Alabama Explanation of Benefit (EOB) Code Crosswalk
Health Care	Health Care Claim Status Code Description	Adj. Reason	Adjustment Reason Code Description	Hipaa Remarks	Hipaa Remarks Code Description	MMIS Edit	MMIS Edit Code Description
Status		Code		Code		Code
Code
0	Cannot provide further status electronically.	19	Claim denied because this is a work-related injury/illness and thus the liability of the Workers Compensation Carrier.	M1	X-ray not taken within the past 12 months or near enough to the start of treatment.	8210	WORKER'S COMP - PROVIDER
1	For more detailed information, see remittance advice.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4252	DIAGNOSIS CODE 10-24 NOT ON FILE
1	For more detailed information, see remittance advice.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N245	INCOMPLETE/INVALID PLAN INFORMATION FOR OTHER INSURANCE.	0643	INVALID OTHER COVERAGE CODE
1	For more detailed information, see remittance advice.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N307	MISSING/INCOMPLETE/INVALID ADJUDICATION OR PAYMENT DATE.	0807	INVALID TPL ADJUDICATION DATE
1	For more detailed information, see remittance advice.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N307	MISSING/INCOMPLETE/INVALID ADJUDICATION OR PAYMENT DATE.	0808	TPL ADJUDUCATION DATE CANNOT BE A FUTURE DATE
1	For more detailed information, see remittance advice.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N245	INCOMPLETE/INVALID PLAN INFORMATION FOR OTHER INSURANCE.	0643	INVALID OTHER COVERAGE CODE
1	For more detailed information, see remittance advice.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M79	Missing/incomplete/invalid charge.	8997	CLAIM MODIFIED POST-PROCESSING.  THE BILLED AMOUNT WAS CHANGED TO ZERO ON THE E NCOUNTER DETAIL.  THE HEADER BILLED AMOUNT WAS REDUCED BY THE ORIGINAL ENCOUNTE R DETAIL BILLED AMOUNT. SEE TASK 8767 FOR ADDITIONAL INFORMATION.
1	For more detailed information, see remittance advice.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N307	MISSING/INCOMPLETE/INVALID ADJUDICATION OR PAYMENT DATE.	0606	INVALID OTHER PAYER DATE
1	For more detailed information, see remittance advice.	A2	Contractual adjustment.	N245	INCOMPLETE/INVALID PLAN INFORMATION FOR OTHER INSURANCE.	0643	INVALID OTHER COVERAGE CODE
7	Claim may be reconsidered at a future date.	18	Duplicate claim/service.	M86	SERVICE DENIED BECAUSE PAYMENT ALREADY MADE FOR SAME/SIMILAR PROCEDURE WITHIN SET TIME FRAME.	5754	OUR RECORDS INDICATE THAT THIS SERVICE HAS ALREADY BEEN PERFORMED ON THIS PATIE NT
7	Claim may be reconsidered at a future date.	18	Duplicate claim/service.	M86	SERVICE DENIED BECAUSE PAYMENT ALREADY MADE FOR SAME/SIMILAR PROCEDURE WITHIN SET TIME FRAME.	5755	OUR RECORDS INDICATE THAT THIS SERVICE HAS ALREADY BEEN PERFORMED ON THIS PATIE NT
8	No payment due to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N29	MISSING DOCUMENTATION/ORDERS/NOTES/SUMMARY/REPORT/CHART.	8560	PAPER CLAIM AND OPERATIVE NOTE REQUIRED FOR PAYMENT DECISION.  PLEASE RESUBMIT.
8	No payment due to contract/plan provisions.	18	Duplicate claim/service.	N117	THIS SERVICE IS PAID ONLY ONCE IN A LIFETIME.	6671	OUR RECORDS INDICATE THAT THIS SERVICE HAS ALREADY BEEN PERFORMED ON THIS RECIP IENT.
8	No payment due to contract/plan provisions.	18	Duplicate claim/service.	N59	Please refer to your provider manual for additional program and provider information.	6646	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
8	No payment due to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6646	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
9	No payment will be made for this claim.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N61	Rebill services on separate claims.	0820	FROM DOS AND TO DOS MAY NOT SPAN THE FISCAL YEAR
9	No payment will be made for this claim.	193	ORIGINAL PAYMENT DECISION IS BEING MAINTAINED. THIS CLAIM WAS PROCESSED PROPERLY THE FIRST TIME.	MA44	No appeal rights. Adjudicative decision based on law.	8555	NCCI REDETERMINIATION - DENIED - NO APPEAL
9	No payment will be made for this claim.	193	ORIGINAL PAYMENT DECISION IS BEING MAINTAINED. THIS CLAIM WAS PROCESSED PROPERLY THE FIRST TIME.	MA46	The new information was considered, however, additional payment cannot be issued. Please review the information listed for the explanation.	8556	NCCI REDETERMINIATION - DENIED
9	No payment will be made for this claim.	193	ORIGINAL PAYMENT DECISION IS BEING MAINTAINED. THIS CLAIM WAS PROCESSED PROPERLY THE FIRST TIME.	MA91	This determination is the result of the appeal you filed.	8558	NCCI ADMINISTRATIVE REVIEW - DENIED
12	One or more originally submitted procedure codes have been combined.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5642	ROUTINE ANCILLARY SERVICES ASSOCIATED WITH AN ABORTION ARE COVERED IN THE TOTAL  ABORTION COST AND ARE NOT REIMBURSABLE SEPARATELY
12	One or more originally submitted procedure codes have been combined.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5643	ROUTINE ANCILLARY SERVICES ASSOCIATED WITH AN ABORTION ARE COVERED IN THE TOTAL  ABORTION COST AND ARE NOT REIMBURSABLE SEPARATELY
12	One or more originally submitted procedure codes have been combined.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N22	This procedure code was added/changed because it more accurately describes the services rendered.	7215	PROCEDURE CODE IS INCIDENTAL
12	One or more originally submitted procedure codes have been combined.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N384	Records indicate that the referenced body part/tooth has been removed in a previous procedure.	5352	CLAIMS HISTORY SHOWS TOOTH HAS BEEN EXTRACTED.
12	One or more originally submitted procedure codes have been combined.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N384	Records indicate that the referenced body part/tooth has been removed in a previous procedure.	5353	CLAIMS HISTORY SHOWS TOOTH HAS BEEN EXTRACTED.
12	One or more originally submitted procedure codes have been combined.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N39	Procedure code is not compatible with tooth number/letter.	5352	CLAIMS HISTORY SHOWS TOOTH HAS BEEN EXTRACTED.
12	One or more originally submitted procedure codes have been combined.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N39	Procedure code is not compatible with tooth number/letter.	5353	CLAIMS HISTORY SHOWS TOOTH HAS BEEN EXTRACTED.
15	One or more originally submitted procedure code have been modified.	6	The procedure code is inconsistent with the patient's age.	MA38	Missing/incomplete/invalid birth date.	7212	PROCEDURE ADDED DUE TO ALTERNATE CODE REPLACEMENT (AGE)
15	One or more originally submitted procedure code have been modified.	7	The procedure code is inconsistent with the patient's gender.	MA39	Missing/incomplete/invalid gender.	7214	PROCEDURE ADDED DUE TO ALTERNATE CODE REPLACEMENT (SEX)
15	One or more originally submitted procedure code have been modified.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N22	This procedure code was added/changed because it more accurately describes the services rendered.	7246	PROCEDURE REPLACED DUE TO INTENSITY OF SERVICE REPLACEMENT
15	One or more originally submitted procedure code have been modified.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N22	This procedure code was added/changed because it more accurately describes the services rendered.	7247	PROCEDURE ADDED DUE TO INTENSITY OF SERVICE REPLACEMENT
15	One or more originally submitted procedure code have been modified.	119	Benefit maximum for this time period or occurrence has been reached.	N20	Service not payable with other service rendered on the same date.	6645	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
15	One or more originally submitted procedure code have been modified.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6645	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
15	One or more originally submitted procedure code have been modified.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	6645	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
15	One or more originally submitted procedure code have been modified.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	6645	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
20	Accepted for processing.	6	The procedure code is inconsistent with the patient's age.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	3100	CLAIM AND PA PRESCRIBING PROV DON'T MATCH
20	Accepted for processing.	15	Payment adjusted because the submitted authorization number is missing, invalid, or does not apply to the billed services or provider.	M62	Missing/incomplete/invalid treatment authorization code.	3104	PA REQUIRED FOR CERTAIN TRANSPORTATION SERVICES
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	3100	CLAIM AND PA PRESCRIBING PROV DON'T MATCH
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4077	NON-COVERED REVENUE CODE
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M62	Missing/incomplete/invalid treatment authorization code.	3104	PA REQUIRED FOR CERTAIN TRANSPORTATION SERVICES
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	3998	BPA-RR-REV - OTHER HDR DIAGNOSIS RESTRICTION
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	3999	BPA-RR-PROC - OTHER HDR DIAGNOSIS RESTRICTION
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4745	BPA-RP-PROC - DIAGNOSIS RESTRICTION
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4210	BPA-RR-REV - ANY HDR DIAGNOSIS RESTRICTION
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4315	BPA-PC-PROC - ANY HDR DIAGNOSIS RESTRICTION
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA30	Missing/incomplete/invalid type of bill.	0826	TYPE OF BILL INVALID FOR CLAIM TYPE
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA31	Missing/incomplete/invalid beginning and ending dates of the period billed.	0554	HEADER BILLED DATE IS PRIOR TO DATES OF SERVICE
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N253	MISSING/INCOMPLETE/INVALID ATTENDING PROVIDER PRIMARY IDENTIFIER.	1960	NPI REQUIRED:  ATTENDING PROVIDER (HEALTHCARE)
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N262	MISSING/INCOMPLETE/INVALID OPERATING PROVIDER PRIMARY IDENTIFIER.	1961	NPI REQUIRED:  OPERATING PROVIDER (HEALTHCARE)
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N4	Missing/incomplete/invalid prior insurance carrier EOB.	8088	SAVE FOR FUTURE USE.
20	Accepted for processing.	38	Services not provided or authorized by designated (network/primary care) providers.	N31	MISSING/INCOMPLETE/INVALID PRESCRIBING PROVIDER IDENTIFIER.	1024	BILLING PROVIDER NOT LISTED AS RECIPIENT LTC PROV
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	M78	Missing/incomplete/invalid HCPCS modifier.	4246	ADJUSTMENT NET PAID AMOUNT EXCEEDS THE CASH RECEIPT BALANCE
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	M85	Subjected to review of physician evaluation and management services.	0589	ADJUSTMENT HAS AUTO DENIAL
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	M85	Subjected to review of physician evaluation and management services.	0595	MANUALLY SUSPEND FOR REVIEW
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	MA120	Missing/incomplete/invalid CLIA certification number.	4208	CLIA NUMBER NOT EFFECTIVE FOR ENTIRE SVC PERIOD
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	MA129	This provider was not certified for this procedure on this date of service.	4208	CLIA NUMBER NOT EFFECTIVE FOR ENTIRE SVC PERIOD
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N123	This is a split service and represents a portion of the units from the originally submitted service.	3019	PA CUTBACK PERFORMED
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N31	MISSING/INCOMPLETE/INVALID PRESCRIBING PROVIDER IDENTIFIER.	1024	BILLING PROVIDER NOT LISTED AS RECIPIENT LTC PROV
20	Accepted for processing.	63	Correction to a prior claim.	M56	Missing/incomplete/invalid payer identifier.	4130	PAYER HIERARCHY NOT FOUND
20	Accepted for processing.	63	Correction to a prior claim.	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	4130	PAYER HIERARCHY NOT FOUND
20	Accepted for processing.	92	Claim Paid in full.	M50	Missing/incomplete/invalid revenue code(s).	4077	NON-COVERED REVENUE CODE
20	Accepted for processing.	92	Claim Paid in full.	MA31	Missing/incomplete/invalid beginning and ending dates of the period billed.	0554	HEADER BILLED DATE IS PRIOR TO DATES OF SERVICE
20	Accepted for processing.	92	Claim Paid in full.	N123	This is a split service and represents a portion of the units from the originally submitted service.	3019	PA CUTBACK PERFORMED
20	Accepted for processing.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5334	PALLIATIVE (EMERGENCY)TREATMENT MAY NOT BE BILLED WITH DEFINITIVE TREATMENT OR  OTHER EMERGECNY PROCEDURES ON THE SAME DAY.
20	Accepted for processing.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5335	PALLIATIVE (EMERGENCY)TREATMENT MAY NOT BE BILLED WITH DEFINITIVE TREATMENT OR  OTHER EMERGECNY PROCEDURES ON THE SAME DAY.
20	Accepted for processing.	119	Benefit maximum for this time period or occurrence has been reached.	N20	Service not payable with other service rendered on the same date.	6400	SPECIMEN COLLECTION FEE IS LIMITED TO ONE PER DAY
20	Accepted for processing.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6154	MAXIMUN UNIT LIMIT HAS BEEN EXCEEDED.
20	Accepted for processing.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6200	THIS PROCEDURE IS LIMITED TO SIXTEEN (16) UNITS PER CALENDAR YEAR.
20	Accepted for processing.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6291	SPECIMEN COLLECTION FEE IS LIMITED TO ONE PER DAY
20	Accepted for processing.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6650	THE LIMIT FOR THESE SERVICES HAS BEEN REACHED FOR THIS CONTRACT YEAR
20	Accepted for processing.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6651	UNITS BILLED FOR PROCEDURE CODE EXCEED MAXIMUM UNITS ALLOWED
20	Accepted for processing.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6652	UNITS BILLED FOR PROCEDURE CODE EXCEED MAXIMUM UNITS ALLOWED
20	Accepted for processing.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M83	Service is not covered unless the patient is classified as at high risk.	5506	SERVICE NOT PAYABLE WITH OTHER SERVICE ON SAME DAY
20	Accepted for processing.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M83	Service is not covered unless the patient is classified as at high risk.	5507	SERVICE NOT PAYABLE WITH OTHER SERVICE ON SAME DAY
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	4114	PRICING BEING REVIEWED
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	7288	SMARTSUSPENSE FLAG
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.	MA66	MISSING/INCOMPLETE/INVALID PRINCIPAL PROCEDURE CODE.	4014	NO PRICING SEGMENT IS ON FILE.
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	4014	NO PRICING SEGMENT IS ON FILE.
20	Accepted for processing.	A1	Claim/Service denied.	M56	Missing/incomplete/invalid payer identifier.	4130	PAYER HIERARCHY NOT FOUND
20	Accepted for processing.	A1	Claim/Service denied.	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	4130	PAYER HIERARCHY NOT FOUND
20	Accepted for processing.	A2	Contractual adjustment.	M78	Missing/incomplete/invalid HCPCS modifier.	4246	ADJUSTMENT NET PAID AMOUNT EXCEEDS THE CASH RECEIPT BALANCE
20	Accepted for processing.	A2	Contractual adjustment.	M85	Subjected to review of physician evaluation and management services.	0589	ADJUSTMENT HAS AUTO DENIAL
20	Accepted for processing.	A2	Contractual adjustment.	M85	Subjected to review of physician evaluation and management services.	0595	MANUALLY SUSPEND FOR REVIEW
20	Accepted for processing.	A2	Contractual adjustment.	MA120	Missing/incomplete/invalid CLIA certification number.	4208	CLIA NUMBER NOT EFFECTIVE FOR ENTIRE SVC PERIOD
20	Accepted for processing.	A2	Contractual adjustment.	MA129	This provider was not certified for this procedure on this date of service.	4208	CLIA NUMBER NOT EFFECTIVE FOR ENTIRE SVC PERIOD
20	Accepted for processing.	A2	Contractual adjustment.	N31	MISSING/INCOMPLETE/INVALID PRESCRIBING PROVIDER IDENTIFIER.	1024	BILLING PROVIDER NOT LISTED AS RECIPIENT LTC PROV
20	Accepted for processing.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5330	TWO RESTORATIONS NOT COVERED FOR THE SAME TOOTH NUMBER SAME DATE OF SERVICE.
20	Accepted for processing.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5331	TWO RESTORATIONS NOT COVERED FOR THE SAME TOOTH NUMBER SAME DATE OF SERVICE.
