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Wednesday, May 26, 2010

D 9 - D21 - MEDICAID DENIAL

Medicaid Claim Denial Codes - 4


D9 Claim/service denied. Claim lacks invoice or statement certifying the actual cost of the
lens, less discounts or the type of intraocular lens used.

Note: Inactive for 004010, since 2/99. Use code 16 and remark codes if necessary.

D10 Claim/service denied. Completed physician financial relationship form not on file.
Note: Inactive for 003070, since 8/97. Use code 17.

D11 Claim lacks completed pacemaker registration form.
Note: Inactive for 003070, since 8/97. Use code 17.

D12 Claim/service denied. Claim does not identify who performed the purchased diagnostic
test or the amount you were charged for the test.
Note: Inactive for 003070, since 8/97. Use code 17.

D13 Claim/service denied. Performed by a facility/supplier in which the ordering/referring
physician has a financial interest.
Note: Inactive for 003070, since 8/97. Use code 17.

D14 Claim lacks indication that plan of treatment is on file.
Note: Inactive for 003070, since 8/97. Use code 17.

D15 Claim lacks indication that service was supervised or evaluated by a physician.
Note: Inactive for 003070, since 8/97. Use code 17.

D16 Claim lacks prior payer payment information.
Note: Inactive as of version 5010. Use code 16 with appropriate claim payment
remark code [N4].

D17 Claim/Service has invalid non-covered days.
Note: Inactive as of version 5010. Use code 16 with appropriate claim payment
remark code [M32, M33].

D18 Claim/Service has missing diagnosis information.
Note: Inactive as of version 5010. Use code 16 with appropriate claim payment
remark code [MA63, MA65].

D19 Claim/Service lacks Physician/Operative or other supporting documentation
Note: Inactive as of version 5010. Use code 16 with appropriate claim payment
remark code [M29, M30, M35, M66].

D20 Claim/Service missing service/product information.
Note: Inactive as of version 5010. Use code 16 with appropriate claim payment
remark code [M20, M67, M19, MA67].

D21 This (these) diagnosis(es) is (are) missing or are invalid
Note: New as of 6/05

W1 Workers Compensation State Fee Schedule Adjustment
Note: New as of 2/00

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