Denial Code (Remarks): (Remarks): PR 2 Denial reason: Coinsurance amount Denial Action: Billed to secondary insurance/patient Denial Code (Remarks): (Remarks): PR 3 Denial reason: Copay amount Denial Action: Billed to secondary insurance/patient Denial Code (Remarks): (Remarks): C ! Denial reason: "#e procedure procedure code is inconsistent $it# t#e modi%er used or a re&uired modi%er is missin' Denial Action: se appropriate modi%er $it# respecti*e o+ procedure Denial Code (Remarks): (Remarks): C , Denial reason: "#e procedure procedure code/bill type is inconsistent $it# t#e place o+ ser*ice Denial Action: Correct t#e Place o+ ser*ice or correct t#e procedure $it# respect o+ place o+ ser*ice Denial Code (Remarks): (Remarks): C Denial reason: "#e procedure/re*enue procedure/re*enue code is inconsistent $it# t#e patient.s a'e Denial Action: Correct t#e procedure code $it# respect o+ patient.s a'e Denial Code (Remarks): (Remarks): C Denial reason: "#e procedur p rocedure/re*enue e/re*enue code is inconsistent $it# t#e patient.s 'ender 'ender Denial Action: Correct t#e procedure code $it# respect o+ patient.s 'ender (0e ale/4emale) Denial Code (Remarks): (Remarks): C 5 Denial reason: "#e dia'nosis is inconsistent $it# t#e patient.s a'e Denial Action: : Correct t#e dia'nosis code $it# respect o+ patient.s a'e Denial Code (Remarks): (Remarks): C 16 Denial reason:"#e dia'nosis is inconsistent $it# t#e patient.s 'ender 'ender Denial Action: : Correct t#e dia'nosis code $it# respect o+ patient.s 'ender (0e ale/4emale) Denial Code (Remarks): (Remarks): C 11 Denial reason: "#e dia'nosis is inconsistent $it# t#e procedure Denial Action: : Correct t#e dia'nosis code Denial Code (Remarks): (Remarks): C 13 Denial reason: "#e date o+ deat# precedes t#e date o+ ser*ice Denial Action: : Correct t#e Date o+ ser*ice Denial Code (Remarks): (Remarks): C 1! Denial reason: "#e date o+ birt# +ollo$s t#e date o+ ser*ice Denial Action: : Correct t#e Date o+ ser*ice Denial Code (Remarks): (Remarks): C 1, Denial reason: Payment ad7usted because t#e submitted aut#ori8ation number is missin'9 in*alid9 or does not apply to t#e billed ser*ices or pro*ider
Denial Action: : 0ubmit t#e claims $it# Aut#ori8ation number or *alid aut#ori8ation Denial Code (Remarks): C 1Denial reason: Claim/ser*ice lacks in+ormation $#ic# is needed +or ad7udication At least one Remark Code must be pro*ided (may be comprised o+ eit#er t#e Remittance Ad*ice Remark Code or CPDP Re7ect Reason Code) Denial Action: : C#eck $it# ot#er remark codes started as / and correct t#e claims Denial Code (Remarks): PR 1 Denial reason: Deductible amount Denial Action: Billed to secondary insurance/patient Denial Code (Remarks): PR 2 Denial reason: Coinsurance amount Denial Action: Billed to secondary insurance/patient Denial Code (Remarks): PR 3 Denial reason: Copay amount Denial Action: Billed to secondary insurance/patient Denial Code (Remarks): C ! Denial reason: "#e procedure code is inconsistent $it# t#e modi%er used or a re&uired modi%er is missin' Denial Action: se appropriate modi%er $it# respecti*e o+ procedure Denial Code (Remarks): C , Denial reason: "#e procedure code/bill type is inconsistent $it# t#e place o+ ser*ice Denial Action: Correct t#e Place o+ ser*ice or correct t#e procedure $it# respect o+ place o+ ser*ice Denial Code (Remarks): C Denial reason: "#e procedure/re*enue code is inconsistent $it# t#e patient.s a'e Denial Action: Correct t#e procedure code $it# respect o+ patient.s a'e Denial Code (Remarks): C Denial reason: "#e procedure/re*enue code is inconsistent $it# t#e patient.s 'ender Denial Action: Correct t#e procedure code $it# respect o+ patient.s 'ender (0e ale/4emale) Denial Code (Remarks): C 5 Denial reason: "#e dia'nosis is inconsistent $it# t#e patient.s a'e Denial Action: : Correct t#e dia'nosis code $it# respect o+ patient.s a'e Denial Code (Remarks): C 16 Denial reason:"#e dia'nosis is inconsistent $it# t#e patient.s 'ender Denial Action: : Correct t#e dia'nosis code $it# respect o+ patient.s 'ender (0e ale/4emale) Denial Code (Remarks): C 11 Denial reason: "#e dia'nosis is inconsistent $it# t#e procedure Denial Action: : Correct t#e dia'nosis code Denial Code (Remarks): C 13 Denial reason: "#e date o+ deat# precedes t#e date o+ ser*ice Denial Action: : Correct t#e Date o+ ser*ice Denial Code (Remarks): C 1! Denial reason: "#e date o+ birt# +ollo$s t#e date o+ ser*ice