20	Accepted for processing.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	6290	MULTIPLE URINALYSIS TESTS CANNOT BE BILLED ON THE SAME DAY
20	Accepted for processing.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N39	Procedure code is not compatible with tooth number/letter.	5326	CORE BUILDUP NOT COVERED WITH OTHER RESTORATION
20	Accepted for processing.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N39	Procedure code is not compatible with tooth number/letter.	5327	CORE BUILDUP NOT COVERED WITH OTHER RESTORATION
20	Accepted for processing.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N39	Procedure code is not compatible with tooth number/letter.	5328	TWO RESTORATIONS NOT COVERED FOR THE SAME TOOTH NUMBER.
20	Accepted for processing.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N39	Procedure code is not compatible with tooth number/letter.	5329	TWO RESTORATIONS NOT COVERED FOR THE SAME TOOTH NUMBER.
20	Accepted for processing.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5451	HOME HEALTH PROVIDERS CANNOT BILL INPATIENT AND OUTPATIENT SERVICES ON THE SAME  CLAIM.
20	Accepted for processing.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	6283	REVENUE CODES 170 -171 MUST NOT EXCEED 10 UNITS UNDER MOTHER'S NUMBER.
20	Accepted for processing.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	MA120	Missing/incomplete/invalid CLIA certification number.	4208	CLIA NUMBER NOT EFFECTIVE FOR ENTIRE SVC PERIOD
20	Accepted for processing.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	MA129	This provider was not certified for this procedure on this date of service.	4208	CLIA NUMBER NOT EFFECTIVE FOR ENTIRE SVC PERIOD
21	Missing or invalid information.	3	Co-payment Amount	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0644	OTHER PAYER PAT RESP AMT IS INVALID
21	Missing or invalid information.	3	Co-payment Amount	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0645	OTHER PAYER PAT RESP QUALIFIER IS INVALID
21	Missing or invalid information.	3	Co-payment Amount	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	1038	DEA NOT ON FILE FOR PRESCRIBER
21	Missing or invalid information.	3	Co-payment Amount	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	1039	PRESCRIBER DEA NOT EFFECTIVE FOR DATE PRESCRIBED
21	Missing or invalid information.	3	Co-payment Amount	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	1040	PRESCRIBER DEA DOES NOT PERMIT DRUG SCHEDULE
21	Missing or invalid information.	3	Co-payment Amount	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	1041	PRESCRIBER PRACTICE TYPE NOT VALID FOR DRUG SCHED
21	Missing or invalid information.	14	The date of birth follows the date of service.	N56	Procedure code billed is not correct/valid for the services billed or the date of service billed.	7262	DOB CANNOT BE GREATER THAN DATE OF SERVICE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0473	ICD9 PROCEDURE 7-24 INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4273	INVALID NDC QUALIFIER CODE, MUST EQUAL N4
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M46	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN CODE.	0511	2ND OCCURRENCE SPAN FROM DATE IS AFTER THE TO DATE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	0350	THE NUMBER OF DETAILS IS NOT EQUAL TO THE SUBMITTED DETAIL COUNT.
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0456	INVALID PROCEDURE TYPE ACC. TO PROCEDURE QUALIFIER
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0457	INVALID PRINCIPAL/OTHER PROCEDURE TYPE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M53	Missing/incomplete/invalid days or units of service.	4251	DECIMAL UNITS NOT BILLABLE FOR PROCEDURE.
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0510	1ST OCCURRENCE SPAN FROM DATE IS AFTER THE TO DATE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	3352	SECOND DIAGNOSIS REQUIRES PRESENT ON ADMISSION INDICATOR
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	3353	THIRD DIAGNOSIS REQUIRES PRESENT ON ADMISSION INDICATOR
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	3354	FOURTH DIAGNOSIS REQUIRES PRESENT ON ADMISSION INDICATOR
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	3355	FIFTH DIAGNOSIS REQUIRES PRESENT ON ADMISSION INDICATOR
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	3356	SIXTH DIAGNOSIS REQUIRES PRESENT ON ADMISSION INDICATOR
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	3357	SEVENTH DIAGNOSIS REQUIRES PRESENT ON ADMISSION INDICATOR
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	3358	EIGHTH DIAGNOSIS REQUIRES PRESENT ON ADMISSION INDICATOR
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	3359	NINTH DIAGNOSIS REQUIRES PRESENT ON ADMISSION INDICATOR
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M67	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE CODE(S)	0369	SECOND OTHER PROCEDURE CODE INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M68	MISSING/INCOMPLETE/INVALID ATTENDING, ORDERING, RENDERING, SUPERVISING  OR REFERRING PHYSICIAN IDENTIFICATION.	0476	DETAIL ATTENDING PHYSICIAN ID INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M68	MISSING/INCOMPLETE/INVALID ATTENDING, ORDERING, RENDERING, SUPERVISING  OR REFERRING PHYSICIAN IDENTIFICATION.	1051	RENDERING PROVIDER NOT ON PROVIDER DATABASE (HDR)
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA102	Missing/incomplete/invalid name or provider identifier for the rendering/referring/ordering/supervising provider.	1007	RENDERING PROVIDER IDENTIFIER NOT ON FILE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA31	Missing/incomplete/invalid beginning and ending dates of the period billed.	0526	DETAIL DATES NOT WITHIN HEADER DATES
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA40	Missing/incomplete/invalid admission date.	0526	DETAIL DATES NOT WITHIN HEADER DATES
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	3351	PRIMARY DIAGNOSIS REQUIRES PRESENT ON ADMISSION INDICATOR
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N183	This is a predetermination advisory message, when this service is submitted for payment additional documentation as specified in plan documents will be required to process benefits.	0455	DENTAL PREDETERMINATION OF BENEFITS NOT ALLOWED
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N228	INCOMPLETE/INVALID CONSENT FORM.	0460	THE ATTACHMENT TYPE IS NOT VALID.
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N228	INCOMPLETE/INVALID CONSENT FORM.	0480	THE ATTACHMENT TYPE IS NOT VALID.
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N245	INCOMPLETE/INVALID PLAN INFORMATION FOR OTHER INSURANCE.	0652	MISSING OR INVALID OTHER PAYER COVERAGE TYPE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N262	MISSING/INCOMPLETE/INVALID OPERATING PROVIDER PRIMARY IDENTIFIER.	0477	DETAIL FIRST OTHER PHYSICIAN ID INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N262	MISSING/INCOMPLETE/INVALID OPERATING PROVIDER PRIMARY IDENTIFIER.	1053	OTHER-1 (OPERATING) PROVIDER ID NOT ON FILE - DTL
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N277	MISSING/INCOMPLETE/INVALID OTHER PAYER RENDERING PROVIDER IDENTIFIER.	1051	RENDERING PROVIDER NOT ON PROVIDER DATABASE (HDR)
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N286	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER PRIMARY IDENTIFIER.	1052	OTHER-2 (REFERRING) PROVIDER ID NOT ON FILE - DTL
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N286	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER PRIMARY IDENTIFIER.	1055	DTL REFERRING PROV NOT ON FILE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1007	RENDERING PROVIDER IDENTIFIER NOT ON FILE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N3	MISSING CONSENT FORM.	0599	ATTACHMENT CONTROL NUMBER MISSING
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N3	MISSING CONSENT FORM.	0603	ATTACHMENT BEING SENT BY PROVIDER FOR AN ELECTRONIC CLAIM.
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N3	MISSING CONSENT FORM.	0607	ATTACHMENT BEING SENT BY PROVIDER FOR AN ELECTRONIC CLAIM.
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	1018	CLINIC RATE NOT ON FILE FOR HOSPITAL
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	4054	FIRST OTHER PROCEDURE CODE NOT ON FILE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	4055	SECOND OTHER PROCEDURE CODE NOT ON FILE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	4056	THIRD OTHER PROCEDURE CODE NOT ON FILE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	4057	FOURTH OTHER PROCEDURE CODE NOT ON FILE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	4058	FIFTH OTHER PROCEDURE CODE NOT ON FILE
21	Missing or invalid information.	18	Duplicate claim/service.	N20	Service not payable with other service rendered on the same date.	5500	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	18	Duplicate claim/service.	N20	Service not payable with other service rendered on the same date.	5501	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	31	Claim denied as patient cannot be identified as our insured.	N382	Missing/incomplete/invalid patient identifier.	2808	COBA - MEDICARE ID NOT ON FILE
21	Missing or invalid information.	96	Non-covered charge(s).	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	4089	MISSING OR INVALID SURGERY CODE-PLEASE VERIFY TO SEE IF HCPC CODE CAN BE BILLED  WITH THE SURGERY REVENUE CODE AND RESUBMIT
21	Missing or invalid information.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5202	CHEMOTHERAPY ADMINISTRATION FEE MAY NOT BE BILLED ON THE SAME DAY AS THIS PROCE DURE
21	Missing or invalid information.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5203	CHEMOTHERAPY ADMINISTRATION FEE MAY NOT BE BILLED ON THES AME DAY AS THIS PROCE DURE
21	Missing or invalid information.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5204	VENIPUNCTURE AND LAB CODES ARE NOT ALLOWED ON THE SAME DAY.
21	Missing or invalid information.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5205	VENIPUNCTURE AND LAB CODES ARE NOT ALLOWED ON THE SAME DAY.
21	Missing or invalid information.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5208	ADMINISTRATION FEE MAY NOT BE BILLED ON THE SAME DAY AS THIS PROCEDURE CODE.
21	Missing or invalid information.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5209	ADMINISTRATION FEE MAY NOT BE BILLED ON THE SAME DAY AS THIS PROCEDURE CODE.
21	Missing or invalid information.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5630	INCIDENTAL SURGERY MAY NOT BE BILLED WITH DEFINITIVE SURGERY ON THE SAME DAY.
21	Missing or invalid information.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5631	INCIDENTAL SURGERY MAY NOT BE BILLED WITH DEFINITIVE SURGERY ON THE SAME DAY.
21	Missing or invalid information.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5632	EXPLORATORY LAP/LYSIS OF ADHESIONS MAY NOT BE BILLED ON THE SAME DAY WITH OTHER  RELATED SURGERY
21	Missing or invalid information.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5633	INCIDENTAL SURGERY NOT COVERED WITH DEFINITIVE SURGERY ON THE SAME DAY
21	Missing or invalid information.	110	BILLING DATE PREDATES SERVICE DATE.	MA06	Missing/incomplete/invalid beginning and/or ending date(s).	7264	DOS CANNOT BE A FUTURE DATE
21	Missing or invalid information.	119	Benefit maximum for this time period or occurrence has been reached.	N20	Service not payable with other service rendered on the same date.	5512	PRENATAL VISIT NOT BE COVERED ON THE SAME DAY AS POSTPARTUM VISIT.
21	Missing or invalid information.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	5338	ORAL EXAM EVALUATIONS ARE LIMITED TO ONE PER DAY.
21	Missing or invalid information.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6180	THE ALLOWED LENS LIMITATION HAS BEEN EXCEEDED
21	Missing or invalid information.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M38	The patient is liable for the charges for this service as you informed the patient in writing before the service was furnished that we would not pay for it, and the patient agreed to pay.	7279	INVALID AMOUNT CHARGED
21	Missing or invalid information.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N183	This is a predetermination advisory message, when this service is submitted for payment additional documentation as specified in plan documents will be required to process benefits.	0455	DENTAL PREDETERMINATION OF BENEFITS NOT ALLOWED
21	Missing or invalid information.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N59	Please refer to your provider manual for additional program and provider information.	5484	LAB SERVICES MUST BE BILLED WITH COMBINATION CODE.  SEE CPT.
21	Missing or invalid information.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N59	Please refer to your provider manual for additional program and provider information.	5486	CHEMISTRY PROFILES MUST BE BILLED USING ONE MULTICHANNEL TEST CODE
21	Missing or invalid information.	146	Diagnosis was invalid for the date(s) of service reported.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	0310	ICD-10 DIAGNOSIS BILLED BEFORE COMPLIANCE DATE
21	Missing or invalid information.	181	PAYMENT ADJUSTED BECAUSE THIS PROCEDURE CODE WAS INVALID ON THE DATE OF SERVICE	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	0309	ICD-10 PROCEDURE BILLED BEFORE COMPLIANCE DATE
21	Missing or invalid information.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5624	EMERGENCY ROOM VISIT/INITIAL HOSPITAL VISIT MAY NOT BE BILLED ON THE SAME DAY
21	Missing or invalid information.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5625	EMERGENCY ROOM VISIT/INITIAL HOSPITAL VISIT MAY NOT BE BILLED ON THE SAME DAY
21	Missing or invalid information.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5634	THE SAME PHYSICAIN MAY NOT BILL HOSPITAL VISIT AND DISCHARGE VISIT ON THE SAME  DAY
21	Missing or invalid information.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5635	THE SAME PHYSICAIN MAY NOT BILL HOSPITAL VISIT AND DISCHARGE VISIT ON THE SAME  DAY
21	Missing or invalid information.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5640	SUBSEQUENT HOSPITAL CARE MAY NOT BE BILLED ON SAME DAY AS INITIAL HOSPITAL CARE
21	Missing or invalid information.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5641	SUBSEQUENT HOSPITAL CARE MAY NOT BE BILLED ON SAME DAY AS INITIAL HOSPITAL CARE
21	Missing or invalid information.	B17	Payment adjusted because this service was not prescribed by a physician, not prescribed prior to delivery, the prescription is incomplete, or the prescription is not current.	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0213	DATE PRESCRIBED IS MISSING
21	Missing or invalid information.	B17	Payment adjusted because this service was not prescribed by a physician, not prescribed prior to delivery, the prescription is incomplete, or the prescription is not current.	N57	MISSING/INCOMPLETE/INVALID PRESCRIBING DATE.	0213	DATE PRESCRIBED IS MISSING
21	Missing or invalid information.	B17	Payment adjusted because this service was not prescribed by a physician, not prescribed prior to delivery, the prescription is incomplete, or the prescription is not current.	N57	MISSING/INCOMPLETE/INVALID PRESCRIBING DATE.	0214	DATE PRESCRIBED IS INVALID
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5202	CHEMOTHERAPY ADMINISTRATION FEE MAY NOT BE BILLED ON THE SAME DAY AS THIS PROCE DURE
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5203	CHEMOTHERAPY ADMINISTRATION FEE MAY NOT BE BILLED ON THES AME DAY AS THIS PROCE DURE
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5204	VENIPUNCTURE AND LAB CODES ARE NOT ALLOWED ON THE SAME DAY.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5205	VENIPUNCTURE AND LAB CODES ARE NOT ALLOWED ON THE SAME DAY.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5208	ADMINISTRATION FEE MAY NOT BE BILLED ON THE SAME DAY AS THIS PROCEDURE CODE.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5209	ADMINISTRATION FEE MAY NOT BE BILLED ON THE SAME DAY AS THIS PROCEDURE CODE.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5210	OUTPATIENT CHEMOTHERAPY AND EMERGENCY DEPARTMENT SERVICE CODES MAY NOT BE BILLE D ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5211	OUTPATIENT CHEMOTHERAPY AND EMERGENCY DEPARTMENT SERVICE CODES MAY NOT BE BILLE D ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5214	PROCEDURE CODE NOT ALLOWED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5232	DAILY MANAGEMENT OF AN EPIDURAL OR SUBARACHNOID CATHETER MAYNOT BE BILLED ON TH E SAME DAY AS A PROCEDURE FOR CATHETHER PLACEMENT.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5233	DAILY MANAGEMENT OF AN EPIDURAL OR SUBARACHNOID CATHETER MAYNOT BE BILLED ON TH E SAME DAY AS A PROCEDURE FOR CATHETHER PLACEMENT.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5262	PROCEDURE CODES 92553, 92556 AND 92557 CANNOT BE BILLED ON THE SAME DAY BY THE  SAME OR DIFFERENT PROVIDER
