CO - 16 denial and remark code. Claim/service lacks information which is needed for adjudication. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT)
This denial code is just intimation that claims has been denied for lack of some information and it always come with other rejection code as given below. Check these codes and take the correction action according the denial.
This denial code is just intimation that claims has been denied for lack of some information and it always come with other rejection code as given below. Check these codes and take the correction action according the denial.
| Remark Code | Remark Code Description | Exception Code Description |
| M67 | Missing/incomplete/invalid other procedure code(s) and/or date(s). | MISSING ICD9 SURGICAL CODE |
| MISSING ICD9CM SURGICAL CODE | ||
| M76 | Missing/incomplete/invalid diagnosis or condition. | MISSING DIAGNOSIS INDICATOR |
| M79 | Missing/incomplete/invalid charge. | MISSING SUBMITTED CHARGE |
| INVALID EXTRA CHARGE AMOUNT | ||
| INV ALLOWED CHRG AMT -PHARMACY | ||
| MA120 | Missing/incomplete/invalid CLIA certification number. | MISSING OR INVALID CLIA CERTIFICATE # |
| CLIA CERT# NOT MATCHED 1ST OR 2ND CYCLES | ||
| CLIA CERTIFICATE# NOT MATCHED 3RD CYCLE. | ||
| CLIA CERTIFICATE INVALID FOR PROC ON DOS | ||
| MA130 | Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable | CANNOT CALCULATE PAYMENT - BAD DATA |
| MA31 | Missing/incomplete/invalid beginning and ending dates of the period billed. | MSSNG DOS OR SCREENING DATE |
| MA32 | Missing/incomplete/invalid number of covered days during the billing period. | MISSING COVERED DAYS |
| COV DAYS, UNITS OF SVC ERROR | ||
| MA33 | Missing/incomplete/invalid noncovered days during the billing period. | TAD CONF WITH UB-82 OR X-OVER |
| MA36 | Missing/incomplete/invalid patient name. | RECIPIENT NAME MISSING |
| MISSING DATA ENTRY RECIP NAME | ||
| MA39 | Missing/incomplete/invalid gender. | INVALID NEWBORN SEX CODE |
| MA40 | Missing/incomplete/invalid admission date. | MISSING ADMISSION DATE |
| MA58 | Missing/incomplete/invalid release of information indicator. | RELEASE OF INFORMATION NOT SIGNED |
| MA63 | Missing/incomplete/invalid principal diagnosis. | MISSING PRIMARY DIAGNOSIS |
| MISSING OR INVALID ICD-9 CODE (PHARMACY) | ||
| MA81 | Missing/incomplete/invalid provider/supplier signature. | NO ADMINISTRATOR SIGNATURE |
| N10 | Payment based on findings of a review organization/professional consult/manual adjudication/medical or dental advisor. | PROC REQUIRES MANUAL PRICING |
| N152 | Missing/incomplete/invalid replacement claim information. | MISSING CREDIT TCN |
| REPLACEMENT CLAIM (ORIG CLAIM NOT FOUND) | ||
| N153 | Missing/incomplete/invalid room and board rate. | REPLACEMENT/VOID RECEIVED FOR CLAIM |
| N208 | MIssing/incomplete/invalid DRG code. | MISSING DRG |
| N253 | Missing/incomplete/invalid attending provider primary identifier. | INVALID ADMITTING LICENSE NO |
| N261 | Missing/incomplete/invalid operating provider name. | MISSING SURGEON NAME OR LIC NO |
| N29 | Missing documentation/orders/notes/summary/ report/chart. | MODIFIER REQUIRES MANUAL REVIEW |
| PROC REQUIRES MANUAL REVIEW | ||
| INSUF DATA TO MAKE DETERMIN. | ||
| EMERGENCY CLIENT ONLY | ||
| N291 | Missing/incomplete/invalid rendering provider secondary identifier. | MISSING SERVICING LICENSE NUMBER |
| N297 | Missing/incomplete/invalid supervising provider primary identifier. | INVALID SUPRV PROV CHK DIGIT |
| N305 | Missing/incomplete/invalid accident date. | INV ACCIDENT IND - MED CLAIM |
| N31 | Missing/incomplete/invalid prescribing/referring/ attending provider license number. | POS PRESCRIBER FIELD HAS DR NAME (ALPHA) |
