The top five denials below are for the period of October 2008 through December 2008. These claims were
identified from Specialty 48, which represents Podiatrists. The denials identified are for all of DME
MAC Jurisdiction A Suppliers
Top FiveClaim Denials # of Denied Claims Reason For Denial
CO 96, N115 2,371 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. Non-covered charge(s)
CO 18, N111 2,409 This service was included in a claim that was previously billed and adjudicated. No appeal rights are attached to the denial of this service to determine whether the service/item is a duplicate. Duplicate claim/service
CO 58 978 Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service
CO 4 701 The procedure code is inconsistent with the modifier used, or a required modifier is missing
CO 16, MA130 685 Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable. Claim/service lacks information which is needed for adjudication
identified from Specialty 48, which represents Podiatrists. The denials identified are for all of DME
MAC Jurisdiction A Suppliers
Top FiveClaim Denials # of Denied Claims Reason For Denial
CO 96, N115 2,371 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. Non-covered charge(s)
CO 18, N111 2,409 This service was included in a claim that was previously billed and adjudicated. No appeal rights are attached to the denial of this service to determine whether the service/item is a duplicate. Duplicate claim/service
CO 58 978 Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service
CO 4 701 The procedure code is inconsistent with the modifier used, or a required modifier is missing
CO 16, MA130 685 Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable. Claim/service lacks information which is needed for adjudication
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