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5270	CLINIC CODES Z5145-Z5149 CANNOT BE BILLED ON THE SAME DAY WITH SAME UNIQUE NUMB ER AS 99241-99245 AND 99281-99285                                               ER AS 99241-99245 AND 99281-99286
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5271	CLINIC CODES AND E&M CODES CANNOT BE BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5280	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5281	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5282	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5283	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5284	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5354	TEMPORARY FILLING NOT PAYABLE ON SAME DATE OF SERVICE AS DEFINITIVE FILLING
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5355	TEMPORARY FILLING NOT PAYABLE ON SAME DATE OF SERVICE AS DEFINITIVE FILLING
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5436	SALPINGECTOMY WILL NOT BE PAID ON THE SAME DAY AS A TUBAL LIGATION
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5437	SALPINGECTOMY WILL NOT BE PAID ON THE SAME DAY AS A TUBAL LIGATION
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5472	CHEMISTRY PROFILE AND CHEMICAL PANEL CANNOT BE BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5473	CHEMISTRY PROFILE AND CHEMICAL PANEL CANNOT BE BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5474	COMPONENTS OF A CBC MAY NOT BE BILLED ON THE SAME DAY AS A COMPLETE CBC
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5475	COMPONENTS OF A CBC MAY NOT BE BILLED ON THE SAME DAY AS A COMPLETE CBC
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5476	COMPONENTS OF A CBC MAY NOT BE BILLED ON THE SAME DAY AS A COMPLETE CBC
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5477	COMPONENTS OF A CBC MAY NOT BE BILLED ON THE SAME DAY AS A COMPLETE CBC
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5478	COMPONENTS OF A URINALYSIS MAY NOT BE BILLED ON THE SAME DAY AS URINALYSIS
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5479	COMPONENTS OF A URINALYSIS MAY NOT BE BILLED ON THE SAME DAY AS URINALYSIS
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5480	COMPONENTS OF A CBC MAY NOT BE BILLED ON THE SAME DAY AS A COMPLETE CBC
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5481	COMPONENTS OF A CBC MAY NOT BE BILLED ON THE SAME DAY AS A COMPLETE CBC
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5482	COMPONENTS OF A CBC MAY NOT BE BILLED ON THE SAME DAY AS A COMPLETE CBC
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5483	COMPONENTS OF A CBC MAY NOT BE BILLED ON THE SAME DAY AS A COMPLETE CBC
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5488	COMPONENTS OF A CBC MAY NOT BE BILLED ON THE SAME DAY AS A COMPLETE CBC
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5500	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5501	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5502	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5503	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5512	PRENATAL VISIT NOT BE COVERED ON THE SAME DAY AS POSTPARTUM VISIT.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5513	PRENATAL VISIT NOT BE COVERED ON THE SAME DAY AS POSTPARTUM VISIT.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5600	PROCEDURE CANNOT BE BILLED ON THE SAME DAY AS CRITICAL CARE
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5601	PROCEDURE CANNOT BE BILLED ON THE SAME DAY AS CRITICAL CARE
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5602	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5603	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5610	PROCEDURE CODES 95115, 95117 OR Z4998 SHALL NOT BE PAID ON THE SAME DAY AS PROC EDURE CODES 95120 - 95134.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5611	PROFESSIONAL SERVICES ARE INCLUDED IN THE PROVISION OF THE EXTRACT.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5612	PROCEDURE CODES 95120-95134 WILL NOT BE PAID ON THE SAME DAY AS PROCEDURE CODES  95135-95170                                                                     95135-95171
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5613	PROCEDURE CODES 95120-95134 WILL NOT BE PAID ON THE SAME DAY AS PROCEDURE CODES  95135-95170                                                                     95135-95171
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5614	PROCEDURE NOT COVERED WHEN BILLED WITH PROCEDURE CODES 90918-90947
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5615	PROCEDURE NOT COVERED WHEN BILLED WITH PROCEDURE CODES 90918-90947
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5616	CRITICAL CARE CANNOT BE BILLED ON THE SAME DAY AS PROCEDURE
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5617	PROCEDURE CANNOT BE BILLED ON THE SAME DAY AS CRITICAL CARE
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5618	THE SAME PHYSICIAN MAY NOT BILL INTUBATION AND NEWBORN RESUSCITATION ON THE SAM E DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5619	THE SAME PHYSICIAN MAY NOT BILL INTUBATION AND NEWBORN RESUSCITATION ON THE SAM E DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5620	STANDBY/RESUCITATION/ATTENDANCE AT DELIVERY CANNOT BE BILLEDTOGETHER.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5621	STANDBY/RESUCITATION/ATTENDANCE AT DELIVERY CANNOT BE BILLED TOGETHER.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5622	ELECTROSHOCK THERAPY MAY NOT BE ON THE SAME DAY AS A HOSPITAL VISIT
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5623	ELECTROSHOCK THERAPY MAY NOT BE ON THE SAME DAY AS A HOSPITAL VISIT
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5626	PROFESSIONAL COMPONENTS AND HOSPITAL VISITS MAY NOT BE BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5627	PROFESSIONAL COMPONENTS AND HOSPITAL VISITS MAY NOT BE BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5648	PROCEDURE CODES NOT ALLOWED ON THE SAME DAY (95130- 95134)
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5791	PROCEDURE CODE NOT COVERED WHEN BILLED ON THE SAME DAY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5802	PREVOCATIONAL SERVICES AND SUPPORTED EMPLOYMENT SHALL NOT BE PAID ON THE SAME D AY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5803	PREVOCATIONAL SERVICES AND SUPPORTED EMPLOYMENT SHALL NOT BE PAID ON THE SAME D AY
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5232	DAILY MANAGEMENT OF AN EPIDURAL OR SUBARACHNOID CATHETER MAYNOT BE BILLED ON TH E SAME DAY AS A PROCEDURE FOR CATHETHER PLACEMENT.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5233	DAILY MANAGEMENT OF AN EPIDURAL OR SUBARACHNOID CATHETER MAYNOT BE BILLED ON TH E SAME DAY AS A PROCEDURE FOR CATHETHER PLACEMENT.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5238	PHYSICIAN VISIT CODES/PRIMARY ANESTHESIA CODES MAY NOT BE BILLED WITHIN 3 DAYS  OR ON SAME DAY OF EACH OTHER.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5239	PHYSICIAN VISIT CODES/PRIMARY ANESTHESIA CODES MAY NOT BE BILLED WITHIN 3 DAYS  OR ON SAME DAY OF EACH OTHER.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5484	LAB SERVICES MUST BE BILLED WITH COMBINATION CODE.  SEE CPT.
21	Missing or invalid information.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5486	CHEMISTRY PROFILES MUST BE BILLED USING ONE MULTICHANNEL TEST CODE
26	Entity not found.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M68	MISSING/INCOMPLETE/INVALID ATTENDING, ORDERING, RENDERING, SUPERVISING  OR REFERRING PHYSICIAN IDENTIFICATION.	1054	ATTENDING PROVIDER NOT FOUND
26	Entity not found.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA102	Missing/incomplete/invalid name or provider identifier for the rendering/referring/ordering/supervising provider.	0231	CLAIM WAS FILED WITHOUT SERVICING PROVIDER
26	Entity not found.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N253	MISSING/INCOMPLETE/INVALID ATTENDING PROVIDER PRIMARY IDENTIFIER.	0381	ATTENDING PHYSICIAN PROVIDER NUMBER MISSING
26	Entity not found.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	0231	CLAIM WAS FILED WITHOUT SERVICING PROVIDER
26	Entity not found.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N31	MISSING/INCOMPLETE/INVALID PRESCRIBING PROVIDER IDENTIFIER.	0206	PRESCRIBING PROVIDER NUMBER NOT IN VALID FORMAT
26	Entity not found.	100	PAYMENT MADE TO PATIENT/INSURED/RESPONSIBLE PARTY/EMPLOYER.	N31	MISSING/INCOMPLETE/INVALID PRESCRIBING PROVIDER IDENTIFIER.	1027	REFERRING PROVIDER NOT FOUND
26	Entity not found.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N257	MISSING/INCOMPLETE/INVALID BILLING PROVIDER/SUPPLIER PRIMARY IDENTIFIER.	0202	BILLING PROVIDER ID IN INVALID FORMAT
33	Subscriber and subscriber id not found.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M20	Missing/incomplete/invalid HCPCS.	0238	RECIPIENT NAME IS MISSING
33	Subscriber and subscriber id not found.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA36	Missing/incomplete/invalid patient name.	0238	RECIPIENT NAME IS MISSING
33	Subscriber and subscriber id not found.	A1	Claim/Service denied.	N382	Missing/incomplete/invalid patient identifier.	0204	RECIPIENT ID - OLD FORMAT
35	Claim/encounter not found.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	3018	STOP LOSS THRESHOLD REACHED - ENCOUNTER CLAIMS
35	Claim/encounter not found.	A2	Contractual adjustment.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	3018	STOP LOSS THRESHOLD REACHED - ENCOUNTER CLAIMS
48	Referral/authorization.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.	M62	Missing/incomplete/invalid treatment authorization code.	3003	PROCEDURE REQUIRES PRIOR AUTHORIZATION
48	Referral/authorization.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.	N54	Claim information is inconsistent with pre-certified/authorized services.	3006	PRIOR AUTH UNITS/AMOUNTS USED
52	Investigating existence of other insurance coverage.	22	Payment adjusted because this care may be covered by another payer per coordination of benefits.	N4	Missing/incomplete/invalid prior insurance carrier EOB.	2507	THIS PATIENT HAS TWO COVERAGE TYPES
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.	MA38	Missing/incomplete/invalid birth date.	7267	ONLY ONE PROVIDER ALLOWED FOR CURRENT PROCEDURES
54	Duplicate of a previously processed claim/line.	96	Non-covered charge(s).	N20	Service not payable with other service rendered on the same date.	5730	THIS PROCEDURE CODE IS NOT COVERED WHEN BILLED WITH MEDICAL PSYCHOTHERAPY CODES
54	Duplicate of a previously processed claim/line.	96	Non-covered charge(s).	N20	Service not payable with other service rendered on the same date.	5731	THIS PROCEDURE CODE IS NOT COVERED WHEN BILLED WITH MEDICAL PSYCHOTHERAPY CODES
54	Duplicate of a previously processed claim/line.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	M86	SERVICE DENIED BECAUSE PAYMENT ALREADY MADE FOR SAME/SIMILAR PROCEDURE WITHIN SET TIME FRAME.	5608	SAME PROVIDER CANNOT BILL APPLICATION/REMOVAL/REPAIR OF CAST FOR THE SAME RECIP IENT.
54	Duplicate of a previously processed claim/line.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	M86	SERVICE DENIED BECAUSE PAYMENT ALREADY MADE FOR SAME/SIMILAR PROCEDURE WITHIN SET TIME FRAME.	5609	SAME PROVIDER CANNOT BILL APPLICATION/REMOVAL/REPAIR OF CAST FOR THE SAME RECIP IENT.
54	Duplicate of a previously processed claim/line.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5460	PROCEDURE CODE IS PART OF THE OUTPATIENT SURGICAL PROCEDURE REIMBURSEMENT.
54	Duplicate of a previously processed claim/line.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5461	PROCEDURE CODE IS PART OF THE OUTPATIENT SURGICAL PROCEDURE REIMBURSEMENT.
54	Duplicate of a previously processed claim/line.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5464	PROCEDURE CODE IS PART OF THE OUTPATIENT SURGICAL PROCEDURE REIMBURSEMENT.
54	Duplicate of a previously processed claim/line.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5465	PROCEDURE CODE IS PART OF THE OUTPATIENT SURGICAL PROCEDURE REIMBURSEMENT.
54	Duplicate of a previously processed claim/line.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N390	This service/report cannot be billed separately.	5815	VISION AND HEARING SCREENING MUST BE BILLED WITH A REGULAR SCREENING AND ARE LI MITED TO ONCE PER YEAR
54	Duplicate of a previously processed claim/line.	119	Benefit maximum for this time period or occurrence has been reached.	N390	This service/report cannot be billed separately.	5815	VISION AND HEARING SCREENING MUST BE BILLED WITH A REGULAR SCREENING AND ARE LI MITED TO ONCE PER YEAR
54	Duplicate of a previously processed claim/line.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6030	NEW PATIENT CODE Z5147 MAY ONLY BE BILLED ONCE PER LIFETIME PER RECIPIENT
54	Duplicate of a previously processed claim/line.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6204	INITIAL VISIT IS LIMITED TO ONE PER RECIPIENT, PER PROVIDER, PER LIFETIME
54	Duplicate of a previously processed claim/line.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6653	PROCEDURE LIMITED TO 1080 HOURS,PER WAIVER YEAR OCTOBER 1 - SEPTEMBER 30.
54	Duplicate of a previously processed claim/line.	B13	Previously paid. Payment for this claim/service may have been provided in a previous payment.	M86	SERVICE DENIED BECAUSE PAYMENT ALREADY MADE FOR SAME/SIMILAR PROCEDURE WITHIN SET TIME FRAME.	5628	THE PAYMENT FOR THIS SERVICE WAS PREVIOUSLY MADE TO ANOTHER PROVIDER OR TO ANOT HER NUMBER FOR THIS PROVIDER
54	Duplicate of a previously processed claim/line.	B13	Previously paid. Payment for this claim/service may have been provided in a previous payment.	M86	SERVICE DENIED BECAUSE PAYMENT ALREADY MADE FOR SAME/SIMILAR PROCEDURE WITHIN SET TIME FRAME.	5629	THE PAYMENT FOR THIS SERVICE WAS PREVIOUSLY MADE TO ANOTHER PROVIDER OR TO ANOT HER NUMBER FOR THIS PROVIDER
54	Duplicate of a previously processed claim/line.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5650	ONLY ONE OUTPATIENT OBSERVATION VISIT MAY BE BILLED PER DAY
54	Duplicate of a previously processed claim/line.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5830	PROCEDURE IS NOT PAYABLE WHEN BILLED WITHOUT A PAID ROOT CANAL FOR THE SAME TOO TH NUMBER.
54	Duplicate of a previously processed claim/line.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5831	MEDICAID'S RECORD DO NOT SHOW A ROOT CANAL PAYMENT THEREFORE THIS PROCEDURE COD E IS NOT COVERED.
54	Duplicate of a previously processed claim/line.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5832	MEDICAID'S RECORD DO NOT SHOW A ROOT CANAL PAYMENT THEREFORE THIS PROCEDURE COD E IS NOT COVERED.
65	Claim/line has been paid.	59	Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.)	MA91	This determination is the result of the appeal you filed.	8554	NCCI REDETERMINIATION - APPROVED
65	Claim/line has been paid.	59	Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.)	MA91	This determination is the result of the appeal you filed.	8557	NCCI ADMINISTRATIVE REVIEW - APPROVED
67	Payment made in full.	123	Payer refund due to overpayment.	MA67	Correction to a prior claim.	8097	AGENCY REQUESTED REFUND DUE TO OTHER INSURANCE
67	Payment made in full.	193	ORIGINAL PAYMENT DECISION IS BEING MAINTAINED. THIS CLAIM WAS PROCESSED PROPERLY THE FIRST TIME.	MA67	Correction to a prior claim.	8097	AGENCY REQUESTED REFUND DUE TO OTHER INSURANCE
68	Partial payment made for this claim.	42	Charges exceed our fee schedule or maximum allowable amount.	N14	Payment based on a contractual amount or agreement, fee schedule, or maximum allowable amount.	9000	THE SUBMITTED CHARGE EXCEEDS THE ALLOWED CHARGE.  CLAIM PAID AT THE MEDICAID    PROGRAM ALLOWED AMOUNT.
