Beneficiary name and/or Medicare number
MA61: Missing/incomplete/invalid Social Security number or health insurance claim number (HICN).
MA36: Missing /incomplete/invalid patient name.
MA27: Missing/incomplete/invalid entitlement number or name shown on the claim.
• Review and make a copy of patient’s Medicare card for file and verify eligibility. For additional information, click here for beneficiary eligibility Frequently Asked Questions (FAQs).
• Enter patient’s name on claim as indicated on Medicare card.
• Include spaces and special characters if indicated on Medicare card. Exception: PC-ACE software currently does not accept special characters; enter space instead.
• Enter patient’s HICN exactly as indicated on Medicare card.
Billing entity/provider
N256: Missing/incomplete/invalid billing provider/supplier name.
N257: Missing/incomplete/invalid billing provider/supplier primary identifier.
N258: Missing/incomplete/invalid billing provider/supplier address.
MA112: Missing/incomplete/invalid group practice information.
• Refer to Item(s) 33 and/or 33A on the claim form. These are required fields. Enter the billing provider/supplier name, address and zip code in Item 33, and the billing provider’s, or group’s, NPI in Item 33A.
Charges on claim
M79: Missing/incomplete/invalid charge.
• Refer to Item 24F on the claim form. Medicare does not pay for services when a charge is not indicated. Enter a charge for each service listed on the claim..
Medicare denial codes, reason, remark and adjustment codes.Medicare, UHC, BCBS, Medicaid denial codes and insurance appeal. Sample appeal letter for denial claim. CO, PR and OA denial reason codes codes.
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Monday, April 25, 2016
Denial Action on Medicare code MA61, MA27, N256, MA112 AND M79
Labels:
Denial and action,
Denial basic,
medicare
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