Tuesday, May 3, 2016

Denial code MA 120, M52, N104 & N345 - How to avoid

CLIA certification number
MA120: Missing/incomplete/invalid CLIA certification number.
• Refer to Item 23 on the claim form. Enter the ten-digit CLIA certification number for laboratory services billed.
• Click here external link for procedures that require a CLIA certification.

Date range not valid with units submitted
M52: Missing/incomplete/invalid –from- date(s) of service.
N345: Date range not valid with units submitted.
• Refer to Item(s) 24A and/or 24G on the claim form. Ensure date(s) of service (DOS) correspond(s) to the number of units/days billed. If billing for more than one unit on a single day, services may need to be itemized, one per line

Facility ZIP code or state code
N104: This claim service is not payable under our claims jurisdiction area. You can identify the correct Medicare contractor to process this claim/service through the CMS website at www.cms.gov external link.
• Refer to Item 32 on the claim form. Service facility information is used to price claims. Enter the state code and ZIP code on the claim.
• Click here external link to see if a 9-digit ZIP code is needed for the facility.
• The state code should be referred to as the province code for providers in U.S. Virgin Islands.

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