70	Payment reflects contract provisions.	11	The diagnosis is inconsistent with the procedure.	N22	This procedure code was added/changed because it more accurately describes the services rendered.	7248	INTENSITY OF PROCEDURE WAS FOUND TO BE HIGHER THAN EXPECTED BASED ON DIAGNOSIS
70	Payment reflects contract provisions.	96	Non-covered charge(s).	N19	Procedure code incidental to primary procedure.	7216	VISIT PROCEDURE CODE IS NOT INDICATED FOR SEPARATE REIMBURSEMENT
70	Payment reflects contract provisions.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N22	This procedure code was added/changed because it more accurately describes the services rendered.	7219	PROCEDURE IS MUTUALLY EXCLUSIVE
70	Payment reflects contract provisions.	B13	Previously paid. Payment for this claim/service may have been provided in a previous payment.	M144	Pre-/post-operative care payment is included in the allowance for the surgery/procedure.	7221	PROCEDURE IS WITHIN THE NUMBER OF DAYS POST-OP RANGE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5300	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5301	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5302	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5303	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5304	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5305	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5306	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5307	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5308	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5309	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5310	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5311	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5312	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5313	PULP THERAPY COMBINATION NOT ALLOWED IN THIS CASE
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5314	PULP THERAPY COMBINATION NOT ALLOWED
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5315	PULP THERAPY COMBINATION NOT ALLOWED
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5316	PULP THERAPY COMBINATION NOT ALLOWED
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5317	PULP THERAPY COMBINATION NOT ALLOWED
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5318	PULP THERAPY COMBINATION NOT ALLOWED
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5319	PULP THERAPY COMBINATION NOT ALLOWED
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5320	PULP THERAPY COMBINATION NOT ALLOWED
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5321	PULP THERAPY COMBINATION NOT ALLOWED
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5322	PULP THERAPY COMBINATION NOT ALLOWED
70	Payment reflects contract provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5323	PULP THERAPY COMBINATION NOT ALLOWED
78	Duplicate of an existing claim/line, awaiting processing.	18	Duplicate claim/service.	N22	This procedure code was added/changed because it more accurately describes the services rendered.	7239	PROCEDURE IS A POSSIBLE DUPLICATE
78	Duplicate of an existing claim/line, awaiting processing.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5606	PAYMENT MADE FOR SIMILAR PROCEDURE
78	Duplicate of an existing claim/line, awaiting processing.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5607	PAYMENT MADE FOR SIMILAR PROCEDURE
78	Duplicate of an existing claim/line, awaiting processing.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N59	Please refer to your provider manual for additional program and provider information.	5660	ONLY ONE HOSPITAL ADMISSION MAY BE BILLED PER HOSPITAL STAY
84	Service not authorized.	15	Payment adjusted because the submitted authorization number is missing, invalid, or does not apply to the billed services or provider.	M62	Missing/incomplete/invalid treatment authorization code.	6052	CODE, SERVICE, PROCEDURE, NDC OR STAY REQUIRES PRIOR AUTHORIZATION
85	Entity not primary.	22	Payment adjusted because this care may be covered by another payer per coordination of benefits.	N4	Missing/incomplete/invalid prior insurance carrier EOB.	2504	FILE SHOWS OTHER INSURANCE, SUBMIT TO OTHER CARRIER
85	Entity not primary.	22	Payment adjusted because this care may be covered by another payer per coordination of benefits.	N4	Missing/incomplete/invalid prior insurance carrier EOB.	2505	RECIPIENT COVERED BY PRIVATE INSURANC(W/ATTACHMNT)
85	Entity not primary.	22	Payment adjusted because this care may be covered by another payer per coordination of benefits.	N4	Missing/incomplete/invalid prior insurance carrier EOB.	2508	RECIPIENT COVERED BY PRIVATE INSURANCE (PHARMACY)
85	Entity not primary.	129	Payment denied - Prior processing information appears incorrect.	N4	Missing/incomplete/invalid prior insurance carrier EOB.	2504	FILE SHOWS OTHER INSURANCE, SUBMIT TO OTHER CARRIER
85	Entity not primary.	129	Payment denied - Prior processing information appears incorrect.	N4	Missing/incomplete/invalid prior insurance carrier EOB.	2505	RECIPIENT COVERED BY PRIVATE INSURANC(W/ATTACHMNT)
85	Entity not primary.	129	Payment denied - Prior processing information appears incorrect.	N4	Missing/incomplete/invalid prior insurance carrier EOB.	2506	INSURANCE DENIAL REQUIRED
85	Entity not primary.	129	Payment denied - Prior processing information appears incorrect.	N4	Missing/incomplete/invalid prior insurance carrier EOB.	2508	RECIPIENT COVERED BY PRIVATE INSURANCE (PHARMACY)
87	Denied: Entity not found.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N279	MISSING/INCOMPLETE/INVALID PAY-TO PROVIDER NAME.	1000	NO PAY-TO PROVIDER RECORD
87	Denied: Entity not found.	31	Claim denied as patient cannot be identified as our insured.	N382	Missing/incomplete/invalid patient identifier.	0203	RECIPIENT I.D. NUMBER MISSING
88	Entity not eligible for benefits for submitted dates of service.	22	Payment adjusted because this care may be covered by another payer per coordination of benefits.	N30	Recipient ineligible for this service.	2007	QMB RECIPIENT ELIGIBLE FOR CROSSOVER ONLY
88	Entity not eligible for benefits for submitted dates of service.	96	Non-covered charge(s).	N30	Recipient ineligible for this service.	2045	ITEM NOT PAYABLE IN LONG TERM CARE FACILITY
88	Entity not eligible for benefits for submitted dates of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5206	THIS SERVICE IS INCLUDED IN THE FACILITY FEE
88	Entity not eligible for benefits for submitted dates of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5207	THIS SERVICE IS INCLUDED IN THE FACILITY FEE
88	Entity not eligible for benefits for submitted dates of service.	100	PAYMENT MADE TO PATIENT/INSURED/RESPONSIBLE PARTY/EMPLOYER.	N30	Recipient ineligible for this service.	2045	ITEM NOT PAYABLE IN LONG TERM CARE FACILITY
88	Entity not eligible for benefits for submitted dates of service.	110	BILLING DATE PREDATES SERVICE DATE.	N304	MISSING/INCOMPLETE/INVALID DISPENSED DATE.	0503	DATE DISPENSED AFTER BILLING DATE
88	Entity not eligible for benefits for submitted dates of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5206	THIS SERVICE IS INCLUDED IN THE FACILITY FEE
88	Entity not eligible for benefits for submitted dates of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5207	THIS SERVICE IS INCLUDED IN THE FACILITY FEE
90	Entity not eligible for medical benefits for submitted dates of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N55	Procedures for billing with group/referring/performing providers were not followed.	1010	PERFORMING PROVIDER NOT IN BILLING GROUP
90	Entity not eligible for medical benefits for submitted dates of service.	38	Services not provided or authorized by designated (network/primary care) providers.	N55	Procedures for billing with group/referring/performing providers were not followed.	1010	PERFORMING PROVIDER NOT IN BILLING GROUP
90	Entity not eligible for medical benefits for submitted dates of service.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.	M68	MISSING/INCOMPLETE/INVALID ATTENDING, ORDERING, RENDERING, SUPERVISING  OR REFERRING PHYSICIAN IDENTIFICATION.	1048	PERFORMING PROVIDER ENROLLMENT STATUS INVALID
90	Entity not eligible for medical benefits for submitted dates of service.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.	MA102	Missing/incomplete/invalid name or provider identifier for the rendering/referring/ordering/supervising provider.	1002	PERFORMING PROV NOT ELIGIBLE FOR DOS
90	Entity not eligible for medical benefits for submitted dates of service.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.	N277	MISSING/INCOMPLETE/INVALID OTHER PAYER RENDERING PROVIDER IDENTIFIER.	1002	PERFORMING PROV NOT ELIGIBLE FOR DOS
90	Entity not eligible for medical benefits for submitted dates of service.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.	N277	MISSING/INCOMPLETE/INVALID OTHER PAYER RENDERING PROVIDER IDENTIFIER.	1048	PERFORMING PROVIDER ENROLLMENT STATUS INVALID
90	Entity not eligible for medical benefits for submitted dates of service.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	MA102	Missing/incomplete/invalid name or provider identifier for the rendering/referring/ordering/supervising provider.	1002	PERFORMING PROV NOT ELIGIBLE FOR DOS
90	Entity not eligible for medical benefits for submitted dates of service.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	N277	MISSING/INCOMPLETE/INVALID OTHER PAYER RENDERING PROVIDER IDENTIFIER.	1002	PERFORMING PROV NOT ELIGIBLE FOR DOS
91	Entity not eligible/not approved for dates of service.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.	N95	This provider type/provider specialty may not bill this service.	1003	PROVIDER INELIGIBLE ON DATE OF SERVICE
91	Entity not eligible/not approved for dates of service.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	N95	This provider type/provider specialty may not bill this service.	1003	PROVIDER INELIGIBLE ON DATE OF SERVICE
94	Entity not referred by selected primary care provider.	38	Services not provided or authorized by designated (network/primary care) providers.	N286	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER PRIMARY IDENTIFIER.	1050	SERVICE NOT REFERRED BY PRIMARY CARE CASE MANAGER
94	Entity not referred by selected primary care provider.	38	Services not provided or authorized by designated (network/primary care) providers.	N286	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER PRIMARY IDENTIFIER.	1820	PATIENT FIRST CLAIM REQUIRES A REFERRAL
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.	M1	X-ray not taken within the past 12 months or near enough to the start of treatment.	8092	AGENCY REQUESTED REFUND DUE TO BILLING ERROR
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.	M1	X-ray not taken within the past 12 months or near enough to the start of treatment.	8094	AGENCY REQUESTED REFUND DUE TO WRONG PROVIDER PAID/EFT ERROR
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.	M104	Information supplied supports a break in therapy.  A new capped rental period will begin with delivery of the equipment.  This is the maximum approved under the fee schedule for this item or service.	8091	AGENCY REQUESTED REFUND DUE TO AUDIT DIVISION REVIEW
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.	MA67	Correction to a prior claim.	8076	PROVIDER SENT REFUND DUE TO PATIENT LIABILITY PROCES                            SING ERROR.
101	Claim was processed as adjustment to previous claim.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	MA67	Correction to a prior claim.	8995	CLAIM MODIFIED POST-PROCESSING.  BILLING PROVIDER OVERRIDDEN TO FORCE CLAIM TO  ADJUDICATE TO SAME BILLING  PROVIDER AS ORIGINAL CLAIM FROM MARCH 2008.
101	Claim was processed as adjustment to previous claim.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	MA91	This determination is the result of the appeal you filed.	8208	NCCI REDETERMINIATION - HISTORY VOID
101	Claim was processed as adjustment to previous claim.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	MA91	This determination is the result of the appeal you filed.	8209	NCCI ADMINISTRATIVE REVIEW - HISTORY VOID
106	This amount is not entity's responsibility.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0236	NO PROCEDURE FOR REVENUE CODE; MEDICAID HAS NO PAYMENT LIABILITY FOR THIS LINE  ITEM.
106	This amount is not entity's responsibility.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0255	PATIENT RSN FOR VISIT REQ ON OUTPATIENT HOSP CLAIM
106	This amount is not entity's responsibility.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0256	ADMIT DIAGNOSIS INVALID ON OUTPATIENT HOSP CLAIM
106	This amount is not entity's responsibility.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0257	PATIENT RSN FOR VISIT INVALID ON INPATIENT CLAIM
107	Processed according to contract/plan provisions.	1	DEDUCTIBLE AMOUNT	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0433	MEDICARE DEDUCTIBLE AMOUNT INVALID
107	Processed according to contract/plan provisions.	2	Coinsurance Amount	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0433	MEDICARE DEDUCTIBLE AMOUNT INVALID
107	Processed according to contract/plan provisions.	5	The procedure code/bill type is inconsistent with the place of service.	MA30	Missing/incomplete/invalid type of bill.	3309	PROCEDURE CODE - TYPE OF BILL RESTRICTION
107	Processed according to contract/plan provisions.	6	The procedure code is inconsistent with the patient's age.	M50	Missing/incomplete/invalid revenue code(s).	4254	BPA-RP-REV - AGE RESTRICTION
107	Processed according to contract/plan provisions.	12	The diagnosis is inconsistent with the provider type.	M76	Missing/incomplete/invalid diagnosis or condition.	4001	BPA-RP-DIAG - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	12	The diagnosis is inconsistent with the provider type.	M76	Missing/incomplete/invalid diagnosis or condition.	4016	BPA-RP-DIAG - PERF PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4002	BPA-RP-NDC - NO COVERAGE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4117	BPA-PC-NDC - FAMILY PLANNING IND RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4138	BPA-RP-NDC - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4160	BPA-PC-NDC - CURR PROV CONTRACT RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4166	BPA-RR-NDC - NO RULE FOR BENEFIT PLAN
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4522	BPA-RP-NDC - BILL PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4947	BPA-RR-NDC - ASSIGNMENT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4960	BPA-RP-NDC - BENE PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4965	BPA-PC-NDC - BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M123	Missing/incomplete/invalid name, strength, or dosage of the drug furnished.	6311	QTY DISPENSED EXCEEDS MAX QTY BASED ON PA
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4062	BPA-RR - NO RULE FOR COND CODE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4901	BPA-RP-DIAG - CONDITION CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4911	BPA-PC-DIAG - CONDITION CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4921	BPA-RP-DRG - CONDITION CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4931	BPA-PC-DRG - CONDITION CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4941	BPA-RP-ICD9 - CONDITION CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4951	BPA-PC-ICD9 - CONDITION CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4971	BPA-RP-REV - CONDITION CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4976	BPA-PC-REV - CONDITION CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4981	BPA-RP-PROC - CONDITION CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	4991	BPA-PC-PROC - CONDITION CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	4902	BPA-RP-DIAG - OCCURRENCE CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	4912	BPA-PC-DIAG - OCCURRENCE CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	4913	BPA-XX-DIAG - DIAG ROLE RESTRICTION -PC and RR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	4922	BPA-RP-DRG -  OCCURRENCE CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	4942	BPA-RP-ICD9 -  OCCURRENCE CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	4952	BPA-PC-ICD9 - OCCURRENCE CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	4972	BPA-RP-REV -  OCCURRENCE CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	4977	BPA-PC-REV -  OCCURRENCE CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	4982	BPA-RP-PROC -  OCCURRENCE CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	4992	BPA-PC-PROC -  OCCURRENCE CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M47	Missing/incomplete/invalid internal or document control number.	0677	ADJ - ORIGINAL ICN NOT FOUND
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M47	Missing/incomplete/invalid internal or document control number.	0678	ADJ - ORIGINAL ICN NOT SUBMITTED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M47	Missing/incomplete/invalid internal or document control number.	0681	ADJ - ORIGINAL ICN NOT FOUND
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M49	Missing/incomplete/invalid value code(s) or amount(s).	0836	MEDICARE PAID, DEDUCTIBLE AMOUNTS INVALID - BOTH CANNOT BE ZERO  **OR** MEDICAR D PAID, COINSURANCE AMOUNTS INVALID - MEDICARE PAID AMOUNT CANNOT BE ZERO WHEN  COINSURANCE IS BILLED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4106	BPA-RP-REV - FAMILY PLANNING IND RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4142	BPA-RP-REV - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4143	BPA-RP-REV - PERF PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4151	BPA-PC-REV - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4152	BPA-PC-REV - PERF PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4154	BPA-PC-REV - FAMILY PLANNING IND RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4162	BPA-PC-REV - CURR PROV CONTRACT RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4167	BPA-RR-REV - NO RULE FOR BENEFIT PLAN
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4227	BPA-RP-REV - NO COVERAGE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4254	BPA-RP-REV - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4520	BPA-PC-REV - BILL PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4525	BPA-RP-REV - BILL PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4529	BPA-RP-REV -  PROV COUNTY RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4757	BPA-PC-REV - CURRENT BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4804	BPA-PC-REV - NO CONTRACT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4929	BPA-RP-REV - ASSIGNMENT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4939	BPA-PC-REV - ASSIGNMENT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4949	BPA-RR-REV - ASSIGNMENT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4970	BPA-RP-REV - BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4975	BPA-PC-REV - BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4021	BPA-RP-PROC - NO COVERAGE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4075	BPA-RP-ICD9 - FAMILY PLANNING IND RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4104	BPA-RP-PROC - FAMILY PLANNING IND RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4112	BPA-PC-ICD9 - FAMILY PLANNING IND RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4118	BPA-PC-PROC - FAMILY PLANNING IND RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4136	BPA-RP-ICD9 - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4140	BPA-RP-PROC - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4141	BPA-RP-PROC - PERF PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4149	BPA-PC-PROC - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4150	BPA-PC-PROC - PERF PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4159	BPA-PC-ICD9 - CURR PROV CONTRACT RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4161	BPA-PC-PROC - CURR PROV CONTRACT RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4194	BPA-RP-PROC - OTHER DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4519	BPA-PC-PROC - BILL PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4524	BPA-RP-PROC - BILL PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4801	BPA-PC-PROC - NO CONTRACT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4928	BPA-RP-PROC - ASSIGNMENT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4938	BPA-PC-PROC - ASSIGNMENT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4948	BPA-RR-PROC - ASSIGNMENT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4961	BPA-RP-PROC - PROV COUNTY RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M53	Missing/incomplete/invalid days or units of service.	4540	BPA-PC-PROC - MIN UNIT RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M56	Missing/incomplete/invalid payer identifier.	0687	CANNOT ADJUST THIS CLAIM DUE TO PROVIDER CHANGES.  VOID THIS CLAIM AND RESUBMIT A NEW CLAIM.
