Modified 3/1/2009)
Code : N110
Description : This facility is not certified for film mammography.
Dates : Start: 02/28/2002
Code : N111
Description : No appeal right except duplicate claim/service issue. This service was included in a claim that has been previously billed and adjudicated.
Dates : Start: 02/28/2002
Code : N112
Description : This claim is excluded from your electronic remittance advice.
Dates : Start: 02/28/2002
Code : N113
Description : Only one initial visit is covered per physician, group practice or provider.
Dates : Start: 04/16/2002 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : N114
Description : During the transition to the Ambulance Fee Schedule, payment is based on the lesser of a blended amount calculated using a percentage of the reasonable charge/cost and fee schedule amounts, or the submitted charge for the service. You will be notified yearly what the percentages for the blended payment calculation will be.
Dates : Start: 05/30/2002
Code : N115
Description : This decision was based on a Local Coverage Determination (LCD). An LCD provides a guide to assist in determining whether a particular item or service is covered. A copy of this policy is available at www.cms.gov/mcd, or if you do not have web access, you may contact the contractor to request a copy of the LCD.
Dates : Start: 05/30/2002 | Last Modified: 07/01/2010
Notes: (Modified 4/1/04, 7/1/10)
Code : N116
Description : This payment is being made conditionally because the service was provided in the home, and it is possible that the patient is under a home health episode of care. When a patient is treated under a home health episode of care, consolidated billing requires that certain therapy services and supplies, such as this, be included in the home health agency's (HHA's) payment. This payment will need to be recouped from you if we establish that the patient is concurrently receiving treatment under an HHA episode of care.
Dates : Start: 06/30/2002
Code : N117
Description : This service is paid only once in a patient's lifetime.
Dates : Start: 07/30/2002 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : N118
Description : This service is not paid if billed more than once every 28 days.
Dates : Start: 07/30/2002
Code : N119
Description : This service is not paid if billed once every 28 days, and the patient has spent 5 or more consecutive days in any inpatient or Skilled /nursing Facility (SNF) within those 28 days.
Dates : Start: 07/30/2002 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : N120
Description : Payment is subject to home health prospective payment system partial episode payment adjustment. Patient was transferred/discharged/readmitted during payment episode.
Dates : Start: 08/09/2002 | Last Modified: 06/30/2003
Notes: (Modified 6/30/03)
Code : N121
Description : Medicare Part B does not pay for items or services provided by this type of practitioner for beneficiaries in a Medicare Part A covered Skilled Nursing Facility (SNF) stay.
Dates : Start: 09/09/2002 | Last Modified: 08/01/2004
Notes: (Modified 8/1/04, 6/30/03)
Code : N122
Description : Add-on code cannot be billed by itself.
Dates : Start: 09/12/2002 | Last Modified: 08/01/2005
Notes: (Modified 8/1/05)
Code : N123
Description : This is a split service and represents a portion of the units from the originally submitted service.
Dates : Start: 09/24/2002
Code : N124
Description : Payment has been denied for the/made only for a less extensive service/item because the information furnished does not substantiate the need for the (more extensive) service/item. The patient is liable for the charges for this service/item as you informed the patient in writing before the service/item was furnished that we would not pay for it, and the patient agreed to pay.
Dates : Start: 09/26/2002
Code : N125
Description : Payment has been (denied for the/made only for a less extensive) service/item because the information furnished does not substantiate the need for the (more extensive) service/item. If you have collected any amount from the patient, you must refund that amount to the patient within 30 days of receiving this notice. The requirements for a refund are in §1834(a)(18) of the Social Security Act (and in §§1834(j)(4) and 1879(h) by cross-reference to §1834(a)(18)). Section 1834(a)(18)(B) specifies that suppliers which knowingly and willfully fail to make appropriate refunds may be subject to civil money penalties and/or exclusion from the Medicare program. If you have any questions about this notice, please contact this office.
Dates : Start: 09/26/2002 | Last Modified: 08/01/2005
Notes: (Modified 8/1/05. Also refer to N356)
Code : N126
Description : Social Security Records indicate that this individual has been deported. This payer does not cover items and services furnished to individuals who have been deported.
Dates : Start: 10/17/2002
Code : N127
Description : This is a misdirected claim/service for a United Mine Workers of America (UMWA) beneficiary. Please submit claims to them.
Dates : Start: 10/31/2007 | Last Modified: 08/01/2004
Notes: (Modified 8/1/04
Code : N128
Description : This amount represents the prior to coverage portion of the allowance.
Dates : Start: 10/31/2002
Code : N129
Description : Not eligible due to the patient's age.
Dates : Start: 10/31/2002 | Last Modified: 08/01/2007
Notes: (Modified 8/1/07)
Code : N130
Description : Consult plan benefit documents/guidelines for information about restrictions for this service.
Dates : Start: 10/31/2002 | Last Modified: 11/01/2009
Notes: (Modified 4/1/07, 7/1/08, 11/1/09)
Code : N131
Description : Total payments under multiple contracts cannot exceed the allowance for this service.
Dates : Start: 10/31/2002
Code : N132
Description : Alert: Payments will cease for services rendered by this US Government debarred or excluded provider after the 30 day grace period as previously notified.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N133
Description : Alert: Services for predetermination and services requesting payment are being processed separately.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N134
Description : Alert: This represents your scheduled payment for this service. If treatment has been discontinued, please contact Customer Service.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N135
Description : Record fees are the patient's responsibility and limited to the specified co-payment.
Dates : Start: 10/31/2002
Code : N136
Description : Alert: To obtain information on the process to file an appeal in Arizona, call the Department's Consumer Assistance Office at (602) 912-8444 or (800) 325-2548.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N137
Description : Alert: The provider acting on the Member's behalf, may file an appeal with the Payer. The provider, acting on the Member's behalf, may file a complaint with the State Insurance Regulatory Authority without first filing an appeal, if the coverage decision involves an urgent condition for which care has not been rendered. The address may be obtained from the State Insurance Regulatory Authority.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 8/1/04, 2/28/03, 4/1/07)
Code : N138
Description : Alert: In the event you disagree with the Dental Advisor's opinion and have additional information relative to the case, you may submit radiographs to the Dental Advisor Unit at the subscriber's dental insurance carrier for a second Independent Dental Advisor Review.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N139
Description : Alert: Under the Code of Federal Regulations, Chapter 32, Section 199.13 a non-participating provider is not an appropriate appealing party. Therefore, if you disagree with the Dental Advisor's opinion, you may appeal the determination if appointed in writing, by the beneficiary, to act as his/her representative. Should you be appointed as a representative, submit a copy of this letter, a signed statement explaining the matter in which you disagree, and any radiographs and relevant information to the subscriber's Dental insurance carrier within 90 days from the date of this letter.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N140
Description : Alert: You have not been designated as an authorized OCONUS provider therefore are not considered an appropriate appealing party. If the beneficiary has appointed you, in writing, to act as his/her representative and you disagree with the Dental Advisor's opinion, you may appeal by submitting a copy of this letter, a signed statement explaining the matter in which you disagree, and any relevant information to the subscriber's Dental insurance carrier within 90 days from the date of this letter.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N141
Description : The patient was not residing in a long-term care facility during all or part of the service dates billed.
Dates : Start: 10/31/2002
Code : N142
Description : The original claim was denied. Resubmit a new claim, not a replacement claim.
Dates : Start: 10/31/2002
Code : N143
Description : The patient was not in a hospice program during all or part of the service dates billed.
Dates : Start: 10/31/2002
Code : N144
Description : The rate changed during the dates of service billed.
Dates : Start: 10/31/2002
Code : N145
Description : Missing/incomplete/invalid provider identifier for this place of service.
Dates : Start: 10/31/2002 | Stop: 06/02/2005
Code : N146
Description : Missing screening document.