Denial Action: : Correct t#e Date o+ ser*ice
Denial Code (Remarks): C 1, Denial reason: Payment ad7usted because t#e submitted aut#ori8ation number is missin'9 in*alid9 or does not apply to t#e billed ser*ices or pro*ider Denial Action: : 0ubmit t#e claims $it# Aut#ori8ation number or *alid aut#ori8ation Denial Code (Remarks): C 1; Denial reason: Duplicate claim/ser*ice Denial Action: : C#eck $it# ot#er remark codes started as / and correct t#e claims Denial Code (Remarks): C 22 Denial reason: Payment ad7usted because t#is care may be co*ered by anot#er payer per coordination o+ bene%ts Denial Action: : 0ubmit t#e claims to ot#er #ealt# care insurance Denial Code (Remarks): C 2! Denial reason: Payment +or c#ar'es ad7usted C#ar'es are co*ered under a capitation a'reement/mana'ed care plan Denial Action: : 0ubmit t#e claims to ot#er #ealt# care insurance Denial Code (Remarks): PR 2Denial reason: <penses incurred prior to co*era'e Denial Action: : Bill to patient Denial Code (Remarks): PR 2 Denial reason: <penses incurred a+ter co*era'e terminated Denial Action: : Bill to patient Denial Code (Remarks): C 25 Denial reason: "#e time limit +or %lin' #as epired Denial Action: : Appeal t#e claim $it# t#e proo+ o+ clearin' #ouse reports Denial Code (Remarks): PR 31 Denial reason: Claim denied as patient cannot be identi%ed as our insured Denial Action: : Correct t#e patient name9 DB and Policy number Denial Code (Remarks): C !, Denial reason: C#ar'es eceed your contracted/ le'islated +ee arran'ement "#is c#an'e to be e=ecti*e -/1/6: C#ar'e eceeds +ee sc#edule/maimum allo$able or contracted/le'islated +ee arran'ement (se >roup Codes PR or C dependin' upon liability) Denial Action: : "ake $rite o= Denial Code (Remarks): C ,6 Denial reason: "#ese are nonco*ered ser*ices because t#is is not deemed a ?medical necessity. by t#e payer Denial Action: : C#eck t#e Dia'nosis codes Denial Code (Remarks): C ,; Denial reason: Payment ad7usted because treatment $as deemed by t#e payer to #a*e been rendered in an inappropriate or in*alid place o+ ser*ice Denial Action: : Correct t#e place o+ ser*ice Denial Code (Remarks): C 5-
Denial reason: onco*ered c#ar'e(s) At least one Remark Code must be pro*ided (may be comprised o+ eit#er t#e Remittance Ad*ice Remark Code or CPDP Re7ect Reason Code) Denial Action: : Correct t#e dia'nosis codes
Denial Code (Remarks): C 5 Denial reason:Payment ad7usted because t#e bene%t +or t#is ser*ice is included in t#e payment/allo$ance +or anot#er ser*ice/procedure t#at #as already been ad7udicated Denial Action: : submit t#e claims $it# appropriate modi%er Denial Code (Remarks): A 166 Denial reason:Payment made to patient/insured/responsible party Denial Action: : Payment made to patient by medicare 0o bill to patient +or collect t#e payment Denial Code (Remarks): A 165 Denial reason: Claim not co*ered by t#is payer/contractor @ou must send t#e claim to t#e correct payer/contractor Denial Action: : C#eck $#et#er it is RR medicare/D
Denial reason:t Payment ad7usted because ?e$ Patient. &uali%cations $ere not met Denial Action: : 0ubmit t#e claims $it# establis#ed patient *isit Denial Code (Remarks): PR B5 Denial reason:t 0er*ices not co*ered because t#e patient is enrolled in a ospice Denial Action: : 0ubmit t#e claims $it# > modi%er