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4313	BPA-PC-PROC - SECONDARY DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4316	BPA-PC -ANY DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4372	BPA-PC-PROC -  SECONDARY HDR DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4530	BPA-RR-PROC - SECONDARY DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4532	BPA-RR-ICD9 - OTHER HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4533	BPA-RP-REV - OTHER HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4560	BPA-RP-ICD9 -  SECONDARY HDR DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4561	BPA-RP-REV -  SECONDARY HDR DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4564	BPA-RR-PROC - HDR  SECONDARY DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4565	BPA-RR-ICD9 - HDR  SECONDARY DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4566	BPA-RR-REV - HDR  SECONDARY DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4724	BPA-RP-ICD9 - ANY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4731	BPA-RP-PROC - ANY DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4733	BPA-RP-REV - ANY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4743	BPA-RP-PROC - SECONDARY DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4744	BPA-RP-PROC -  SECONDARY HDR DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4747	BPA-PC-ICD9 - HDR  SECONDARY DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4748	BPA-PC-REV - SECONDARY HDR DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4765	BPA-RP-ICD9 - NO COVERAGE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4806	BPA-PC-ICD9 - NO CONTRACT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4835	BPA-PC-PROC - OTHER DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4905	BPA-RP-ICD9 - OTHER HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4906	BPA-RP-PROC - OTHER HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4923	BPA-PC-ICD9 - OTHER HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M64	Missing/incomplete/invalid other diagnosis.	4973	BPA-RR-PROC - ANY DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4001	BPA-RP-DIAG - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4016	BPA-RP-DIAG - PERF PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4093	BPA-RP-DIAG - DIAG ROLE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4109	BPA-PC-DIAG - FAMILY PLANNING IND RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4144	BPA-PC-DIAG - PERF PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4157	BPA-PC-DIAG - CURR PROV CONTRACT RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4244	BPA-RP-DIAG - NO COVERAGE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4319	BPA-PC-ICD9 - ANY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4322	BPA-PC-REV - ANY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4361	BPA - DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4521	BPA-RP-DIAG - BILL PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4523	BPA-RP-ICD9 - BILL PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4535	BPA-RP-ICD9 -  EMERGENCY DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4536	BPA-RP-PROC -  EMERGENCY DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4538	BPA-RP-REV -  EMERGENCY DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4539	BPA-PC-PROC -  EMERGENCY DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4716	BPA-PC-ICD9 - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4756	BPA-PC-DIAG - CURRENT BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4802	BPA-PC-DIAG - NO CONTRACT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4900	BPA-RP-DIAG - BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4910	BPA-PC-DIAG - BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4927	BPA-RP-DIAG - ASSIGNMENT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4933	BPA-PC-PROC - OTHER HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4937	BPA-PC-DIAG - ASSIGNMENT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4940	BPA-RP-ICD9 - BENE PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4943	BPA-PC-REV - OTHER HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4950	BPA-PC-ICD9 - BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4966	BPA-RR - DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	4993	BPA-RR-PROC - PRIMARY DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M77	Missing/incomplete/invalid place of service.	4029	BPA-RP-DIAG - PLACE OF SERVICE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M77	Missing/incomplete/invalid place of service.	4155	BPA-RR-PROC - PLACE OF SERVICE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M77	Missing/incomplete/invalid place of service.	4762	BPA-PC-ICD9 - PLACE OF SERVICE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M77	Missing/incomplete/invalid place of service.	4767	BPA-RP-ICD9 - PLACE OF SERVICE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M77	Missing/incomplete/invalid place of service.	4821	BPA-PC-PROC - PLACE OF SERVICE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M77	Missing/incomplete/invalid place of service.	4822	BPA-PC-DIAG - PLACE OF SERVICE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA30	Missing/incomplete/invalid type of bill.	3309	PROCEDURE CODE - TYPE OF BILL RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA30	Missing/incomplete/invalid type of bill.	4219	BPA-RR-REV - NO RULE FOR TYPE OF BILL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA30	Missing/incomplete/invalid type of bill.	4362	BPA-PC-DIAG - TYPE OF BILL RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA30	Missing/incomplete/invalid type of bill.	4363	BPA-PC-DRG - TYPE OF BILL RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA30	Missing/incomplete/invalid type of bill.	4364	BPA-PC-ICD9 - TYPE OF BILL RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA30	Missing/incomplete/invalid type of bill.	4751	BPA-PC-REV - TYPE OF BILL RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA36	Missing/incomplete/invalid patient name.	4723	BPA-RP-ICD9 - PRIMARY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA36	Missing/incomplete/invalid patient name.	4734	BPA-PC-DRG - PRIMARY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA39	Missing/incomplete/invalid gender.	4064	BPA-RP-ICD9 - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA39	Missing/incomplete/invalid gender.	4562	BPA-RP-REV - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA39	Missing/incomplete/invalid gender.	4935	BPA-RP-DRG - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA39	Missing/incomplete/invalid gender.	4936	BPA-PC-DRG - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA39	Missing/incomplete/invalid gender.	4944	BPA-PC-ICD9 - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA39	Missing/incomplete/invalid gender.	4962	BPA-PC-NDC - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA39	Missing/incomplete/invalid gender.	4963	BPA-PC-PROC - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA39	Missing/incomplete/invalid gender.	4964	BPA-PC-REV - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4073	BPA-RP-DIAG - FAMILY PLANNING IND RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4311	BPA-PC-PROC - PRIMARY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4312	BPA-PC-PROC - PRIMARY DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4318	BPA-PC-ICD9 - PRIMARY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4321	BPA-PC-REV - PRIMARY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4527	BPA-PC-NDC - PRIMARY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4580	BPA-RP-PROC - DIAGNOSIS RESTRICTION - GROUP
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4581	BPA-PC-PROC - DIAGNOSIS RESTRICTION - GROUP
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4736	BPA-RP-REV - PRIMARY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4742	BPA-RP-PROC - PRIMARY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA63	Missing/incomplete/invalid principal diagnosis.	4746	BPA-RP-PROC - PRIMARY DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA65	Missing/incomplete/invalid admitting diagnosis.	4310	BPA-PC-PROC - ADMIT DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA65	Missing/incomplete/invalid admitting diagnosis.	4317	BPA-PC-ICD9 - ADMIT DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA65	Missing/incomplete/invalid admitting diagnosis.	4320	BPA-PC-REV - ADMIT DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA65	Missing/incomplete/invalid admitting diagnosis.	4726	BPA-RP-ICD9 - ADMIT DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA65	Missing/incomplete/invalid admitting diagnosis.	4732	BPA-RP-REV -  ADMIT DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA65	Missing/incomplete/invalid admitting diagnosis.	4741	BPA-RP-PROC - ADMIT DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N142	The original claim was denied.  Resubmit a new claim, not a replacement claim.	0685	ADJ - ORIGINAL CLAIM NOT IN A PAID STATUS
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N152	Missing/incomplete/invalid replacement claim information.	0680	ADJ - REQUEST PROVIDER DOES NOT MATCH ORIGINAL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N152	Missing/incomplete/invalid replacement claim information.	0684	ADJ - REQUEST RECIPIENT DOES NOT MATCH ORIGINAL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N152	Missing/incomplete/invalid replacement claim information.	0686	ADJ - REPLACEMENT CLAIM NOT SAME CLAIM TYPE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N208	MISSING/INCOMPLETE/INVALID DRG CODE.	4920	BPA-RP-DRG - BENE PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N208	MISSING/INCOMPLETE/INVALID DRG CODE.	4930	BPA-PC-DRG - BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1980	TAXONOMY IS NOT VALID FOR BILLING PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1985	TAXONOMY IS INVALID: BILLING PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N284	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER TAXONOMY.	1975	TAXONOMY IS INVALID: DTL REFERRING PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N284	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER TAXONOMY.	1979	TAXONOMY IS NOT VALID FOR DTL REFERRING PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N284	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER TAXONOMY.	1982	TAXONOMY IS NOT VALID FOR REFERRING PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N284	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER TAXONOMY.	1987	TAXONOMY IS INVALID: REFERRING PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N286	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER PRIMARY IDENTIFIER.	0225	REFERRING PROVIDER - INVALID FORMAT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N286	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER PRIMARY IDENTIFIER.	1962	NPI REQUIRED: REFERRING PROVIDER (HEALTHCARE)
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1974	TAXONOMY IS INVALID: DTL PERFORMING PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1978	TAXONOMY IS NOT VALID FOR DTL PERFORMING PROV
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1981	TAXONOMY IS NOT VALID FOR PERFORMING PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1986	TAXONOMY IS INVALID: PERFORMING PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1815	PERF PROV ENROLL STATUS NOT VALID FOR DOS
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N301	MISSING/INCOMPLETE/INVALID PROCEDURE DATE(S).	0474	ICD9 PROCEDURE 7-24 OR DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N301	MISSING/INCOMPLETE/INVALID PROCEDURE DATE(S).	0475	ICD9 PROCEDURE 7-24 DATE INVALID
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N302	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE DATE(S).	0367	FIRST OTHER ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N302	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE DATE(S).	0368	FIRST OTHER ICD9 PROCEDURE DATE INVALID
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N302	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE DATE(S).	0370	SECOND OTHER ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N302	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE DATE(S).	0371	SECOND OTHER ICD9 PROCEDURE DATE INVALID
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N302	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE DATE(S).	0373	THIRD OTHER ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N302	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE DATE(S).	0374	THIRD OTHER ICD9 PROCEDURE DATE INVALID
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N302	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE DATE(S).	0376	FOURTH OTHER ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N302	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE DATE(S).	0377	FOURTH OTHER ICD9 PROCEDURE DATE INVALID
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N302	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE DATE(S).	0379	FIFTH OTHER ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N302	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE DATE(S).	0380	FIFTH OTHER ICD9 PROCEDURE DATE INVALID
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N303	MISSING/INCOMPLETE/INVALID PRINCIPAL PROCEDURE DATE.	0364	PRINCIPAL ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N303	MISSING/INCOMPLETE/INVALID PRINCIPAL PROCEDURE DATE.	0365	PRINCIPAL ICD9 PROCEDURE DATE INVALID
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	1807	CROSSOVER ONLY PROVIDER CANNOT BILL CLAIM TYPE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	1825	COBA DENIAL - DO NOT CROSSOVER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4061	BPA-RR -  NO RULE FOR CLAIM TYPE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4314	BPA-RP-DIAG - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4371	BPA-RP-PROC - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4373	BPA-RP-NDC - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4374	BPA-RP-REV - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4376	BPA-RP-ICD9 - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4871	BPA-PC-PROC - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4872	BPA-PC-DIAG - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4873	BPA-PC-NDC - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4874	BPA-PC-REV - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	4876	BPA-PC-ICD9 - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N362	THE NUMBER OF DAYS OR UNITS OF SERVICE EXCEEDS OUR ACCEPTABLE MAXIMUM.	3315	NURSERY DAYS EXCEED LIMIT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N362	THE NUMBER OF DAYS OR UNITS OF SERVICE EXCEEDS OUR ACCEPTABLE MAXIMUM.	4224	BPA-RP-PROC - QUANTITY RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N382	Missing/incomplete/invalid patient identifier.	0675	ADJ - RECIPIENT ID NOT SUBMITTED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N382	Missing/incomplete/invalid patient identifier.	0679	ADJ - REQUEST RECIPIENT ID NOT FOUND
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N382	Missing/incomplete/invalid patient identifier.	2807	COBA-NO MEDICAID ID FOR MEDICARE ID
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	0364	PRINCIPAL ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	0367	FIRST OTHER ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	0370	SECOND OTHER ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	0373	THIRD OTHER ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	0376	FOURTH OTHER ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	0379	FIFTH OTHER ICD9 PROCEDURE DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	0474	ICD9 PROCEDURE 7-24 OR DATE MISSING
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N77	Missing/incomplete/invalid designated provider number.	0676	ADJ - PROVIDER ID NOT SUBMITTED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N94	Claim/Service denied because a more specific taxonomy code is required for adjudication.	1976	TAXONOMY IS INVALID: DTL OTHER PROVIDER 2
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N94	Claim/Service denied because a more specific taxonomy code is required for adjudication.	1977	TAXONOMY IS NOT VALID FOR DTL OTHER PROVIDER 2
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N94	Claim/Service denied because a more specific taxonomy code is required for adjudication.	1983	TAXONOMY IS NOT VALID FOR FACILITY PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N94	Claim/Service denied because a more specific taxonomy code is required for adjudication.	1984	TAXONOMY IS NOT VALID FOR OTHER PROVIDER 2
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N94	Claim/Service denied because a more specific taxonomy code is required for adjudication.	1988	TAXONOMY IS INVALID: FACILITY PROVIDER
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N94	Claim/Service denied because a more specific taxonomy code is required for adjudication.	1989	TAXONOMY IS INVALID: OTHER PROVIDER 2
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N95	This provider type/provider specialty may not bill this service.	1826	SERVICE FOR MATERNITY WAIVER/CARE RECIPIENT MUST BE BILLED WITH GLOBAL SERVICE  FEE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N95	This provider type/provider specialty may not bill this service.	4177	BPA-PC-ICD9 - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N95	This provider type/provider specialty may not bill this service.	4250	BPA-RR - NO RULE FOR PRIMARY PT/PS BILL/PERF
107	Processed according to contract/plan provisions.	17	Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever	N307	MISSING/INCOMPLETE/INVALID ADJUDICATION OR PAYMENT DATE.	0243	MISSING MEDICARE PAID DATE
107	Processed according to contract/plan provisions.	18	Duplicate claim/service.	N20	Service not payable with other service rendered on the same date.	5804	ONLY ONE TYPE OF RESPITE CARE IS ALLOWED FOR A GIVEN DATE OF SERVICE.
107	Processed according to contract/plan provisions.	24	Payment for charges adjusted. Charges are covered under a capitation agreement/managed care plan.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	2017	RECIPIENT SERVICES COVERED BY HMO PLAN
107	Processed according to contract/plan provisions.	29	The time limit for filing has expired.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0555	SERVICE(S) PAST THE MAXIMUM MEDICAID FILING LIMIT
107	Processed according to contract/plan provisions.	29	The time limit for filing has expired.	M46	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN CODE.	0512	SERVICE(S) PAST THE MAXIMUM MEDICAID FILING LIMIT
107	Processed according to contract/plan provisions.	29	The time limit for filing has expired.	N59	Please refer to your provider manual for additional program and provider information.	0557	MEPD LATE FILING
107	Processed according to contract/plan provisions.	31	Claim denied as patient cannot be identified as our insured.	N382	Missing/incomplete/invalid patient identifier.	2807	COBA-NO MEDICAID ID FOR MEDICARE ID
107	Processed according to contract/plan provisions.	42	Charges exceed our fee schedule or maximum allowable amount.	N14	Payment based on a contractual amount or agreement, fee schedule, or maximum allowable amount.	5760	ESWL PRICING
107	Processed according to contract/plan provisions.	42	Charges exceed our fee schedule or maximum allowable amount.	N59	Please refer to your provider manual for additional program and provider information.	5760	ESWL PRICING
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N14	Payment based on a contractual amount or agreement, fee schedule, or maximum allowable amount.	5760	ESWL PRICING
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N59	Please refer to your provider manual for additional program and provider information.	5760	ESWL PRICING
107	Processed according to contract/plan provisions.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.	M123	Missing/incomplete/invalid name, strength, or dosage of the drug furnished.	6311	QTY DISPENSED EXCEEDS MAX QTY BASED ON PA
107	Processed according to contract/plan provisions.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.	N54	Claim information is inconsistent with pre-certified/authorized services.	3000	UNITS EXCEED AUTHORIZED UNITS ON PA MASTER FILE
107	Processed according to contract/plan provisions.	96	Non-covered charge(s).	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4002	BPA-RP-NDC - NO COVERAGE
107	Processed according to contract/plan provisions.	96	Non-covered charge(s).	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4021	BPA-RP-PROC - NO COVERAGE
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5200	ADMINISTRATION FEE MAY NOT BE BILLED ON THE SAME DAY AS AN OFFICE VISIT AND/OR  VACCINE REPLACEMENT
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5201	ADMINISTRATION FEE MAY NOT BE BILLED ON THE SAME DAY AS AN OFFICE VISIT AND/OR  VACCINE REPLACEMENT
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5516	ANTEPARTUM, POSTPARTUM CARE/VAGINAL DELIVERY MAY NOT BE BILLED WITH GLOBAL OB C ARE
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5517	ANTEPARTUM, POSTPARTUM CARE/VAGINAL DELIVERY MAY NOT BE BILLED WITH GLOBAL OB C ARE
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5522	ROUTINE PRENATAL LAB, OFFICE/HOSPITAL VISITS MAY NOT BE BILLED WITH GLOBAL OB P ROCEDURE
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5523	ROUTINE PRENATAL LAB, OFFICE/HOSPITAL VISITS MAY NOT BE BILLED WITH GLOBAL OB P ROCEDURE
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5636	HYSTERECTOMY ANCILLARY CODES MAY NOT BE PAID IN ADDITION TO  THE HYSTERECTOMY P ROCEDURE CODE
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5637	HYSTERECTOMY ANCILLARY CODES MAY NOT BE PAID IN ADDITION TO  THE HYSTERECTOMY P ROCEDURE CODE
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5638	HOSPITAL ADMISSION/VISITS MAY NOT BE BILLED ON OR AFTER OB GLOBAL
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5639	HOSPITAL ADMISSION/VISITS MAY NOT BE BILLED ON OR AFTER OB GLOBAL
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N390	This service/report cannot be billed separately.	5814	PROCEDURE NOT COVERED WITH SPECIFIC CODES.