Dates : Start: 10/31/2002 | Last Modified: 08/01/2004
Notes: (Modified 8/1/04) Related to N243
Code : N147
Description : Long term care case mix or per diem rate cannot be determined because the patient ID number is missing, incomplete, or invalid on the assignment request.
Dates : Start: 10/31/2002
Code : N148
Description : Missing/incomplete/invalid date of last menstrual period.
Dates : Start: 10/31/2002
Code : N149
Description : Rebill all applicable services on a single claim.
Dates : Start: 10/31/2002
Code : N150
Description : Missing/incomplete/invalid model number.
Dates : Start: 10/31/2002
Code : N151
Description : Telephone contact services will not be paid until the face-to-face contact requirement has been met.
Dates : Start: 10/31/2002
Code : N152
Description : Missing/incomplete/invalid replacement claim information.
Dates : Start: 10/31/2002
Code : N153
Description : Missing/incomplete/invalid room and board rate.
Dates : Start: 10/31/2002
Code : N154
Description : Alert: This payment was delayed for correction of provider's mailing address.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N155
Description : Alert: Our records do not indicate that other insurance is on file. Please submit other insurance information for our records.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N156
Description : Alert: The patient is responsible for the difference between the approved treatment and the elective treatment.
Dates : Start: 10/31/2002 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N157
Description : Transportation to/from this destination is not covered.
Dates : Start: 02/28/2003 | Last Modified: 02/01/2004
Notes: (Modified 2/1/04)
Code : N158
Description : Transportation in a vehicle other than an ambulance is not covered.
Dates : Start: 02/28/2003
Code : N159
Description : Payment denied/reduced because mileage is not covered when the patient is not in the ambulance.
Dates : Start: 02/28/2003
Code : N160
Description : The patient must choose an option before a payment can be made for this procedure/ equipment/ supply/ service.
Dates : Start: 02/28/2003 | Last Modified: 02/01/2004
Notes: (Modified 2/1/04)
Code : N161
Description : This drug/service/supply is covered only when the associated service is covered.
Dates : Start: 02/28/2003
Code : N162
Description : Alert: Although your claim was paid, you have billed for a test/specialty not included in your Laboratory Certification. Your failure to correct the laboratory certification information will result in a denial of payment in the near future.
Dates : Start: 02/28/2003 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N163
Description : Medical record does not support code billed per the code definition.
Dates : Start: 02/28/2003
Code : N164
Description : Transportation to/from this destination is not covered.
Dates : Start: 02/28/2003 | Stop: 01/31/2004
Notes: Consider using N157
Code : N165
Description : Transportation in a vehicle other than an ambulance is not covered.
Dates : Start: 02/28/2003 | Stop: 01/31/2004
Notes: Consider using N158)
Code : N166
Description : Payment denied/reduced because mileage is not covered when the patient is not in the ambulance.
Dates : Start: 02/28/2003 | Stop: 01/31/2004
Notes: Consider using N159
Code : N167
Description : Charges exceed the post-transplant coverage limit.
Dates : Start: 02/28/2003
Code : N168
Description : The patient must choose an option before a payment can be made for this procedure/ equipment/ supply/ service.
Dates : Start: 02/28/2003 | Stop: 01/31/2004
Notes: Consider using N160
Code : N169
Description : This drug/service/supply is covered only when the associated service is covered.
Dates : Start: 02/28/2003 | Stop: 01/31/2004
Notes: Consider using N161
Code : N170
Description : A new/revised/renewed certificate of medical necessity is needed.
Dates : Start: 02/28/2003
Code : N171
Description : Payment for repair or replacement is not covered or has exceeded the purchase price.
Dates : Start: 02/28/2003
Code : N172
Description : The patient is not liable for the denied/adjusted charge(s) for receiving any updated service/item.
Dates : Start: 02/28/2003
Code : N173
Description : No qualifying hospital stay dates were provided for this episode of care.
Dates : Start: 02/28/2003
Code : N174
Description : This is not a covered service/procedure/ equipment/bed, however patient liability is limited to amounts shown in the adjustments under group 'PR'.
Dates : Start: 02/28/2003
Code : N175
Description : Missing review organization approval.
Dates : Start: 02/28/2003 | Last Modified: 02/29/2008
Notes: (Modified 8/1/04, 2/29/08) Related to N241
Code : N176
Description : Services provided aboard a ship are covered only when the ship is of United States registry and is in United States waters. In addition, a doctor licensed to practice in the United States must provide the service.
Dates : Start: 02/28/2003
Code : N177
Description : Alert: We did not send this claim to patient's other insurer. They have indicated no additional payment can be made.
Dates : Start: 02/28/2003 | Last Modified: 04/01/2007
Notes: (Modified 6/30/03, 4/1/07)
Code : N178
Description : Missing pre-operative photos or visual field results.
Dates : Start: 02/28/2003 | Last Modified: 08/01/2004
Notes: (Modified 8/1/04) Related to N244
Code : N179
Description : Additional information has been requested from the member. The charges will be reconsidered upon receipt of that information.
Dates : Start: 02/28/2003
Code : N180
Description : This item or service does not meet the criteria for the category under which it was billed.
Dates : Start: 02/28/2003
Code : N181
Description : Additional information is required from another provider involved in this service.
Dates : Start: 02/28/2003 | Last Modified: 12/01/2006
Notes: (Modified 12/1/06)
Code : N182
Description : This claim/service must be billed according to the schedule for this plan.
Dates : Start: 02/28/2003
Code : N183
Description : Alert: This is a predetermination advisory message, when this service is submitted for payment additional documentation as specified in plan documents will be required to process benefits.
Dates : Start: 02/28/2003 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N184
Description : Rebill technical and professional components separately.
Dates : Start: 02/28/2003
Code : N185
Description : Alert: Do not resubmit this claim/service.
Dates : Start: 02/28/2003 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N186
Description : Non-Availability Statement (NAS) required for this service. Contact the nearest Military Treatment Facility (MTF) for assistance.
Dates : Start: 02/28/2003
Code : N187
Description : Alert: You may request a review in writing within the required time limits following receipt of this notice by following the instructions included in your contract or plan benefit documents.
Dates : Start: 02/28/2003 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N188
Description : The approved level of care does not match the procedure code submitted.
Dates : Start: 02/28/2003
Code : N189
Description : Alert: This service has been paid as a one-time exception to the plan's benefit restrictions.
Dates : Start: 02/28/2003 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N190
Description : Missing contract indicator.
Dates : Start: 02/28/2003 | Last Modified: 08/01/2004
Notes: (Modified 8/1/04) Related to N229
Code : N191
Description : The provider must update insurance information directly with payer.
Dates : Start: 02/28/2003
Code : N192
Description : Patient is a Medicaid/Qualified Medicare Beneficiary.
Dates : Start: 02/28/2003
Code : N193
Description : Specific federal/state/local program may cover this service through another payer.
Dates : Start: 02/28/2003
Code : N194
Description : Technical component not paid if provider does not own the equipment used.
Dates : Start: 02/25/2003
Code : N195
Description : The technical component must be billed separately.
Dates : Start: 02/25/2003
Code : N196
Description : Alert: Patient eligible to apply for other coverage which may be primary.
Dates : Start: 02/25/2003 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N197
Description : The subscriber must update insurance information directly with payer.
Dates : Start: 02/25/2003
Code : N198
Description : Rendering provider must be affiliated with the pay-to provider.
Dates : Start: 02/25/2003
Code : N199
Description : Additional payment/recoupment approved based on payer-initiated review/audit.
Dates : Start: 02/25/2003 | Last Modified: 08/01/2006
Notes: (Modified 8/1/06)
Code : N200
Description : The professional component must be billed separately.
Dates : Start: 02/25/2003
Code : N201
Description : A mental health facility is responsible for payment of outside providers who furnish these services/supplies to residents.