| SERVICING LICENSE NOT ON FILE | ||
| MISSING OR INVALID PRESCRIBER LICENSE # | ||
| INV REFER LIC NO.-CHEC RELATED | ||
| MSSNG REFER PROV NAME OR LIC# | ||
| N318 | Missing/incomplete/invalid discharge or end of care date. | INVALID DISCHARGE DATE |
| NO DISCH DATE-SERV ENDS MID MONTH | ||
| N329 | Missing/incomplete/invalid patient birth date. | MISSING BIRTHDATE- ID/B SUFFIX |
| N330 | Missing/incomplete/invalid patient death date. | INVALID DATE OF DEATH |
| N341 | Missing/incomplete/invalid surgery date. | MISSING DATE OF SURGERY |
| N349 | The administration method and drug must be reported to adjudicate this service. | M/I COMPOUND ROUTE OF ADMINISTRATION |
| M/I COMPOUND DISPENSING UNIT FORM INDCTR | ||
| N351 | Service date outside of the approved treatment plan service dates. | SURG DATE NOT WITHIN DOS |
| N358 | Alert: This decision may be reviewed if additional documentation as described in the contract or plan benefit documents is submitted. | MODIFIER REQUIRES MANUAL REVIEW |
| EMERGENCY ONLY CLIENT | ||
| N362 | The number of days or Units of Service exceeds our acceptable maximum. | INV PA ESTIMATED DAYS OF STAY |
| N37 | Missing/incomplete/invalid tooth number/letter. | MISSING TOOTH NUMBER |
| BILATERALLY MISSING TEETH CLM LACKS INFO | ||
| N378 | Missing/incomplete/invalid prescription quantity. | MISSING DRUG QUANTITY |
| M/I QUANTITY INTENDED TO BE DISPENSED | ||
| M/I DAYS SUPPLY INTENDED TO BE DISPENSED | ||
| M/I COMPOUND INGREDIENT QUANTITY | ||
| N382 | Missing/incomplete/invalid patient identifier. | ID WITH B SUFFIX-CHECK BIRTHDT |
| N388 | Missing/incomplete/invalid prescription number. | MISSING PRESCRIPTION NUMBER |
| N43 | Bed hold or leave days exceeded. | INV THERAP LEAVE DAYS-PREADMIT |
| N50 | Missing/incomplete/invalid discharge information. | DISCH DTE CONFLICTS WITH DEST |
| INVLD/MSSNG DSCHRG DESTINATION | ||
| RECIPIENT HAS BEEN DISCHARGED | ||
| RECIPIENT DISCHARGED WHILE ON MCARE | ||
| RECIPIENT TRANSFERED TO A HOSP | ||
| RECIPIENT TRANSFERED ELSEWHERE | ||
| DISCHARGE BEFORE FIRST SVC DT | ||
| N530 | Our records indicate a mismatch in enrollment information for this patient. | ELIG FILE MISSING NAME OR RACE |
| N57 | Missing/incomplete/invalid prescribing/dispensed date. | INVALID DISPENSING DATE |
| N58 | Missing/incomplete/invalid patient liability amount. | RESERVED AMT GTR THAN SPDN |
| SUSPENDED CROSSOVER | ||
| N75 | Missing/incomplete/invalid tooth surface information. | MISSING TOOTH SURFACE |
| N95 | This provider type/provider specialty may not bill this service. | CASE MNGMNT FEE - INV COS |
MA120 Missing/incomplete/invalid CLIA certification number.
Common Reasons for Message
CLIA certification number billed in Item 23 of CMS-1500 Claim Form (or electronic equivalent) was either missing or invalid
Incorrect qualifier was used on electronic claim
Next Step
Resubmit claim with valid CLIA certification number in Item 23 of CMS-1500 Claim Form
CLIA numbers are 10 digits with letter "D" in third position
Resubmit with valid qualifier or CLIA certificate number on Electronic Claim
Qualifier to indicate CLIA certification number must be submitted as X4
Review EDI training document This link will take you to an external website. on billing laboratory claims electronically
Claim Submission Tips
Apply for CLIA Certification This link will take you to an external website. prior to rendering lab services
Review codes This link will take you to an external website. that require a CLIA certification number
Qualifier is only required on electronic claims
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