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5524	POSTPARTUM SERVICES MAY NOT BE BILLED WITH GLOBAL OB ON OR WITHIN 62 DAYS OF DE LIVERY
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5525	POSTPARTUM SERVICES MAY NOT BE BILLED WITH GLOBAL OB ON OR WITHIN 62 DAYS OF DE LIVERY
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5820	LTC VENT CANNOT BE BILLED WITHOUT LTC STAY
107	Processed according to contract/plan provisions.	107	The related or qualifying claim/service was not identified on this claim.	M47	Missing/incomplete/invalid internal or document control number.	0677	ADJ - ORIGINAL ICN NOT FOUND
107	Processed according to contract/plan provisions.	107	The related or qualifying claim/service was not identified on this claim.	M47	Missing/incomplete/invalid internal or document control number.	0678	ADJ - ORIGINAL ICN NOT SUBMITTED
107	Processed according to contract/plan provisions.	107	The related or qualifying claim/service was not identified on this claim.	M47	Missing/incomplete/invalid internal or document control number.	0681	ADJ - ORIGINAL ICN NOT FOUND
107	Processed according to contract/plan provisions.	107	The related or qualifying claim/service was not identified on this claim.	N59	Please refer to your provider manual for additional program and provider information.	5350	NO EXTRACTION CODE IN HISTORY IN 180 TIME FRAME.
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N362	THE NUMBER OF DAYS OR UNITS OF SERVICE EXCEEDS OUR ACCEPTABLE MAXIMUM.	3315	NURSERY DAYS EXCEED LIMIT
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N43	Bed hold or leave days exceeded.	6690	REVENUE CODE 183 IS LIMITED TO 6 DAYS EACH CALENDAR QUARTER.
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N43	Bed hold or leave days exceeded.	6691	REVENUE CODE 184 IS LIMITED TO 14 DAYS PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	5410	MORE THAN ONE CONTACT LENS FITTING CANNOT BE BILLED FOR THE SAME DATE OF SERVIC E.
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	5411	MORE THAN ONE CONTACT LENS FITTING CANNOT BE BILLED FOR THE SAME DATE OF SERVIC E.
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6128	DME PROCEDURE LIMITED TO 1 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6129	DME PROCEDURE LIMITED TO 4 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6130	DME PROCEDURE LIMITED TO 5 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6131	DME PROCEDURE LIMITED TO 10 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6132	DME PROCEDURE LIMITED TO 12 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6133	DME PROCEDURE LIMITED TO 50 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6134	DME PROCEDURE LIMITED TO 90 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6135	DME PROCEDURE LIMITED TO 100 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6136	DME PROCEDURE LIMITED TO 500 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6137	DME PROCEDURE LIMITED TO 1000 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6138	DME PROCEDURE LIMITED TO 1 PER 2 CALENDAR YEARS
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6139	DME PROCEDURE LIMITED TO 4 PER CALENDAR YEAR
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6140	DME PROCEDURE RENTAL LIMITED TO 1 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6141	DME PROCEDURE RENTAL LIMITED TO 2 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6142	DME PROCEDURE RENTAL LIMITED TO 31 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6143	DME BATTERY CHARGER TOTAL LIMIT OF 1 PER CALENDAR YEAR
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6144	DME BATTERY TOTAL LIMIT OF 2 PER CALENDAR YEAR
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6181	THE ALLOWED LENS LIMITATION HAS BEEN EXCEEDED
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6182	THE ALLOWED FRAMES LIMITATION HAS BEEN EXCEEDED
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6185	EYE LENS LIMIT LESS THAN 21
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6186	EYE FRAME LIMIT LESS THAN 21
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6187	EYE EXAM LIMIT LESS THAN 21
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6188	EYE FITTING LIMIT LESS THAN 21
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6189	EYE EXAM LIMIT 1 PER 3 YR (21 AND OLDER)
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6190	EYE REFRACTION LIMIT 1 PER 3 YR (21 AND OLDER)
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6191	EYE REFRACTION LIMIT LESS THAN 21
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6292	LAB DRUG SCREENING LIMIT OF 1 PER DAY
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6301	MORE THAN ONE OBSTETRICAL DELIVERY CODE MAY NOT BE BILLED W ITHIN SIX MONTHS
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6401	OB ULTRASOUND LIMIT HAS BEEN REACHED FOR THIS RECIPIENT. ANY FURTHER WILL REQUI RE PRIOR AUTHORIZATION.
107	Processed according to contract/plan provisions.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N61	Rebill services on separate claims.	0590	MEPD CLAIM SPANS FISCAL YEAR END
107	Processed according to contract/plan provisions.	129	Payment denied - Prior processing information appears incorrect.	N61	Rebill services on separate claims.	0596	FILE SEPARATE CLAIMS FOR DIFFERENT YEARS
107	Processed according to contract/plan provisions.	226	Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete.	N307	MISSING/INCOMPLETE/INVALID ADJUDICATION OR PAYMENT DATE.	0243	MISSING MEDICARE PAID DATE
107	Processed according to contract/plan provisions.	A1	Claim/Service denied.	N59	Please refer to your provider manual for additional program and provider information.	9990	CLAIM DENIED.  CORRECT AND RESUBMIT.
107	Processed according to contract/plan provisions.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5644	HOSPITAL VISITS AND SUBSEQUENT CRITICAL CARE MAY NOT BE BILLED ON THE SAME DAY
107	Processed according to contract/plan provisions.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5645	HOSPITAL VISITS AND SUBSEQUENT CRITICAL CARE MAY NOT BE BILLED ON THE SAME DAY
107	Processed according to contract/plan provisions.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5740	INDIVIDUAL THERAPY AND GROUP THERAPY MAY NOT BE BILLED ON THE SAME DAY.
107	Processed according to contract/plan provisions.	B15	This service/procedure requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5324	WHEN PROPHYLAXIS AND FLUORIDE ARE PERFORMED ON THE SAME DAY,THE COMBINED CODE M UST BE BILLED.
107	Processed according to contract/plan provisions.	B15	This service/procedure requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5325	WHEN PROPHYLAXIS AND FLUORIDE ARE PERFORMED ON THE SAME DAY,THE COMBINED CODE M UST BE BILLED.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	M115	This item is denied when provided to this patient by a non-demonstration supplier.	1827	NON-MEPD CLAIM FOR MEPD RECIPIENT
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	5816	HIV CODES MUST BE BILLED IN CONJUNCTION WITH FAMILY PLANNING CODES.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5200	ADMINISTRATION FEE MAY NOT BE BILLED ON THE SAME DAY AS AN OFFICE VISIT AND/OR  VACCINE REPLACEMENT
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5201	ADMINISTRATION FEE MAY NOT BE BILLED ON THE SAME DAY AS AN OFFICE VISIT AND/OR  VACCINE REPLACEMENT
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5400	PROCEDURE CANNOT BE BILLED ON THE SAME DAY BY THE PROVIDER
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5401	PROCEDURE CANNOT BE BILLED ON THE SAME DAY BY THE PROVIDER
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5402	SCREENING PROVIDER MAY NOT BILL FOR SCREENING EXAM AND INCLUSIVE MEDICAL SERVIC ES ON THE SAME DAY
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5403	SCREENING PROVIDER MAY NOT BILL FOR SCREENING EXAM AND INCLUSIVE MEDICAL SERVIC ES ON THE SAME DAY
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5412	PROCEDURE CODE V2020 AND V2025 CANNOT BE BILLED ON THE SAME DAY OF SERVICE.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5413	PROCEDURE CODE V2020 AND V2025 CANNOT BE BILLED ON THE SAME DAY OF SERVICE.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5414	EPSDT VISION SCREEN AND EXTERNAL OCULAR PHOTOGRAPHY NOT COVERED ON THE SAME DAY
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5415	EPSDT VISION SCREEN AND EXTERNAL OCULAR PHOTOGRAPHY NOT COVERED ON THE SAME DAY
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5438	COMPREHENSIVE EPSDT SCREENING AND FP VISIT MAY NOT BE BILLED ON THE SAME DAY.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5439	COMPREHENSIVE EPSDT SCREENING AND FP VISIT MAY NOT BE BILLEDON THE SAME DAY.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5710	SERVICE CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5711	SERVICE CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5712	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5713	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5714	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5715	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5716	SERVICES CANNOT BE BILLED ON THE SAME DAY FOR THE SAME RECIPIENT.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5717	SERVICES CANNOT BE BILLED ON THE SAME DAY FOR THE SAME RECIPIENT.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5718	SERVICES CANNOT BE BILLED ON THE SAME DAY FOR THE SAME RECIPENT
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5719	SERVICES CANNOT BE BILLED ON THE SAME DAY FOR THE SAME RECIPENT
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5720	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5721	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5722	SERVICES CANNOT BE BILLED ON THE SAME DAY FOR THE SAME RECIPIENT.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5723	SERVICES CANNOT BE BILLED ON THE SAME DAY FOR THE SAME RECIPIENT.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5724	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5725	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5726	THIS SERVICE IS NOT ALLOWED ON THE SAME DAY AS DAY TREATMENT
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5727	THIS SERVICE IS NOT ALLOWED ON THE SAME DAY AS DAY TREATMENT
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5728	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5729	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5732	THE SAME PROVIDER MAY NOT BILL HOSPITAL VISITS/PSYCHOTHERAPY ON THE SAME DAY
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5733	THE SAME PROVIDER MAY NOT BILL HOSPITAL VISITS/PSYCHOTHERAPY ON THE SAME DAY
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5734	THE SAME PROVIDER MAY NOT BILL PSYCHOTHERAPY/OFFICE VISITS ON THE SAME DAY
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5735	THE SAME PROVIDER MAY NOT BILL PSYCHOTHERAPY/OFFICE VISITS ON THE SAME DAY
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5736	SERVICES CANNOT BE BILLED ON THE SAME DAY BY THE SAME PROVIDER
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5738	SERVICES CANNOT BE BILLED ON THE SAME DAY FOR THE SAME RECIPIENT
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N390	This service/report cannot be billed separately.	5661	SUBSEQUENT CRITICAL CARE NOT  VALID WITHOUT INITAL CARE.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N390	This service/report cannot be billed separately.	5816	HIV CODES MUST BE BILLED IN CONJUNCTION WITH FAMILY PLANNING CODES.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N390	This service/report cannot be billed separately.	5818	THERAPY CODE PAYABLE ONLY WITH THERAPEUTIC TREATMENT.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N390	This service/report cannot be billed separately.	5819	OBSERVATION MUST BE BILLED IN CONJUNCTION WITH FACILITY FEE.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5440	FAMILY PLANNING VISIT NOT PAYABLE AFTER STERILIZATION
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5441	FAMILY PLANNING VISIT NOT PAYABLE AFTER STERILIZATION
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5818	THERAPY CODE PAYABLE ONLY WITH THERAPEUTIC TREATMENT.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5819	OBSERVATION MUST BE BILLED IN CONJUNCTION WITH FACILITY FEE.
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	6303	MORE THAN ONE OBSTETRICAL DELIVERY CODE MAY NOT BE BILLED WITHIN SIX MONTHS.
107	Processed according to contract/plan provisions.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4160	BPA-PC-NDC - CURR PROV CONTRACT RESTRICTION
107	Processed according to contract/plan provisions.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	M50	Missing/incomplete/invalid revenue code(s).	4162	BPA-PC-REV - CURR PROV CONTRACT RESTRICTION
107	Processed according to contract/plan provisions.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	M50	Missing/incomplete/invalid revenue code(s).	4529	BPA-RP-REV -  PROV COUNTY RESTRICTION
107	Processed according to contract/plan provisions.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4159	BPA-PC-ICD9 - CURR PROV CONTRACT RESTRICTION
107	Processed according to contract/plan provisions.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4161	BPA-PC-PROC - CURR PROV CONTRACT RESTRICTION
107	Processed according to contract/plan provisions.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	M76	Missing/incomplete/invalid diagnosis or condition.	4157	BPA-PC-DIAG - CURR PROV CONTRACT RESTRICTION
109	Entity not eligible.	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.	M78	Missing/incomplete/invalid HCPCS modifier.	1817	MATERNITY CARE PROV CAN ONLY BILL MATERNITY SVCS
109	Entity not eligible.	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.	N95	This provider type/provider specialty may not bill this service.	1817	MATERNITY CARE PROV CAN ONLY BILL MATERNITY SVCS
109	Entity not eligible.	8	The procedure code is inconsistent with the provider  type/specialty (taxonomy).	M78	Missing/incomplete/invalid HCPCS modifier.	1817	MATERNITY CARE PROV CAN ONLY BILL MATERNITY SVCS
109	Entity not eligible.	8	The procedure code is inconsistent with the provider  type/specialty (taxonomy).	N95	This provider type/provider specialty may not bill this service.	1817	MATERNITY CARE PROV CAN ONLY BILL MATERNITY SVCS
109	Entity not eligible.	26	Expenses incurred prior to coverage.	N30	Recipient ineligible for this service.	2003	ITEMIZED SERVICE DATE NOT IN ELIGIBILITY SPAN
109	Entity not eligible.	30	Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	2001	RECIPIENT IS NOT ON ELIGIBILITY FILE
109	Entity not eligible.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N219	PAYMENT BASED ON PREVIOUS PAYER'S ALLOWED AMOUNT.	0825	MEDICARE ALLOWED AMOUNT MISSING OR INVALID
109	Entity not eligible.	141	Claim adjustment because the claim spans eligible and ineligible periods of coverage.	N30	Recipient ineligible for this service.	2003	ITEMIZED SERVICE DATE NOT IN ELIGIBILITY SPAN
109	Entity not eligible.	141	Claim adjustment because the claim spans eligible and ineligible periods of coverage.	N61	Rebill services on separate claims.	2077	RECIPIENT IS NOT ELIGIBLE ALL DATES OF SERVICES
109	Entity not eligible.	141	Claim adjustment because the claim spans eligible and ineligible periods of coverage.	N61	Rebill services on separate claims.	2804	DETAILS COVERED BY MORE THAN ONE PLAN CODE
117	Claim requires signature-on-file indicator.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA75	Missing/incomplete/invalid patient or authorized representative signature.	0228	CLAIMANT SIGNATURE MISSING
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	0913	GROUP NUMBER NOT FOUND IN REVENUE GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	0925	GROUP NUMBER NOT FOUND IN REFERENCE GROUP TABLE.
