Friday, June 3, 2011

Medicare denial code N347,N449,N522 & MA04 description

CO -18, 22 denail codes and related remark codes 



Adj. Reason Code
Adj. Reason Code Description
Remark
Code

Remark Code Descripton
Exception Code Descripton
18 Duplicate claim/service.
N347
Your claim for a referred or puchased service cannot be
paid because payment has already been made for this same service
EXACT DUP OR MANUAL PRICE
18 Duplicate claim/service.
N449
Payment based on a comparable drug/service/
supply.
DRUG/CHEMICAL DUPLICATION NOT ALLOWED
18 Duplicate claim/service.
N522
Duplicate of a claim processed, or to be processed, as a crossover claim.
MEDICAID/MEDICARE EXACT DUP
18 Duplicate claim/service.
POSSIBLE DUP DENTAL EXTRACT 
EXACT DUP OF PAID CLAIM
ICF EXACT DUPLICATE
ICF POSSIBLE CLAIM CONFLICT
SURGICAL SESSION - TWO CLAIMS
LTC EXACT DUP CLAIM THIS CYCLE
EXACT DUP WITH PAID CLAIM
SAME/OVRLP DOS THIS CYCLE INPT
EXACT DUP CLAIM THIS CYCLE
DUPLICATE PYMT - CS MNGMNT FEE
DUPLICATE PAID/CAPTURED CLAIM
CLAIM NOT PAID/CAPTURED
CCE EXACT DUPE CLAIM THIS CYCLE
DUPLICATE PROCEDURE EXCEEDS UNIT LIMIT
DUP/CONFLICTING SURFACE
22 This care may be covered by another payer per coordination of benefits.
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.
RECIP HAS MEDICAL INSURANCE
MEDICARE ELIG-NO ATTCHMT
MEDICARE WITHIN DATE(S) OF SVC
RR TRAVELERS MEDICARE WITHIN DOS
MEDICARE COVERED DOS OVERLAP
RR TRAVELERS MEDICARE & DOS OVERLAP
RECIP HAS TPL-CLM W/ATTACHMENT
DENTAL-CLAIM HAS ATTACHMENT
CLAIM HAS ATTACHMENT
22 This care may be covered by another payer per coordination of benefits.
MA64
Our records indicate that we should be the third payer for this claim. We cannot process this claim until we have received payment information from the primary and secondary payers.
MEDICARE DOS OVERLAP TPL
RR MDCRE/TPL OVERLAP
22 This care may be covered by another payer per coordination of benefits.
MA92
Missing plan information for other insurance.
RECIP HAS MEDICAL INSURANCE
22 This care may be covered by another payer per coordination of benefits.
MENTL HLTH XOVR CLM NON-QMB CLIENT
QMB - SEND BILL TO MEDICARE
CROSSOVER SERVICE ONLY
PATIENT TRANSFERED TO MEDICARE
AMOUNT BILLED LESS THAN MINIM
DENTAL BILL AMT LESS THAN MIN
TPL BILLED LESS THAN MINIMUM
TPL NOT REPORTED ON CROSSOVER CLAIM
TPL AMOUNT NOT NUMERIC

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