What does co 252 denial code mean?
That code means that you need to have additional documentation to support the claim. If it is an HMO, Work Comp or other liability they will require notes to be sent or other documentation.
What is remark code MA04?
Reviewing the issues below will assist in resolving rejections with Remark Code MA04: “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.”
What is a reason code used on an EOB?
What is a reason code used on an EOB? Reason codes appear on an explanation of benefits (EOB) to communicate why a claim has been adjusted. The letters preceding the number codes identify: Contractual Obligation (CO), Correction or reversal to a prior decision (CR), and Patient Responsibility (PR).
What does Medicare denial code Co 150 mean?
The denial reason code CO150 (Payment adjusted because the payer deems the information submitted does not support this level of service) is No. 5 on the list of RemitDATA’s Top 10 denial codes for Medicare claims.
What is remark code N30?
N30 – Recipient ineligible for this service. Professional 15 – The authorization number is missing, invalid, or does not apply to the billed services or provider.
What is denial code CO 197?
CO 197 Denial Code: Precertification/authorization/notification absent. Some of the insurance companies request to obtaining prior authorization from them before the service/surgery. This may be required for certain specific procedures or may even be for all procedures.
What is denial code CO 151?
Description. Reason Code: 151. Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.
What is denial code CO 236?
CO-236: This procedure or procedure/modifier combination is not compatible with another procedure or procedure/modifier combination that was provided on the same day according to the National Correct Coding Initiative (NCCI) or workers compensation state regulations/fee schedule requirements.
What does denial co-252 mean and how to resolve it?
Can someone explain to me what denial CO-252 means and how to resolve it? Is there a website I can visit that would explain more on denials/rejections and how to resolve them? Any assistance would be greatly appreciated. That code means that you need to have additional documentation to support the claim.
What is the reason code for Medicare denial?
Reason Code : 34538 Description : CLAIM SUBMITTED AS MEDICARE PRIMARY AND A POSITIVE WORKING ELDERLY RECORD EXISTS AT CWF. THE CONTRACTOR ID EQUAL TO ‘11121’. THE CLAIM SHOULD BE BILLED TO THE EMPLOYER GROUP HEALTH PLAN.
Can a denial code be adjustment or responsibility?
Same denial code can be adjustment as well as patient responsibility. For example PR 45, We could bill patient but for CO 45, its a adjustment and we can’t bill the patient.