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0906	GROUP NUMBER NOT FOUND IN ICD-9 GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0917	GROUP NUMBER NOT FOUND IN PROCEDURE GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	0259	DATE BILLED IS INVALID
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	0909	GROUP NUMBER NOT FOUND IN DIAGNOSIS GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M77	Missing/incomplete/invalid place of service.	0250	CLAIM HAS NO DETAILS
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M77	Missing/incomplete/invalid place of service.	0903	GROUP NUMBER NOT FOUND IN PLACE OF SERVICE GROUP T
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA112	Missing/incomplete/invalid group practice information.	0915	GROUP NUMBER NOT FOUND IN COUNTY GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA112	Missing/incomplete/invalid group practice information.	0916	GROUP NOT FOUND IN PROVIDER GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA112	Missing/incomplete/invalid group practice information.	0921	GROUP NUMBER NOT FOUND IN PROVIDER LIST TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA30	Missing/incomplete/invalid type of bill.	0914	GROUP NUMBER NOT FOUND IN TYPE OF BILL GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA31	Missing/incomplete/invalid beginning and ending dates of the period billed.	0259	DATE BILLED IS INVALID
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N188	The approved level of care does not match the procedure code submitted.	0905	GROUP NUMBER NOT FOUND IN LEVEL OF CARE GROUP TABL
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N216	PATIENT IS NOT ENROLLED IN THIS PORTION OF OUR BENEFIT PACKAGE.	0919	GROUP NUMBER NOT FOUND IN AID CODE TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N55	Procedures for billing with group/referring/performing providers were not followed.	0902	PROCEDURE CODE GROUP NOT FOUND
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N75	Missing/incomplete/invalid tooth surface information.	0918	TOOTH SURFACE NUMBER NOT FOUND IN TOOTH SURFACE GR
122	Missing/invalid data prevents payer from processing claim.	63	Correction to a prior claim.	M47	Missing/incomplete/invalid internal or document control number.	0924	SYSTEM ERROR - ADJ - ORIGINAL CLAIM NOT FOUND
122	Missing/invalid data prevents payer from processing claim.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	MA112	Missing/incomplete/invalid group practice information.	0915	GROUP NUMBER NOT FOUND IN COUNTY GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	MA112	Missing/incomplete/invalid group practice information.	0916	GROUP NOT FOUND IN PROVIDER GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	MA112	Missing/incomplete/invalid group practice information.	0921	GROUP NUMBER NOT FOUND IN PROVIDER LIST TABLE
125	Entity's name.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M57	Missing/incomplete/invalid provider identifier.	1065	PROVIDER NAME MISMATCH
125	Entity's name.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N279	MISSING/INCOMPLETE/INVALID PAY-TO PROVIDER NAME.	1065	PROVIDER NAME MISMATCH
125	Entity's name.	140	Patient/Insured health identification number and name do not match.	MA36	Missing/incomplete/invalid patient name.	0513	NAME ON CLAIM MUST MATCH NAME ON FILE
142	Entity's license/certification number.	5	The procedure code/bill type is inconsistent with the place of service.	MA120	Missing/incomplete/invalid CLIA certification number.	4212	BILLING OUT OF CLIA CERTIFICATE TYPE
142	Entity's license/certification number.	5	The procedure code/bill type is inconsistent with the place of service.	N39	Procedure code is not compatible with tooth number/letter.	4212	BILLING OUT OF CLIA CERTIFICATE TYPE
142	Entity's license/certification number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0226	ANESTHESIA CLAIMS REQUIRE REFERRING PROVIDER
142	Entity's license/certification number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N286	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER PRIMARY IDENTIFIER.	0226	ANESTHESIA CLAIMS REQUIRE REFERRING PROVIDER
142	Entity's license/certification number.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.	N262	MISSING/INCOMPLETE/INVALID OPERATING PROVIDER PRIMARY IDENTIFIER.	1021	FIRST OTHER (OPERATING) PROVIDER ID NOT ON FILE
142	Entity's license/certification number.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.	N286	MISSING/INCOMPLETE/INVALID REFERRING PROVIDER PRIMARY IDENTIFIER.	1022	OTHER-2 (REFERRING) PROVIDER ID NOT ON FILE - HDR
142	Entity's license/certification number.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	1020	ATTENDING PHYSICIAN ID NOT ON FILE
142	Entity's license/certification number.	100	PAYMENT MADE TO PATIENT/INSURED/RESPONSIBLE PARTY/EMPLOYER.	MA120	Missing/incomplete/invalid CLIA certification number.	4207	CLIA NUMBER NOT ON FILE FOR DATES OF SERVICE
142	Entity's license/certification number.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	MA120	Missing/incomplete/invalid CLIA certification number.	4207	CLIA NUMBER NOT ON FILE FOR DATES OF SERVICE
142	Entity's license/certification number.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	MA120	Missing/incomplete/invalid CLIA certification number.	4212	BILLING OUT OF CLIA CERTIFICATE TYPE
142	Entity's license/certification number.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	N39	Procedure code is not compatible with tooth number/letter.	4212	BILLING OUT OF CLIA CERTIFICATE TYPE
143	Entity's state license number.	2	Coinsurance Amount	MA34	Missing/incomplete/invalid number of coinsurance days during the billing period.	0816	COINSURANCE DAYS NOT NUMERIC
143	Entity's state license number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0802	MISSING OR INVALID PRESCRIBER ID QUALIFIER
143	Entity's state license number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA42	Missing/incomplete/invalid admission source.	0230	MISSING ATTENDING SURGEON PRESCRIBER NUMBER
143	Entity's state license number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N262	MISSING/INCOMPLETE/INVALID OPERATING PROVIDER PRIMARY IDENTIFIER.	0230	MISSING ATTENDING SURGEON PRESCRIBER NUMBER
143	Entity's state license number.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.	N31	MISSING/INCOMPLETE/INVALID PRESCRIBING PROVIDER IDENTIFIER.	0804	BILLING PROVIDER CANNOT BE PRESCRIBER
145	Entity's specialty code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1900	TAXONOMY IS INVALID BILLING PROVIDER
145	Entity's specialty code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1906	TAXONOMY IS NOT VALID FOR BILLING PROVIDER
145	Entity's specialty code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1912	TAXONOMY IS MISSING: BILLING PROVIDER
145	Entity's specialty code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1901	TAXONOMY IS INVALID PREFORMING PROVIDER
145	Entity's specialty code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1907	TAXONOMY IS NOT VALID FOR PERFORMING PROVIDER
145	Entity's specialty code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1913	TAXONOMY IS MISSING:  PERFORMING PROVIDER
145	Entity's specialty code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1919	TAXONOMY IS INVALID: DTL PERFORMING PROVIDER
145	Entity's specialty code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1921	TAXONOMY IS MISSING: DTL PERFORMING PROVIDER
145	Entity's specialty code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1925	TAXONOMY IS NOT VALID FOR DTL PERFORMING PROV
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1900	TAXONOMY IS INVALID BILLING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1906	TAXONOMY IS NOT VALID FOR BILLING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1912	TAXONOMY IS MISSING: BILLING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1901	TAXONOMY IS INVALID PREFORMING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1907	TAXONOMY IS NOT VALID FOR PERFORMING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1913	TAXONOMY IS MISSING:  PERFORMING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1919	TAXONOMY IS INVALID: DTL PERFORMING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1921	TAXONOMY IS MISSING: DTL PERFORMING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1925	TAXONOMY IS NOT VALID FOR DTL PERFORMING PROV
145	Entity's specialty code.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M57	Missing/incomplete/invalid provider identifier.	1805	BILLING PROVIDER SPECIALTY NOT FOUND FOR CLAIM DOS
145	Entity's specialty code.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N95	This provider type/provider specialty may not bill this service.	1805	BILLING PROVIDER SPECIALTY NOT FOUND FOR CLAIM DOS
145	Entity's specialty code.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N95	This provider type/provider specialty may not bill this service.	1810	PERFORMING PROVIDER SPECIALTY NOT FOUND FOR DOS
145	Entity's specialty code.	A2	Contractual adjustment.	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1900	TAXONOMY IS INVALID BILLING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1906	TAXONOMY IS NOT VALID FOR BILLING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.	N255	MISSING/INCOMPLETE/INVALID BILLING PROVIDER TAXONOMY.	1912	TAXONOMY IS MISSING: BILLING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1901	TAXONOMY IS INVALID PREFORMING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1907	TAXONOMY IS NOT VALID FOR PERFORMING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1913	TAXONOMY IS MISSING:  PERFORMING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1919	TAXONOMY IS INVALID: DTL PERFORMING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1921	TAXONOMY IS MISSING: DTL PERFORMING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	1925	TAXONOMY IS NOT VALID FOR DTL PERFORMING PROV
153	Entity's id number.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M78	Missing/incomplete/invalid HCPCS modifier.	7271	CURRENT PROCEDURE LINES MUST HAVE SAME PROVIDER ID
153	Entity's id number.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N55	Procedures for billing with group/referring/performing providers were not followed.	1803	BILLING PROVIDER MUST BE GROUP PROVIDER NUMBER
154	Relationship of surgeon & assistant surgeon.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N55	Procedures for billing with group/referring/performing providers were not followed.	1804	VERFIY PERFORMING PROVIDER NOT GROUP PROVIDER
158	Entity's date of birth	6	The procedure code is inconsistent with the patient's age.	MA38	Missing/incomplete/invalid birth date.	7266	AGE CANNOT BE GREATER THAN 124 YEARS
158	Entity's date of birth	14	The date of birth follows the date of service.	MA06	Missing/incomplete/invalid beginning and/or ending date(s).	7265	BIRTHDATE CANNOT BE A FUTURE DATE
164	Entity's contract/member number.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N219	PAYMENT BASED ON PREVIOUS PAYER'S ALLOWED AMOUNT.	0830	MEDICARE HDR ALLOW AMNT NOT EQUAL SUM OF DTL ALLOW
171	Other insurance coverage information (health, liability, auto, etc.).	23	Payment adjusted because charges have been paid by another payer.	MA92	MISSING PLAN INFORMATION FOR OTHER INSURANCE.	0576	CLAIM HAS THIRD-PARTY PAYMENT
178	Submitted charges.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N59	Please refer to your provider manual for additional program and provider information.	5234	ADDITIONAL PAIN CONTROL PROCEDURES PAID AT 50% OF MEDICAID ALLOWED.
178	Submitted charges.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N59	Please refer to your provider manual for additional program and provider information.	5235	ADDITIONAL PAIN CONTROL PROCEDURES PAID AT 50% OF MEDICAID ALLOWED.
178	Submitted charges.	59	Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.)	N59	Please refer to your provider manual for additional program and provider information.	5508	SECONDARY SURGICAL PROCEDURE WITHIN THE SAME INCISION PAID AT 50% OF MEDICAID A LLOWED
178	Submitted charges.	59	Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.)	N59	Please refer to your provider manual for additional program and provider information.	5509	SECONDARY SURGICAL PROCEDURE WITHIN THE SAME INCISION PAID AT 50% OF MEDICAID A LLOWED
178	Submitted charges.	59	Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.)	N59	Please refer to your provider manual for additional program and provider information.	5520	REGIONAL ANESTHESIA PAYMENT IS 50% OF LEVEL III PRICE
178	Submitted charges.	59	Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.)	N59	Please refer to your provider manual for additional program and provider information.	5521	REGIONAL ANESTHESIA PAYMENT IS 50% OF LEVEL III PRICE
178	Submitted charges.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5230	SUBSEQUENT PROCEDURE INCLUDED IN PRIMARY ANESTHESIA CHARGE
178	Submitted charges.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5231	SUBSEQUENT PROCEDURE INCLUDED IN PRIMARY ANESTHESIA CHARGE
178	Submitted charges.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M54	Missing/incomplete/invalid total charges.	4005	SUBMITTED TO ALLOWED EXCEEDS PERCENT
178	Submitted charges.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M54	Missing/incomplete/invalid total charges.	4006	ALLOWED TO SUBMITTED EXCEEDS PERCENT
178	Submitted charges.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M54	Missing/incomplete/invalid total charges.	4009	ALLOWED TO SUBMITTED EXCEEDS PERCENT
178	Submitted charges.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M54	Missing/incomplete/invalid total charges.	4084	SUBMITTED TO ALLOWED EXCEEDS PERCENT
178	Submitted charges.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5234	ADDITIONAL PAIN CONTROL PROCEDURES PAID AT 50% OF MEDICAID ALLOWED.
178	Submitted charges.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5235	ADDITIONAL PAIN CONTROL PROCEDURES PAID AT 50% OF MEDICAID ALLOWED.
178	Submitted charges.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5508	SECONDARY SURGICAL PROCEDURE WITHIN THE SAME INCISION PAID AT 50% OF MEDICAID A LLOWED
178	Submitted charges.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5509	SECONDARY SURGICAL PROCEDURE WITHIN THE SAME INCISION PAID AT 50% OF MEDICAID A LLOWED
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M52	Missing/incomplete/invalid from date(s) of service.	0264	DETAIL FROM DATE OF SERVICE IS MISSING
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M52	Missing/incomplete/invalid from date(s) of service.	0265	DETAIL FROM DATE OF SERVICE IS INVALID
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M52	Missing/incomplete/invalid from date(s) of service.	0395	HEADER STATEMENT COVERS PERIOD "FROM" DATE MISSING
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M52	Missing/incomplete/invalid from date(s) of service.	0396	HEADER STATEMENT COVERS PERIOD "FROM" DATE INVALID
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M52	Missing/incomplete/invalid from date(s) of service.	0527	DETAIL FROM DATE OF SERVICE IS AFTER ICN DATE
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0239	DETAIL TO DATE OF SERVICE IS MISSING
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M59	Missing/incomplete/invalid to date(s) of service.	0239	DETAIL TO DATE OF SERVICE IS MISSING
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M59	Missing/incomplete/invalid to date(s) of service.	0240	THE DETAIL "TO" DATE IS INVALID
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M59	Missing/incomplete/invalid to date(s) of service.	0514	DATE RECEIVED FOR PROCESSING-PRIOR TO DATE OF SERV
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA31	Missing/incomplete/invalid beginning and ending dates of the period billed.	0507	FIRST DATE OF SERV GREATER THAN LAST DATE OF SERV
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA36	Missing/incomplete/invalid patient name.	0514	DATE RECEIVED FOR PROCESSING-PRIOR TO DATE OF SERV
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N304	MISSING/INCOMPLETE/INVALID DISPENSED DATE.	0216	DATE DISPENSED IS INVALID
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N341	MISSING/INCOMPLETE/INVALID SURGERY DATE.	0575	SURGERY DTE CANNOT BE OUTSIDE HDR DATES OF SERVICE
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N37	Missing/incomplete/invalid tooth number/letter.	0264	DETAIL FROM DATE OF SERVICE IS MISSING
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N74	Resubmit with multiple claims, each claim covering services provided in only one calendar month.	0574	SERVICE DATES ARE NOT IN SAME MONTH
187	Date(s) of service.	78	Non-Covered days/Room charge adjustment.	MA32	Missing/incomplete/invalid number of covered days during the billing period.	0821	NON-COVERED DAYS MISSING OR NOT NUMERIC
187	Date(s) of service.	78	Non-Covered days/Room charge adjustment.	MA33	Missing/incomplete/invalid noncovered days during the billing period.	0821	NON-COVERED DAYS MISSING OR NOT NUMERIC
187	Date(s) of service.	110	BILLING DATE PREDATES SERVICE DATE.	M59	Missing/incomplete/invalid to date(s) of service.	0514	DATE RECEIVED FOR PROCESSING-PRIOR TO DATE OF SERV
187	Date(s) of service.	110	BILLING DATE PREDATES SERVICE DATE.	MA36	Missing/incomplete/invalid patient name.	0514	DATE RECEIVED FOR PROCESSING-PRIOR TO DATE OF SERV
187	Date(s) of service.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M59	Missing/incomplete/invalid to date(s) of service.	0537	HDR FROM DATE OF SERVICE > HDR TO DATE OF SERVICE
187	Date(s) of service.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	MA31	Missing/incomplete/invalid beginning and ending dates of the period billed.	0537	HDR FROM DATE OF SERVICE > HDR TO DATE OF SERVICE
187	Date(s) of service.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	MA32	Missing/incomplete/invalid number of covered days during the billing period.	0821	NON-COVERED DAYS MISSING OR NOT NUMERIC
187	Date(s) of service.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	MA33	Missing/incomplete/invalid noncovered days during the billing period.	0821	NON-COVERED DAYS MISSING OR NOT NUMERIC
187	Date(s) of service.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	MA40	Missing/incomplete/invalid admission date.	0812	ADMIT DATE IS GREATER THAN ICN DATE
187	Date(s) of service.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N262	MISSING/INCOMPLETE/INVALID OPERATING PROVIDER PRIMARY IDENTIFIER.	0815	SURGICAL ICD9 REQUIRES OPERATING PHYSICIAN
187	Date(s) of service.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N280	MISSING/INCOMPLETE/INVALID PAY-TO PROVIDER PRIMARY IDENTIFIER.	0201	INVALID PAY-TO PROVIDER NUMBER
187	Date(s) of service.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N31	MISSING/INCOMPLETE/INVALID PRESCRIBING PROVIDER IDENTIFIER.	0815	SURGICAL ICD9 REQUIRES OPERATING PHYSICIAN
187	Date(s) of service.	141	Claim adjustment because the claim spans eligible and ineligible periods of coverage.	N61	Rebill services on separate claims.	0803	DATED EXCEED SOBRA/QMB ELIGIBILITY
188	Statement from-through dates.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA32	Missing/incomplete/invalid number of covered days during the billing period.	0570	TOTAL DAYS LESS THAN COVERED DAYS
189	Hospital admission date.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N307	MISSING/INCOMPLETE/INVALID ADJUDICATION OR PAYMENT DATE.	0813	MEDICARE PAID DATE > ICN DATE
214	Original date of prescription/orders/referral.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N304	MISSING/INCOMPLETE/INVALID DISPENSED DATE.	0215	DATE DISPENSED IS MISSING
214	Original date of prescription/orders/referral.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N304	MISSING/INCOMPLETE/INVALID DISPENSED DATE.	0502	DATE DISPENSED EARLIER THAN DATE PRESCRIBED
214	Original date of prescription/orders/referral.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N304	MISSING/INCOMPLETE/INVALID DISPENSED DATE.	0502	DATE DISPENSED EARLIER THAN DATE PRESCRIBED
214	Original date of prescription/orders/referral.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N57	MISSING/INCOMPLETE/INVALID PRESCRIBING DATE.	0500	DATE PRESCRIBED AFTER BILLING DATE
214	Original date of prescription/orders/referral.	A2	Contractual adjustment.	N304	MISSING/INCOMPLETE/INVALID DISPENSED DATE.	0502	DATE DISPENSED EARLIER THAN DATE PRESCRIBED
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	0217	MISSING DRUG CODE
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	0218	INVALID DRUG CODE
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	3316	PHARMACY ONLY - NDC IS NOT PAYABLE BY ALABAMA MEDICAID
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4260	NDC REQUIRED FOR PROCEDURE
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4264	NDC NOT ON THE DRUG FILE
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4265	INVALID HCPCS/NDC COMBINATION FOR PRIMARY NDC
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4266	NDC NOT COVERED - PRIMARY NDC NOT ACTIVE ON DOS
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4267	NDC NOT COVERED - SECONDARY NDC NOT ACTIVE ON DOS
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4268	NDC NOT COVERED - NDC NOT REBATABLE ON DOS
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4269	NDC NOT COVERED - SECOND NDC NOT REBATABLE ON DOS
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4270	NDC NOT COVERED - NDC RATED LESS THAN EFFECTIVE
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4271	DUPLICATE NDC FOR CLAIM DETAIL
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4272	NDC NOT COVERED - OBSOLETE OR TERMINATED ON DOS
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4278	NDC NOT COVERED - NDC NOT EFFECTIVE ON THE DOS
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4279	NDC NOT COVERED - NDC INACTIVE ON THE DOS
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4280	NDC NOT COVERED - NDC IN REJECT REGARDLESS ON DOS
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4281	NDC NOT COVERED - REPACKAGED NDC
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M62	Missing/incomplete/invalid treatment authorization code.	3313	NDC DRUG, PRODUCT IS NOT PREFERRED
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M97	Not paid to practitioner when provided to patient in this place of service.  Payment included in the reimbursement issued the facility.	3314	PHARMACY ONLY - OTC DRUG NOT COVERED FOR LTC RECIP
218	NDC number.	18	Duplicate claim/service.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4271	DUPLICATE NDC FOR CLAIM DETAIL
218	NDC number.	46	This (these) service(s) is (are) not covered.	N30	Recipient ineligible for this service.	4999	RECIPIENT IS PART D ELIGIBLE - CLAIM NOT COVERED.  IF A RECIPIENT HAS MEDICAREP ART A OR B, THE RECIPIENT IS ELIGIBLE FOR MEDICARE PART D DRUG COVERAGE AND MED ICAID WILL ONLY PAY FOR DRUGS SPECIFICALLY EXCLUDED FROM MEDICARE PART D.