Dates : Start: 02/25/2003 | Stop: 01/01/2011
Notes: Consider using N538
Code : N202
Description : Additional information/explanation will be sent separately
Dates : Start: 06/30/2003 | Last Modified: 11/01/2009
Notes: (Modified 4/1/07, 11/1/09)
Code : N203
Description : Missing/incomplete/invalid anesthesia time/units
Dates : Start: 06/30/2003
Code : N204
Description : Services under review for possible pre-existing condition. Send medical records for prior 12 months
Dates : Start: 06/30/2003
Code : N205
Description : Information provided was illegible
Dates : Start: 06/30/2003
Code : N206
Description : The supporting documentation does not match the information sent on the claim.
Dates : Start: 06/30/2003 | Last Modified: 03/06/2012
Notes: (Modified 3/6/12)
Code : N207
Description : Missing/incomplete/invalid weight.
Dates : Start: 06/30/2003 | Last Modified: 11/18/2005
Notes: (Modified 11/18/05)
Code : N208
Description : Missing/incomplete/invalid DRG code
Dates : Start: 06/30/2003
Code : N209
Description : Missing/incomplete/invalid taxpayer identification number (TIN).
Dates : Start: 06/30/2003 | Last Modified: 07/01/2008
Notes: (Modified 7/1/08)
Code : N210
Description : Alert: You may appeal this decision
Dates : Start: 06/30/2003 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N211
Description : Alert: You may not appeal this decision
Dates : Start: 06/30/2003 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N212
Description : Charges processed under a Point of Service benefit
Dates : Start: 02/01/2004
Code : N213
Description : Missing/incomplete/invalid facility/discrete unit DRG/DRG exempt status information
Dates : Start: 04/01/2004
Code : N214
Description : Missing/incomplete/invalid history of the related initial surgical procedure(s)
Dates : Start: 04/01/2004
Code : N215
Description : Alert: A payer providing supplemental or secondary coverage shall not require a claims determination for this service from a primary payer as a condition of making its own claims determination.
Dates : Start: 04/01/2004 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N216
Description : We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package
Dates : Start: 04/01/2004 | Last Modified: 03/01/2010
Notes: (modified 3/1/2010)
Code : N217
Description : We pay only one site of service per provider per claim
Dates : Start: 08/01/2004
Code : N218
Description : You must furnish and service this item for as long as the patient continues to need it. We can pay for maintenance and/or servicing for the time period specified in the contract or coverage manual.
Dates : Start: 08/01/2004
Code : N219
Description : Payment based on previous payer's allowed amount.
Dates : Start: 08/01/2004
Code : N220
Description : Alert: See the payer's web site or contact the payer's Customer Service department to obtain forms and instructions for filing a provider dispute.
Dates : Start: 08/01/2004 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N221
Description : Missing Admitting History and Physical report.
Dates : Start: 08/01/2004
Code : N222
Description : Incomplete/invalid Admitting History and Physical report.
Dates : Start: 08/01/2004
Code : N223
Description : Missing documentation of benefit to the patient during initial treatment period.
Dates : Start: 08/01/2004
Code : N224
Description : Incomplete/invalid documentation of benefit to the patient during initial treatment period.
Dates : Start: 08/01/2004
Code : N225
Description : Incomplete/invalid documentation/orders/notes/summary/report/chart.
Dates : Start: 08/01/2004 | Last Modified: 08/01/2005
Notes: (Modified 8/1/05)
Code : N226
Description : Incomplete/invalid American Diabetes Association Certificate of Recognition.
Dates : Start: 08/01/2004
Code : N227
Description : Incomplete/invalid Certificate of Medical Necessity.
Dates : Start: 08/01/2004
Code : N228
Description : Incomplete/invalid consent form.
Dates : Start: 08/01/2004
Code : N229
Description : Incomplete/invalid contract indicator.
Dates : Start: 08/01/2004
Code : N230
Description : Incomplete/invalid indication of whether the patient owns the equipment that requires the part or supply.
Dates : Start: 08/01/2004
Code : N231
Description : Incomplete/invalid invoice or statement certifying the actual cost of the lens, less discounts, and/or the type of intraocular lens used.
Dates : Start: 08/01/2004
Code : N232
Description : Incomplete/invalid itemized bill/statement.
Dates : Start: 08/01/2004 | Last Modified: 07/01/2008
Notes: (Modified 7/1/08)
Code : N233
Description : Incomplete/invalid operative note/report.
Dates : Start: 08/01/2004 | Last Modified: 07/01/2008
Notes: (Modified 7/1/08)
Code : N234
Description : Incomplete/invalid oxygen certification/re-certification.
Dates : Start: 08/01/2004
Code : N235
Description : Incomplete/invalid pacemaker registration form.
Dates : Start: 08/01/2004
Code : N236
Description : Incomplete/invalid pathology report.
Dates : Start: 08/01/2004
Code : N237
Description : Incomplete/invalid patient medical record for this service.
Dates : Start: 08/01/2004
Code : N238
Description : Incomplete/invalid physician certified plan of care
Dates : Start: 08/01/2004
Code : N239
Description : Incomplete/invalid physician financial relationship form.
Dates : Start: 08/01/2004
Code : N240
Description : Incomplete/invalid radiology report.
Dates : Start: 08/01/2004
Code : N241
Description : Incomplete/invalid review organization approval.
Dates : Start: 08/01/2004 | Last Modified: 02/29/2008
Notes: (Modified 2/29/08)
Code : N242
Description : Incomplete/invalid radiology film(s)/image(s).
Dates : Start: 08/01/2004 | Last Modified: 07/01/2008
Notes: (Modified 7/1/08)
Code : N243
Description : Incomplete/invalid/not approved screening document.
Dates : Start: 08/01/2004
Code : N244
Description : Incomplete/invalid pre-operative photos/visual field results.
Dates : Start: 08/01/2004
Code : N245
Description : Incomplete/invalid plan information for other insurance
Dates : Start: 08/01/2004
Code : N246
Description : State regulated patient payment limitations apply to this service.
Dates : Start: 12/02/2004
Code : N247
Description : Missing/incomplete/invalid assistant surgeon taxonomy.
Dates : Start: 12/02/2004
Code : N248
Description : Missing/incomplete/invalid assistant surgeon name.
Dates : Start: 12/02/2004
Code : N249
Description : Missing/incomplete/invalid assistant surgeon primary identifier.
Dates : Start: 12/02/2004
Code : N250
Description : Missing/incomplete/invalid assistant surgeon secondary identifier.
Dates : Start: 12/02/2004
Code : N251
Description : Missing/incomplete/invalid attending provider taxonomy.
Dates : Start: 12/02/2004
Code : N252
Description : Missing/incomplete/invalid attending provider name.
Dates : Start: 12/02/2004
Code : N253
Description : Missing/incomplete/invalid attending provider primary identifier.
Dates : Start: 12/02/2004
Code : N254
Description : Missing/incomplete/invalid attending provider secondary identifier.
Dates : Start: 12/02/2004
Code : N255
Description : Missing/incomplete/invalid billing provider taxonomy.
Dates : Start: 12/02/2004
Code : N256
Description : Missing/incomplete/invalid billing provider/supplier name.
Dates : Start: 12/02/2004
Code : N257
Description : Missing/incomplete/invalid billing provider/supplier primary identifier.
Dates : Start: 12/02/2004
Code : N258
Description : Missing/incomplete/invalid billing provider/supplier address.
Dates : Start: 12/02/2004
Code : N259
Description : Missing/incomplete/invalid billing provider/supplier secondary identifier.
Dates : Start: 12/02/2004
Code : N260
Description : Missing/incomplete/invalid billing provider/supplier contact information.
Dates : Start: 12/02/2004
Code : N261
Description : Missing/incomplete/invalid operating provider name.
