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MCR - 835 Denial Code List PR - Patient Responsibility - We could bill the patient for this denial however please make sure that any oth...
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Medicaid Claim Denial Codes 1 Deductible Amount 2 Coinsurance Amount 3 Co-payment Amount 4 The procedure code is inconsistent w...
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Claim appeal If you believe you were underpaid by us, the first step in resolving your concern is to submit a Claim Reconsideration as d...
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PROVIDER ADJ DETAILS The provider-level adjustment details section is used to show adjustments that are not specific to a particular cla...
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Claim denials for maximum units per visit Check your units of the CPT. Check LCD Guidelines for Maximum unit. We can appeal the claim wit...
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CO 97 Payment adjusted because this procedure/service is not paid separately. Explanation: • The benefit for this service ...
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MCR - 835 Denial Code List OA : Other adjustments OA Group Reason code applies when other Group reason code cant be applied. Its most...
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A “clean” claim is defined as a one that does not require the payer to investigate or develop on a prepayment basis. Clean claims must be ...
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MCR - 835 Denial Code List CO : Contractual Obligations - Denial based on the contract and as per the fee schedule amount. CO should ...
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CO/PR 96 Non-covered charge(s) (THE PROCEDURE CODE SUBMITTED IS A NON-COVERED MEDICARE SERVICE) Resources/tips for avoiding this deni...
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