Dates : Start: 12/02/2004
Code : N262
Description : Missing/incomplete/invalid operating provider primary identifier.
Dates : Start: 12/02/2004
Code : N263
Description : Missing/incomplete/invalid operating provider secondary identifier.
Dates : Start: 12/02/2004
Code : N264
Description : Missing/incomplete/invalid ordering provider name.
Dates : Start: 12/02/2004
Code : N265
Description : Missing/incomplete/invalid ordering provider primary identifier.
Dates : Start: 12/02/2004
Code : N266
Description : Missing/incomplete/invalid ordering provider address.
Dates : Start: 12/02/2004
Code : N267
Description : Missing/incomplete/invalid ordering provider secondary identifier.
Dates : Start: 12/02/2004
Code : N268
Description : Missing/incomplete/invalid ordering provider contact information.
Dates : Start: 12/02/2004
Code : N269
Description : Missing/incomplete/invalid other provider name.
Dates : Start: 12/02/2004
Code : N270
Description : Missing/incomplete/invalid other provider primary identifier.
Dates : Start: 12/02/2004
Code : N271
Description : Missing/incomplete/invalid other provider secondary identifier.
Dates : Start: 12/02/2004
Code : N272
Description : Missing/incomplete/invalid other payer attending provider identifier.
Dates : Start: 12/02/2004
Code : N273
Description : Missing/incomplete/invalid other payer operating provider identifier.
Dates : Start: 12/02/2004
Code : N274
Description : Missing/incomplete/invalid other payer other provider identifier.
Dates : Start: 12/02/2004
Code : N275
Description : Missing/incomplete/invalid other payer purchased service provider identifier.
Dates : Start: 12/02/2004
Code : N276
Description : Missing/incomplete/invalid other payer referring provider identifier.
Dates : Start: 12/02/2004
Code : N277
Description : Missing/incomplete/invalid other payer rendering provider identifier.
Dates : Start: 12/02/2004
Code : N278
Description : Missing/incomplete/invalid other payer service facility provider identifier.
Dates : Start: 12/02/2004
Code : N279
Description : Missing/incomplete/invalid pay-to provider name.
Dates : Start: 12/02/2004
Code : N280
Description : Missing/incomplete/invalid pay-to provider primary identifier.
Dates : Start: 12/02/2004
Code : N281
Description : Missing/incomplete/invalid pay-to provider address.
Dates : Start: 12/02/2004
Code : N282
Description : Missing/incomplete/invalid pay-to provider secondary identifier.
Dates : Start: 12/02/2004
Code : N283
Description : Missing/incomplete/invalid purchased service provider identifier.
Dates : Start: 12/02/2004
Code : N284
Description : Missing/incomplete/invalid referring provider taxonomy.
Dates : Start: 12/02/2004
Code : N285
Description : Missing/incomplete/invalid referring provider name.
Dates : Start: 12/02/2004
Code : N286
Description : Missing/incomplete/invalid referring provider primary identifier.
Dates : Start: 12/02/2004
Code : N287
Description : Missing/incomplete/invalid referring provider secondary identifier.
Dates : Start: 12/02/2004
Code : N288
Description : Missing/incomplete/invalid rendering provider taxonomy.
Dates : Start: 12/02/2004
Code : N289
Description : Missing/incomplete/invalid rendering provider name.
Dates : Start: 12/02/2004
Code : N290
Description : Missing/incomplete/invalid rendering provider primary identifier.
Dates : Start: 12/02/2004
Code : N291
Description : Missing/incomplete/invalid rendering provider secondary identifier.
Dates : Start: 12/02/2004 | Last Modified: 11/01/2010
Code : N292
Description : Missing/incomplete/invalid service facility name.
Dates : Start: 12/02/2004
Code : N293
Description : Missing/incomplete/invalid service facility primary identifier.
Dates : Start: 12/02/2004
Code : N294
Description : Missing/incomplete/invalid service facility primary address.
Dates : Start: 12/02/2004
Code : N295
Description : Missing/incomplete/invalid service facility secondary identifier.
Dates : Start: 12/02/2004
Code : N296
Description : Missing/incomplete/invalid supervising provider name.
Dates : Start: 12/02/2004
Code : N297
Description : Missing/incomplete/invalid supervising provider primary identifier.
Dates : Start: 12/02/2004
Code : N298
Description : Missing/incomplete/invalid supervising provider secondary identifier.
Dates : Start: 12/02/2004
Code : N299
Description : Missing/incomplete/invalid occurrence date(s).
Dates : Start: 12/02/2004
Code : N300
Description : Missing/incomplete/invalid occurrence span date(s).
Dates : Start: 12/02/2004
Code : N301
Description : Missing/incomplete/invalid procedure date(s).
Dates : Start: 12/02/2004
Code : N302
Description : Missing/incomplete/invalid other procedure date(s).
Dates : Start: 12/02/2004
Code : N303
Description : Missing/incomplete/invalid principal procedure date.
Dates : Start: 12/02/2004
Code : N304
Description : Missing/incomplete/invalid dispensed date.
Dates : Start: 12/02/2004
Code : N305
Description : Missing/incomplete/invalid accident date.
Dates : Start: 12/02/2004
Code : N306
Description : Missing/incomplete/invalid acute manifestation date.
Dates : Start: 12/02/2004
Code : N307
Description : Missing/incomplete/invalid adjudication or payment date.
Dates : Start: 12/02/2004
Code : N308
Description : Missing/incomplete/invalid appliance placement date.
Dates : Start: 12/02/2004
Code : N309
Description : Missing/incomplete/invalid assessment date.
Dates : Start: 12/02/2004
Code : N310
Description : Missing/incomplete/invalid assumed or relinquished care date.
Dates : Start: 12/02/2004
Code : N311
Description : Missing/incomplete/invalid authorized to return to work date.
Dates : Start: 12/02/2004
Code : N312
Description : Missing/incomplete/invalid begin therapy date.
Dates : Start: 12/02/2004
Code : N313
Description : Missing/incomplete/invalid certification revision date.
Dates : Start: 12/02/2004
Code : N314
Description : Missing/incomplete/invalid diagnosis date.
Dates : Start: 12/02/2004
Code : N315
Description : Missing/incomplete/invalid disability from date.
Dates : Start: 12/02/2004
Code : N316
Description : Missing/incomplete/invalid disability to date.
Dates : Start: 12/02/2004
Code : N317
Description : Missing/incomplete/invalid discharge hour.
Dates : Start: 12/02/2004
Code : N318
Description : Missing/incomplete/invalid discharge or end of care date.
Dates : Start: 12/02/2004
Code : N319
Description : Missing/incomplete/invalid hearing or vision prescription date.
Dates : Start: 12/02/2004
Code : N320
Description : Missing/incomplete/invalid Home Health Certification Period.
Dates : Start: 12/02/2004
Code : N321
Description : Missing/incomplete/invalid last admission period.
Dates : Start: 12/02/2004
Code : N322
Description : Missing/incomplete/invalid last certification date.
Dates : Start: 12/02/2004
Code : N323
Description : Missing/incomplete/invalid last contact date.
Dates : Start: 12/02/2004
Code : N324
Description : Missing/incomplete/invalid last seen/visit date.
Dates : Start: 12/02/2004
Code : N325
Description : Missing/incomplete/invalid last worked date.
Dates : Start: 12/02/2004
Code : N326
Description : Missing/incomplete/invalid last x-ray date.
Dates : Start: 12/02/2004
Code : N327
Description : Missing/incomplete/invalid other insured birth date.
Dates : Start: 12/02/2004
Code : N328
Description : Missing/incomplete/invalid Oxygen Saturation Test date.
Dates : Start: 12/02/2004
Code : N329
Description : Missing/incomplete/invalid patient birth date.
Dates : Start: 12/02/2004
Code : N330
Description : Missing/incomplete/invalid patient death date.
Dates : Start: 12/02/2004
Code : N331
Description : Missing/incomplete/invalid physician order date.
Dates : Start: 12/02/2004
Code : N332
Description : Missing/incomplete/invalid prior hospital discharge date.
Dates : Start: 12/02/2004
Code : N333
Description : Missing/incomplete/invalid prior placement date.
Dates : Start: 12/02/2004
Code : N334
Description : Missing/incomplete/invalid re-evaluation date
Dates : Start: 12/02/2004
Code : N335
Description : Missing/incomplete/invalid referral date.
Dates : Start: 12/02/2004
Code : N336
Description : Missing/incomplete/invalid replacement date.
Dates : Start: 12/02/2004
Code : N337
Description : Missing/incomplete/invalid secondary diagnosis date.
Dates : Start: 12/02/2004
Code : N338
Description : Missing/incomplete/invalid shipped date.
Dates : Start: 12/02/2004
Code : N339
Description : Missing/incomplete/invalid similar illness or symptom date.
Dates : Start: 12/02/2004
Code : N340
Description : Missing/incomplete/invalid subscriber birth date.
Dates : Start: 12/02/2004
Code : N341
Description : Missing/incomplete/invalid surgery date.
Dates : Start: 12/02/2004
Code : N342
Description : Missing/incomplete/invalid test performed date.
Dates : Start: 12/02/2004
Code : N343
Description : Missing/incomplete/invalid Transcutaneous Electrical Nerve Stimulator (TENS) trial start date.
Dates : Start: 12/02/2004
Code : N344
Description : Missing/incomplete/invalid Transcutaneous Electrical Nerve Stimulator (TENS) trial end date.
Dates : Start: 12/02/2004
Code : N345
Description : Date range not valid with units submitted.
Dates : Start: 03/30/2005
Code : N346
Description : Missing/incomplete/invalid oral cavity designation code.
Dates : Start: 03/30/2005
Code : N347
Description : Your claim for a referred or purchased service cannot be paid because payment has already been made for this same service to another provider by a payment contractor representing the payer.
Dates : Start: 03/30/2005
Code : N348
Description : You chose that this service/supply/drug would be rendered/supplied and billed by a different practitioner/supplier.
Dates : Start: 08/01/2005
Code : N349
Description : The administration method and drug must be reported to adjudicate this service.
Dates : Start: 08/01/2005
Code : N350
Description : Missing/incomplete/invalid description of service for a Not Otherwise Classified (NOC) code or for an Unlisted/By Report procedure.
Dates : Start: 08/01/2005 | Last Modified: 07/01/2008
Notes: (Modified 7/1/08)
Code : N351
Description : Service date outside of the approved treatment plan service dates.
Dates : Start: 08/01/2005
Code : N352
Description : Alert: There are no scheduled payments for this service. Submit a claim for each patient visit.
Dates : Start: 08/01/2005 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N353
Description : Alert: Benefits have been estimated, when the actual services have been rendered, additional payment will be considered based on the submitted claim.
Dates : Start: 08/01/2005 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N354
Description : Incomplete/invalid invoice
Dates : Start: 08/01/2005
Code : N355
Description : Alert: The law permits exceptions to the refund requirement in two cases: - If you did not know, and could not have reasonably been expected to know, that we would not pay for this service; or - If you notified the patient in writing before providing the service that you believed that we were likely to deny the service, and the patient signed a statement agreeing to pay for the service. If you come within either exception, or if you believe the carrier was wrong in its determination that we do not pay for this service, you should request appeal of this determination within 30 days of the date of this notice. Your request for review should include any additional information necessary to support your position. If you request an appeal within 30 days of receiving this notice, you may delay refunding the amount to the patient until you receive the results of the review. If the review decision is favorable to you, you do not need to make any refund. If, however, the review is unfavorable, the law specifies that you must make the refund within 15 days of receiving the unfavorable review decision. The law also permits you to request an appeal at any time within 120 days of the date you receive this notice. However, an appeal request that is received more than 30 days after the date of this notice, does not permit you to delay making the refund. Regardless of when a review is requested, the patient will be notified that you have requested one, and will receive a copy of the determination. The patient has received a separate notice of this denial decision. The notice advises that he/she may be entitled to a refund of any amounts paid, if you should have known that we would not pay and did not tell him/her. It also instructs the patient to contact our office if he/she does not hear anything about a refund within 30 days
Dates : Start: 08/01/2005 | Last Modified: 04/01/2007
Notes: (Modified 11/18/05, Modified 4/1/07)
Code : N356
Description : Not covered when performed with, or subsequent to, a non-covered service.
Dates : Start: 08/01/2005 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
Code : N357
Description : Time frame requirements between this service/procedure/supply and a related service/procedure/supply have not been met.
Dates : Start: 11/18/2005
Code : N358
Description : Alert: This decision may be reviewed if additional documentation as described in the contract or plan benefit documents is submitted.
Dates : Start: 11/18/2005 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N359
Description : Missing/incomplete/invalid height.
Dates : Start: 11/18/2005
Code : N360
Description : Alert: Coordination of benefits has not been calculated when estimating benefits for this pre-determination. Submit payment information from the primary payer with the secondary claim.
Dates : Start: 11/18/2005 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N361
Description : Payment adjusted based on multiple diagnostic imaging procedure rules
Dates : Start: 11/18/2005 | Stop: 10/01/2007 | Last Modified: 12/01/2006
Notes: (Modified 12/1/06) Consider using Reason Code 59
Code : N362
Description : The number of Days or Units of Service exceeds our acceptable maximum.
Dates : Start: 11/18/2005
Code : N363
Description : Alert: in the near future we are implementing new policies/procedures that would affect this determination.
Dates : Start: 11/18/2005 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N364
Description : Alert: According to our agreement, you must waive the deductible and/or coinsurance amounts.
Dates : Start: 11/18/2005 | Last Modified: 04/01/2007
Notes: (Modified 4/1/07)
Code : N365
Description : This procedure code is not payable. It is for reporting/information purposes only.
Dates : Start: 04/01/2006
Code : N366
Description : Requested information not provided. The claim will be reopened if the information previously requested is submitted within one year after the date of this denial notice.
Dates : Start: 04/01/2006
Code : N367
Description : Alert: The claim information has been forwarded to a Consumer Spending Account processor for review; for example, flexible spending account or health savings account.
Dates : Start: 04/01/2006 | Last Modified: 07/01/2008
Notes: (Modified 4/1/07, 11/5/07, 7/1/08)
Code : N368
Description : You must appeal the determination of the previously adjudicated claim.
Dates : Start: 04/01/2006
Code : N369
Description : Alert: Although this claim has been processed, it is deficient according to state legislation/regulation.
Dates : Start: 04/01/2006
Code : N370
Description : Billing exceeds the rental months covered/approved by the payer.
Dates : Start: 08/01/2006
Code : N371
Description : Alert: title of this equipment must be transferred to the patient.
Dates : Start: 08/01/2006
Code : N372
Description : Only reasonable and necessary maintenance/service charges are covered.
Dates : Start: 08/01/2006
Code : N373
Description : It has been determined that another payer paid the services as primary when they were not the primary payer. Therefore, we are refunding to the payer that paid as primary on your behalf.
Dates : Start: 12/01/2006
Code : N374
Description : Primary Medicare Part A insurance has been exhausted and a Part B Remittance Advice is required.
Dates : Start: 12/01/2006
Code : N375
Description : Missing/incomplete/invalid questionnaire/information required to determine dependent eligibility.
Dates : Start: 12/01/2006
Code : N376
Description : Subscriber/patient is assigned to active military duty, therefore primary coverage may be TRICARE.
Dates : Start: 12/01/2006
Code : N377
Description : Payment based on a processed replacement claim.
Dates : Start: 12/01/2006 | Last Modified: 11/05/2007
Notes: (Modified 11/5/07)
Code : N378
Description : Missing/incomplete/invalid prescription quantity.
Dates : Start: 12/01/2006
Code : N379
Description : Claim level information does not match line level information.
Dates : Start: 12/01/2006
Code : N380
Description : The original claim has been processed, submit a corrected claim.
Dates : Start: 04/01/2007
Code : N381
Description : Consult our contractual agreement for restrictions/billing/payment information related to these charges.
Dates : Start: 04/01/2007
Code : N382
Description : Missing/incomplete/invalid patient identifier.
Dates : Start: 04/01/2007
Code : N383
Description : Not covered when deemed cosmetic.
Dates : Start: 04/01/2007 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
Code : N384
Description : Records indicate that the referenced body part/tooth has been removed in a previous procedure.
Dates : Start: 04/01/2007
Code : N385
Description : Notification of admission was not timely according to published plan procedures.
Dates : Start: 04/01/2007 | Last Modified: 11/05/2007
Notes: (Modified 11/5/07)
Code : N386
Description : This decision was based on a National Coverage Determination (NCD). An NCD provides a coverage determination as to whether a particular item or service is covered. A copy of this policy is available at www.cms.gov/mcd/search.asp. If you do not have web access, you may contact the contractor to request a copy of the NCD.
Dates : Start: 04/01/2007 | Last Modified: 07/01/2010
Notes: (Modified 7/1/2010)
Code : N387
Description : Alert: Submit this claim to the patient's other insurer for potential payment of supplemental benefits. We did not forward the claim information.
Dates : Start: 04/01/2007 | Last Modified: 03/01/2009
Notes: (Modified 3/1/2009)
Code : N388
Description : Missing/incomplete/invalid prescription number
Dates : Start: 08/01/2007
Code : N389
Description : Duplicate prescription number submitted.
Dates : Start: 08/01/2007
Code : N390
Description : This service/report cannot be billed separately.
Dates : Start: 08/01/2007 | Last Modified: 07/01/2008
Notes: (Modified 7/1/08)
Code : N391
Description : Missing emergency department records.
Dates : Start: 08/01/2007
Code : N392
Description : Incomplete/invalid emergency department records.
Dates : Start: 08/01/2007
Code : N393
Description : Missing progress notes/report.
Dates : Start: 08/01/2007 | Last Modified: 07/01/2008
Notes: (Modified 7/1/08)
Code : N394
Description : Incomplete/invalid progress notes/report.
Dates : Start: 08/01/2007 | Last Modified: 07/01/2008
Notes: (Modified 7/1/08)
Code : N395
Description : Missing laboratory report.
Dates : Start: 08/01/2007
Code : N396
Description : Incomplete/invalid laboratory report.
Dates : Start: 08/01/2007
Code : N397
Description : Benefits are not available for incomplete service(s)/undelivered item(s).
Dates : Start: 08/01/2007
Code : N398
Description : Missing elective consent form.
Dates : Start: 08/01/2007
Code : N399
Description : Incomplete/invalid elective consent form.
Dates : Start: 08/01/2007
Code : N400
Description : Alert: Electronically enabled providers should submit claims electronically.
Dates : Start: 08/01/2007
Code : N401
Description : Missing periodontal charting.
Dates : Start: 08/01/2007
Code : N402
Description : Incomplete/invalid periodontal charting.
Dates : Start: 08/01/2007
Code : N403
Description : Missing facility certification.
Dates : Start: 08/01/2007
Code : N404
Description : Incomplete/invalid facility certification.
Dates : Start: 08/01/2007
Code : N405
Description : This service is only covered when the donor's insurer(s) do not provide coverage for the service.
Dates : Start: 08/01/2007
Code : N406
Description : This service is only covered when the recipient's insurer(s) do not provide coverage for the service.
Dates : Start: 08/01/2007
Code : N407
Description : You are not an approved submitter for this transmission format.
Dates : Start: 08/01/2007
Code : N408
Description : This payer does not cover deductibles assessed by a previous payer.
Dates : Start: 08/01/2007
Code : N409
Description : This service is related to an accidental injury and is not covered unless provided within a specific time frame from the date of the accident.
Dates : Start: 08/01/2007
Code : N410
Description : Not covered unless the prescription changes.
Dates : Start: 08/01/2007 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
Code : N411
Description : This service is allowed one time in a 6-month period. (This temporary code will be deactivated on 2/1/09. Must be used with Reason Code 119.)
Dates : Start: 08/01/2007 | Stop: 02/01/2009
Code : N412
Description : This service is allowed 2 times in a 12-month period. (This temporary code will be deactivated on 2/1/09. Must be used with Reason Code 119.)
Dates : Start: 08/01/2007 | Stop: 02/01/2009
Code : N413
Description : This service is allowed 2 times in a benefit year. (This temporary code will be deactivated on 2/1/09. Must be used with Reason Code 119.)
Dates : Start: 08/01/2007 | Stop: 02/01/2009
Code : N414
Description : This service is allowed 4 times in a 12-month period. (This temporary code will be deactivated on 2/1/09. Must be used with Reason Code 119.)
Dates : Start: 08/01/2007 | Stop: 02/01/2009
Code : N415
Description : This service is allowed 1 time in an 18-month period. (This temporary code will be deactivated on 2/1/09. Must be used with Reason Code 119.)
Dates : Start: 08/01/2007 | Stop: 02/01/2009
Code : N416
Description : This service is allowed 1 time in a 3-year period. (This temporary code will be deactivated on 2/1/09. Must be used with Reason Code 119.)
Dates : Start: 08/01/2007 | Stop: 02/01/2009
Code : N417
Description : This service is allowed 1 time in a 5-year period. (This temporary code will be deactivated on 2/1/09. Must be used with Reason Code 119.)
Dates : Start: 08/01/2007 | Stop: 02/01/2009
Code : N418
Description : Misrouted claim. See the payer's claim submission instructions.
Dates : Start: 08/01/2007
Code : N419
Description : Claim payment was the result of a payer's retroactive adjustment due to a retroactive rate change.
Dates : Start: 08/01/2007
Code : N420
Description : Claim payment was the result of a payer's retroactive adjustment due to a Coordination of Benefits or Third Party Liability Recovery.
Dates : Start: 08/01/2007
Code : N421
Description : Claim payment was the result of a payer's retroactive adjustment due to a review organization decision.
Dates : Start: 08/01/2007 | Last Modified: 05/08/2008
Notes: (Modified 2/29/08, typo fixed 5/8/08)
Code : N422
Description : Claim payment was the result of a payer's retroactive adjustment due to a payer's contract incentive program.
Dates : Start: 08/01/2007 | Last Modified: 05/08/2008
Notes: (Typo fixed 5/8/08)
Code : N423
Description : Claim payment was the result of a payer's retroactive adjustment due to a non standard program.
Dates : Start: 08/01/2007
Code : N424
Description : Patient does not reside in the geographic area required for this type of payment.
Dates : Start: 08/01/2007
Code : N425
Description : Statutorily excluded service(s).
Dates : Start: 08/01/2007
Code : N426
Description : No coverage when self-administered.
Dates : Start: 08/01/2007
Code : N427
Description : Payment for eyeglasses or contact lenses can be made only after cataract surgery.
Dates : Start: 08/01/2007
Code : N428
Description : Not covered when performed in this place of service.
Dates : Start: 08/01/2007 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
Code : N429
Description : Not covered when considered routine.
Dates : Start: 08/01/2007 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
Code : N430
Description : Procedure code is inconsistent with the units billed.
Dates : Start: 11/05/2007
Code : N431
Description : Not covered with this procedure.
Dates : Start: 11/05/2007 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
Code : N432
Description : Adjustment based on a Recovery Audit.
Dates : Start: 11/05/2007
Code : N433
Description : Resubmit this claim using only your National Provider Identifier (NPI)
Dates : Start: 02/29/2008
Code : N434
Description : Missing/Incomplete/Invalid Present on Admission indicator.
Dates : Start: 07/01/2008
Code : N435
Description : Exceeds number/frequency approved /allowed within time period without support documentation.
Dates : Start: 07/01/2008
Code : N436
Description : The injury claim has not been accepted and a mandatory medical reimbursement has been made.
Dates : Start: 07/01/2008
Code : N437
Description : Alert: If the injury claim is accepted, these charges will be reconsidered.
Dates : Start: 07/01/2008
Code : N438
Description : This jurisdiction only accepts paper claims
Dates : Start: 07/01/2008
Code : N439
Description : Missing anesthesia physical status report/indicators.
Dates : Start: 07/01/2008
Code : N440
Description : Incomplete/invalid anesthesia physical status report/indicators.
Dates : Start: 07/01/2008
Code : N441
Description : This missed appointment is not covered.
Dates : Start: 07/01/2008
Code : N442
Description : Payment based on an alternate fee schedule.
Dates : Start: 07/01/2008
Code : N443
Description : Missing/incomplete/invalid total time or begin/end time.
Dates : Start: 07/01/2008
Code : N444
Description : Alert: This facility has not filed the Election for High Cost Outlier form with the Division of Workers' Compensation.
Dates : Start: 07/01/2008
Code : N445
Description : Missing document for actual cost or paid amount.
Dates : Start: 07/01/2008
Code : N446
Description : Incomplete/invalid document for actual cost or paid amount.
Dates : Start: 07/01/2008
Code : N447
Description : Payment is based on a generic equivalent as required documentation was not provided.
Dates : Start: 07/01/2008
Code : N448
Description : This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement
Dates : Start: 07/01/2008
Code : N449
Description : Payment based on a comparable drug/service/supply.
Dates : Start: 07/01/2008
Code : N450
Description : Covered only when performed by the primary treating physician or the designee.
Dates : Start: 07/01/2008
Code : N451
Description : Missing Admission Summary Report.
Dates : Start: 07/01/2008
Code : N452
Description : Incomplete/invalid Admission Summary Report.
Dates : Start: 07/01/2008
Code : N453
Description : Missing Consultation Report.
Dates : Start: 07/01/2008
Code : N454
Description : Incomplete/invalid Consultation Report.
Dates : Start: 07/01/2008
Code : N455
Description : Missing Physician Order.
Dates : Start: 07/01/2008
Code : N456
Description : Incomplete/invalid Physician Order.
Dates : Start: 07/01/2008
Code : N457
Description : Missing Diagnostic Report.
Dates : Start: 07/01/2008
Code : N458
Description : Incomplete/invalid Diagnostic Report.
Dates : Start: 07/01/2008
Code : N459
Description : Missing Discharge Summary.
Dates : Start: 07/01/2008
Code : N460
Description : Incomplete/invalid Discharge Summary.
Dates : Start: 07/01/2008
Code : N461
Description : Missing Nursing Notes.
Dates : Start: 07/01/2008
Code : N462
Description : Incomplete/invalid Nursing Notes.
Dates : Start: 07/01/2008
Code : N463
Description : Missing support data for claim.
Dates : Start: 07/01/2008
Code : N464
Description : Incomplete/invalid support data for claim.
Dates : Start: 07/01/2008
Code : N465
Description : Missing Physical Therapy Notes/Report.
Dates : Start: 07/01/2008
Code : N466
Description : Incomplete/invalid Physical Therapy Notes/Report.
Dates : Start: 07/01/2008
Code : N467
Description : Missing Report of Tests and Analysis Report.
Dates : Start: 07/01/2008
Code : N468
Description : Incomplete/invalid Report of Tests and Analysis Report.
Dates : Start: 07/01/2008
Code : N469
Description : Alert: Claim/Service(s) subject to appeal process, see section 935 of Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA).
Dates : Start: 07/01/2008
Code : N470
Description : This payment will complete the mandatory medical reimbursement limit.
Dates : Start: 07/01/2008
Code : N471
Description : Missing/incomplete/invalid HIPPS Rate Code.
Dates : Start: 07/01/2008
Code : N472
Description : Payment for this service has been issued to another provider.
Dates : Start: 07/01/2008
Code : N473
Description : Missing certification.
Dates : Start: 07/01/2008
Code : N474
Description : Incomplete/invalid certification
Dates : Start: 07/01/2008
Code : N475
Description : Missing completed referral form.
Dates : Start: 07/01/2008
Code : N476
Description : Incomplete/invalid completed referral form
Dates : Start: 07/01/2008
Code : N477
Description : Missing Dental Models.
Dates : Start: 07/01/2008
Code : N478
Description : Incomplete/invalid Dental Models
Dates : Start: 07/01/2008
Code : N479
Description : Missing Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer).
Dates : Start: 07/01/2008
Code : N480
Description : Incomplete/invalid Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer).
Dates : Start: 07/01/2008
Code : N481
Description : Missing Models.
Dates : Start: 07/01/2008
Code : N482
Description : Incomplete/invalid Models
Dates : Start: 07/01/2008
Code : N483
Description : Missing Periodontal Charts.
Dates : Start: 07/01/2008
Code : N484
Description : Incomplete/invalid Periodontal Charts
Dates : Start: 07/01/2008
Code : N485
Description : Missing Physical Therapy Certification.
Dates : Start: 07/01/2008
Code : N486
Description : Incomplete/invalid Physical Therapy Certification.
Dates : Start: 07/01/2008
Code : N487
Description : Missing Prosthetics or Orthotics Certification.
Dates : Start: 07/01/2008
Code : N488
Description : Incomplete/invalid Prosthetics or Orthotics Certification
Dates : Start: 07/01/2008
Code : N489
Description : Missing referral form.
Dates : Start: 07/01/2008
Code : N490
Description : Incomplete/invalid referral form
Dates : Start: 07/01/2008
Code : N491
Description : Missing/Incomplete/Invalid Exclusionary Rider Condition.
Dates : Start: 07/01/2008
Code : N492
Description : Alert: A network provider may bill the member for this service if the member requested the service and agreed in writing, prior to receiving the service, to be financially responsible for the billed charge.
Dates : Start: 07/01/2008
Code : N493
Description : Missing Doctor First Report of Injury.
Dates : Start: 07/01/2008
Code : N494
Description : Incomplete/invalid Doctor First Report of Injury.
Dates : Start: 07/01/2008
Code : N495
Description : Missing Supplemental Medical Report.
Dates : Start: 07/01/2008
Code : N496
Description : Incomplete/invalid Supplemental Medical Report.
Dates : Start: 07/01/2008
Code : N497
Description : Missing Medical Permanent Impairment or Disability Report.
Dates : Start: 07/01/2008
Code : N498
Description : Incomplete/invalid Medical Permanent Impairment or Disability Report.
Dates : Start: 07/01/2008
Code : N499
Description : Missing Medical Legal Report.
Dates : Start: 07/01/2008
Code : N500
Description : Incomplete/invalid Medical Legal Report.
Dates : Start: 07/01/2008
Code : N501
Description : Missing Vocational Report.
Dates : Start: 07/01/2008
Code : N502
Description : Incomplete/invalid Vocational Report.
Dates : Start: 07/01/2008
Code : N503
Description : Missing Work Status Report.
Dates : Start: 07/01/2008
Code : N504
Description : Incomplete/invalid Work Status Report.
Dates : Start: 07/01/2008
Code : N505
Description : Alert: This response includes only services that could be estimated in real time. No estimate will be provided for the services that could not be estimated in real time.
Dates : Start: 11/01/2008
Code : N506
Description : Alert: This is an estimate of the member's liability based on the information available at the time the estimate was processed. Actual coverage and member liability amounts will be determined when the claim is processed. This is not a pre-authorization or a guarantee of payment.
Dates : Start: 11/01/2008
Code : N507
Description : Plan distance requirements have not been met.
Dates : Start: 11/01/2008
Code : N508
Description : Alert: This real time claim adjudication response represents the member responsibility to the provider for services reported. The member will receive an Explanation of Benefits electronically or in the mail. Contact the insurer if there are any questions.
Dates : Start: 11/01/2008
Code : N509
Description : Alert: A current inquiry shows the member's Consumer Spending Account contains sufficient funds to cover the member liability for this claim/service. Actual payment from the Consumer Spending Account will depend on the availability of funds and determination of eligible services at the time of payment processing.
Dates : Start: 11/01/2008
Code : N510
Description : Alert: A current inquiry shows the member's Consumer Spending Account does not contain sufficient funds to cover the member's liability for this claim/service. Actual payment from the Consumer Spending Account will depend on the availability of funds and determination of eligible services at the time of payment processing.
Dates : Start: 11/01/2008
Code : N511
Description : Alert: Information on the availability of Consumer Spending Account funds to cover the member liability on this claim/service is not available at this time.
Dates : Start: 11/01/2008
Code : N512
Description : Alert: This is the initial remit of a non-NCPDP claim originally submitted real-time without change to the adjudication.
Dates : Start: 11/01/2008
Code : N513
Description : Alert: This is the initial remit of a non-NCPDP claim originally submitted real-time with a change to the adjudication.
Dates : Start: 11/01/2008
Code : N514
Description : Consult plan benefit documents/guidelines for information about restrictions for this service.
Dates : Start: 11/01/2008 | Stop: 01/01/2011
Notes: Consider using N130
Code : N515
Description : Alert: Submit this claim to the patient's other insurer for potential payment of supplemental benefits. We did not forward the claim information. (use N387 instead)
Dates : Start: 11/01/2008 | Stop: 10/01/2009
Code : N516
Description : Records indicate a mismatch between the submitted NPI and EIN.
Dates : Start: 03/01/2009
Code : N517
Description : Resubmit a new claim with the requested information.
Dates : Start: 03/01/2009
Code : N518
Description : No separate payment for accessories when furnished for use with oxygen equipment.
Dates : Start: 03/01/2009
Code : N519
Description : Invalid combination of HCPCS modifiers.
Dates : Start: 07/01/2009
Code : N520
Description : Alert: Payment made from a Consumer Spending Account.
Dates : Start: 07/01/2009
Code : N521
Description : Mismatch between the submitted provider information and the provider information stored in our system.
Dates : Start: 11/01/2009
Code : N522
Description : Duplicate of a claim processed, or to be processed, as a crossover claim.
Dates : Start: 11/01/2009 | Last Modified: 03/01/2010
Code : N523
Description : The limitation on outlier payments defined by this payer for this service period has been met. The outlier payment otherwise applicable to this claim has not been paid.
Dates : Start: 03/01/2010
Code : N524
Description : Based on policy this payment constitutes payment in full.
Dates : Start: 03/01/2010
Code : N525
Description : These services are not covered when performed within the global period of another service.
Dates : Start: 03/01/2010
Code : N526
Description : Not qualified for recovery based on employer size.
Dates : Start: 03/01/2010
Code : N527
Description : We processed this claim as the primary payer prior to receiving the recovery demand.
Dates : Start: 03/01/2010
Code : N528
Description : Patient is entitled to benefits for Institutional Services only.
Dates : Start: 03/01/2010 | Last Modified: 07/01/2010
Notes: (Modified 7/1/10)
Code : N529
Description : Patient is entitled to benefits for Professional Services only.
Dates : Start: 03/01/2010 | Last Modified: 07/01/2010
Notes: (Modified 7/1/10)
Code : N530
Description : Not Qualified for Recovery based on enrollment information.
Dates : Start: 03/01/2010 | Last Modified: 07/01/2010
Notes: (Modified 7/1/10)
Code : N531
Description : Not qualified for recovery based on direct payment of premium.
Dates : Start: 03/01/2010
Code : N532
Description : Not qualified for recovery based on disability and working status.
Dates : Start: 03/01/2010
Code : N533
Description : Services performed in an Indian Health Services facility under a self-insured tribal Group Health Plan.
Dates : Start: 07/01/2010
Code : N534
Description : This is an individual policy, the employer does not participate in plan sponsorship.
Dates : Start: 07/01/2010
Code : N535
Description : Payment is adjusted when procedure is performed in this place of service based on the submitted procedure code and place of service.
Dates : Start: 07/01/2010
Code : N536
Description : We are not changing the prior payer's determination of patient responsibility, which you may collect, as this service is not covered by us.
Dates : Start: 07/01/2010
Code : N537
Description : We have examined claims history and no records of the services have been found.
Dates : Start: 07/01/2010
Code : N538
Description : A facility is responsible for payment to outside providers who furnish these services/supplies/drugs to its patients/residents.
Dates : Start: 07/01/2010
Code : N539
Description : Alert: We processed appeals/waiver requests on your behalf and that request has been denied.
Dates : Start: 07/01/2010
Code : N540
Description : Payment adjusted based on the interrupted stay policy.
Dates : Start: 11/01/2010
Code : N541
Description : Mismatch between the submitted insurance type code and the information stored in our system.
Dates : Start: 11/01/2010
Code : N542
Description : Missing income verification.
Dates : Start: 03/08/2011
Code : N543
Description : Incomplete/invalid income verification
Dates : Start: 03/08/2011
Code : N544
Description : Alert: Although this was paid, you have billed with a referring/ordering provider that does not match our system record. Unless, corrected, this will not be paid in the future.
Dates : Start: 07/01/2011
Code : N545
Description : Payment reduced based on status as an unsuccessful eprescriber per the Electronic Prescribing (eRx) Incentive Program.
Dates : Start: 07/01/2011
Code : N546
Description : Payment represents a previous reduction based on the Electronic Prescribing (eRx) Incentive Program.
Dates : Start: 07/01/2011
Code : N547
Description : A refund request (Frequency Type Code 8) was processed previously.
Dates : Start: 03/06/2012
Code : N548
Description : Alert: Patient's calendar year deductible has been met.
Dates : Start: 03/06/2012
Code : N549
Description : Alert: Patient's calendar year out-of-pocket maximum has been met.
Dates : Start: 03/06/2012
Code : N550
Description : Alert: You have not responded to requests to revalidate your provider/supplier enrollment information. Your failure to revalidate your enrollment information will result in a payment hold in the near future.
Dates : Start: 03/06/2012
Code : N551
Description : Payment adjusted based on the Ambulatory Surgical Center (ASC) Quality Reporting Program.
Dates : Start: 03/06/2012
Code : N552
Description : Payment adjusted to reverse a previous withhold/bonus amount.
Dates : Start: 03/06/2012
Code : N553
Description : Payment adjusted based on a Low Income Subsidy (LIS) retroactive coverage or status change.
Dates : Start: 03/06/2012
Code : N554
Description : Missing/Incomplete/Invalid Family Planning Indicator
Dates : Start: 07/01/2012
Code : N555
Description : Missing medication list.
Dates : Start: 07/01/2012
Code : N556
Description : Incomplete/invalid medication list.
Dates : Start: 07/01/2012
Code : N557
Description : This claim/service is not payable under our service area. The claim must be filed to the Payer/Plan in whose service area the specimen was collected.
Dates : Start: 07/01/2012
Code : N558
Description : This claim/service is not payable under our service area. The claim must be filed to the Payer/Plan in whose service area the equipment was received.
Dates : Start: 07/01/2012
Code : N559
Description : This claim/service is not payable under our service area. The claim must be filed to the Payer/Plan in whose service area the Ordering Physician is located.
Dates : Start: 07/01/2012


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