218	NDC number.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.	M62	Missing/incomplete/invalid treatment authorization code.	3313	NDC DRUG, PRODUCT IS NOT PREFERRED
218	NDC number.	96	Non-covered charge(s).	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4004	NDC IS NOT ON FILE
218	NDC number.	96	Non-covered charge(s).	N30	Recipient ineligible for this service.	4999	RECIPIENT IS PART D ELIGIBLE - CLAIM NOT COVERED.  IF A RECIPIENT HAS MEDICAREP ART A OR B, THE RECIPIENT IS ELIGIBLE FOR MEDICARE PART D DRUG COVERAGE AND MED ICAID WILL ONLY PAY FOR DRUGS SPECIFICALLY EXCLUDED FROM MEDICARE PART D.
218	NDC number.	96	Non-covered charge(s).	N60	A valid NDC is required for payment of drug claims effective October 02.	4007	NDC IS DEACTIVED AND NOT PAYABLE ON DATE FILLED
218	NDC number.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	M97	Not paid to practitioner when provided to patient in this place of service.  Payment included in the reimbursement issued the facility.	3314	PHARMACY ONLY - OTC DRUG NOT COVERED FOR LTC RECIP
218	NDC number.	D2	Claim lacks the name, strength, or dosage of the drug furnished.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4260	NDC REQUIRED FOR PROCEDURE
218	NDC number.	D2	Claim lacks the name, strength, or dosage of the drug furnished.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4264	NDC NOT ON THE DRUG FILE
218	NDC number.	D2	Claim lacks the name, strength, or dosage of the drug furnished.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4265	INVALID HCPCS/NDC COMBINATION FOR PRIMARY NDC
218	NDC number.	D2	Claim lacks the name, strength, or dosage of the drug furnished.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4266	NDC NOT COVERED - PRIMARY NDC NOT ACTIVE ON DOS
218	NDC number.	D2	Claim lacks the name, strength, or dosage of the drug furnished.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4267	NDC NOT COVERED - SECONDARY NDC NOT ACTIVE ON DOS
218	NDC number.	D2	Claim lacks the name, strength, or dosage of the drug furnished.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4268	NDC NOT COVERED - NDC NOT REBATABLE ON DOS
218	NDC number.	D2	Claim lacks the name, strength, or dosage of the drug furnished.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4269	NDC NOT COVERED - SECOND NDC NOT REBATABLE ON DOS
218	NDC number.	D2	Claim lacks the name, strength, or dosage of the drug furnished.	M119	MISSING/INCOMPLETE/INVALID/DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC).	4270	NDC NOT COVERED - NDC RATED LESS THAN EFFECTIVE
219	Prescription number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0212	MISSING PRESCRIPTION NUMBER
219	Prescription number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N388	Missing/incomplete/invalid prescription number.	0212	MISSING PRESCRIPTION NUMBER
221	Drug days supply and dosage.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0220	QUANTITY DISPENSED IS INVALID
221	Drug days supply and dosage.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0221	MISSING DAYS SUPPLY
221	Drug days supply and dosage.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0222	ESTIMATED DAYS SUPPLY INVALID
221	Drug days supply and dosage.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N378	Missing/incomplete/invalid prescription quantity.	0219	QUANTITY DISPENSED IS MISSING
221	Drug days supply and dosage.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N378	Missing/incomplete/invalid prescription quantity.	0220	QUANTITY DISPENSED IS INVALID
221	Drug days supply and dosage.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N60	A valid NDC is required for payment of drug claims effective October 02.	0219	QUANTITY DISPENSED IS MISSING
221	Drug days supply and dosage.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0222	ESTIMATED DAYS SUPPLY INVALID
221	Drug days supply and dosage.	A2	Contractual adjustment.	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0222	ESTIMATED DAYS SUPPLY INVALID
228	Type of bill for UB-92 claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0274	TYPE OF BILL CODE INVALID
228	Type of bill for UB-92 claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA30	Missing/incomplete/invalid type of bill.	0273	TYPE OF BILL MISSING
228	Type of bill for UB-92 claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA30	Missing/incomplete/invalid type of bill.	0274	TYPE OF BILL CODE INVALID
228	Type of bill for UB-92 claim.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	1032	PROVIDER TYPE - CLAIM INPUT CONFLICT
228	Type of bill for UB-92 claim.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N34	INCORRECT CLAIM FORM/FORMAT FOR THIS SERVICE.	1032	PROVIDER TYPE - CLAIM INPUT CONFLICT
229	Hospital admission source.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA41	Missing/incomplete/invalid admission type.	0278	ADMIT TYPE MISSING
229	Hospital admission source.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA42	Missing/incomplete/invalid admission source.	0229	SOURCE OF ADMISSION MISSING
229	Hospital admission source.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA75	Missing/incomplete/invalid patient or authorized representative signature.	0229	SOURCE OF ADMISSION MISSING
229	Hospital admission source.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N46	Missing/incomplete/invalid admission hour.	0278	ADMIT TYPE MISSING
229	Hospital admission source.	129	Payment denied - Prior processing information appears incorrect.	MA41	Missing/incomplete/invalid admission type.	0278	ADMIT TYPE MISSING
229	Hospital admission source.	129	Payment denied - Prior processing information appears incorrect.	MA42	Missing/incomplete/invalid admission source.	0229	SOURCE OF ADMISSION MISSING
229	Hospital admission source.	129	Payment denied - Prior processing information appears incorrect.	MA75	Missing/incomplete/invalid patient or authorized representative signature.	0229	SOURCE OF ADMISSION MISSING
229	Hospital admission source.	129	Payment denied - Prior processing information appears incorrect.	N46	Missing/incomplete/invalid admission hour.	0278	ADMIT TYPE MISSING
230	Hospital admission hour.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0275	ADMIT DATE MISSING
230	Hospital admission hour.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA40	Missing/incomplete/invalid admission date.	0275	ADMIT DATE MISSING
230	Hospital admission hour.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA40	Missing/incomplete/invalid admission date.	0276	ADMIT DATE INVALID
230	Hospital admission hour.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA40	Missing/incomplete/invalid admission date.	0277	INVALID ADMISSION HOUR
230	Hospital admission hour.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N46	Missing/incomplete/invalid admission hour.	0277	INVALID ADMISSION HOUR
230	Hospital admission hour.	110	BILLING DATE PREDATES SERVICE DATE.	M52	Missing/incomplete/invalid from date(s) of service.	0519	ADMIT DATE GREATER THAN FIRST DATE OF SERVICE
230	Hospital admission hour.	110	BILLING DATE PREDATES SERVICE DATE.	MA40	Missing/incomplete/invalid admission date.	0519	ADMIT DATE GREATER THAN FIRST DATE OF SERVICE
231	Hospital admission type.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA41	Missing/incomplete/invalid admission type.	0279	INVALID TYPE OF ADMISSION
231	Hospital admission type.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA42	Missing/incomplete/invalid admission source.	0279	INVALID TYPE OF ADMISSION
234	Patient discharge status.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA41	Missing/incomplete/invalid admission type.	0280	PATIENT STATUS IS MISSING
234	Patient discharge status.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA43	Missing/incomplete/invalid patient status.	0280	PATIENT STATUS IS MISSING
234	Patient discharge status.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA43	Missing/incomplete/invalid patient status.	0281	PATIENT STATUS IS INVALID
234	Patient discharge status.	129	Payment denied - Prior processing information appears incorrect.	MA41	Missing/incomplete/invalid admission type.	0280	PATIENT STATUS IS MISSING
234	Patient discharge status.	129	Payment denied - Prior processing information appears incorrect.	MA43	Missing/incomplete/invalid patient status.	0280	PATIENT STATUS IS MISSING
234	Patient discharge status.	129	Payment denied - Prior processing information appears incorrect.	MA43	Missing/incomplete/invalid patient status.	0281	PATIENT STATUS IS INVALID
239	Dental information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M53	Missing/incomplete/invalid days or units of service.	0602	UNITS NOT EQUAL TO TEETH BILLED
239	Dental information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N61	Rebill services on separate claims.	0602	UNITS NOT EQUAL TO TEETH BILLED
242	Tooth numbers, surfaces, and/or quadrants involved.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M52	Missing/incomplete/invalid from date(s) of service.	0266	MISSING TOOTH SURFACE
242	Tooth numbers, surfaces, and/or quadrants involved.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M53	Missing/incomplete/invalid days or units of service.	0261	MISSING TOOTH NUMBER
242	Tooth numbers, surfaces, and/or quadrants involved.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N346	Missing/incomplete/invalid oral cavity designation code.	4120	ORAL CAVITY DESIGNATION CODE INVALID
242	Tooth numbers, surfaces, and/or quadrants involved.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N37	Missing/incomplete/invalid tooth number/letter.	0261	MISSING TOOTH NUMBER
242	Tooth numbers, surfaces, and/or quadrants involved.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N37	Missing/incomplete/invalid tooth number/letter.	0262	INVALID TOOTH NUMBER
242	Tooth numbers, surfaces, and/or quadrants involved.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N37	Missing/incomplete/invalid tooth number/letter.	0600	THE NUMBER OF QUADRANTS BILLED ON THE CLAIM IS NOT EQUAL TO THE NUMBER OF UNITS
242	Tooth numbers, surfaces, and/or quadrants involved.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N37	Missing/incomplete/invalid tooth number/letter.	0601	TOOTH NUMBERS CANNOT BE BILLED WITH A PROCEDURE THAT REQUIRES QUADRANTS.
242	Tooth numbers, surfaces, and/or quadrants involved.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N39	Procedure code is not compatible with tooth number/letter.	4120	ORAL CAVITY DESIGNATION CODE INVALID
242	Tooth numbers, surfaces, and/or quadrants involved.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N75	Missing/incomplete/invalid tooth surface information.	0263	INVALID TOOTH SURFACE
242	Tooth numbers, surfaces, and/or quadrants involved.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N75	Missing/incomplete/invalid tooth surface information.	0266	MISSING TOOTH SURFACE
244	Tooth number or letter.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N37	Missing/incomplete/invalid tooth number/letter.	4211	INVALID TOOTH NUMBER FOR THIS PROCEDURE
244	Tooth number or letter.	96	Non-covered charge(s).	N37	Missing/incomplete/invalid tooth number/letter.	4211	INVALID TOOTH NUMBER FOR THIS PROCEDURE
244	Tooth number or letter.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	5351	PULP CAP NOT ALLOWED FOR THIS TOOTH/DATE OF SERVICE.
245	Dental quadrant/arch.	11	The diagnosis is inconsistent with the procedure.	N346	Missing/incomplete/invalid oral cavity designation code.	0450	INVALID QUADRANT
245	Dental quadrant/arch.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N346	Missing/incomplete/invalid oral cavity designation code.	0450	INVALID QUADRANT
247	Line information.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	MA54	Physician certification or election consent for hospice care not received timely.	7280	CLAIM LEVEL PROVIDER OR PROCEDURE LINE PROVIDER IS REQUIRED
248	Accident date, state, description and cause.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N305	MISSING/INCOMPLETE/INVALID ACCIDENT DATE.	0569	DATE OF ACCIDENT IS GREATER THAN LAST DATE OF SERV
249	Place of service.	5	The procedure code/bill type is inconsistent with the place of service.	M77	Missing/incomplete/invalid place of service.	1819	INVALID POS FOR FQHC PROVIDER
249	Place of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M77	Missing/incomplete/invalid place of service.	0248	PLACE OF SERVICE IS MISSING OR BLANK
249	Place of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M77	Missing/incomplete/invalid place of service.	0249	PLACE OF SERVICE IS INVALID
249	Place of service.	129	Payment denied - Prior processing information appears incorrect.	M77	Missing/incomplete/invalid place of service.	0248	PLACE OF SERVICE IS MISSING OR BLANK
249	Place of service.	129	Payment denied - Prior processing information appears incorrect.	M77	Missing/incomplete/invalid place of service.	0249	PLACE OF SERVICE IS INVALID
255	Diagnosis code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4226	DIAGNOSIS MUST BE BILLED AT THE HIGHEST SUBDIVISION
255	Diagnosis code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	0258	MISSING DIAGNOSIS CODE
255	Diagnosis code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M78	Missing/incomplete/invalid HCPCS modifier.	0258	MISSING DIAGNOSIS CODE
255	Diagnosis code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M81	YOU ARE REQUIRED TO CODE TO THE HIGHEST LEVEL OF SPECIFICITY.	4226	DIAGNOSIS MUST BE BILLED AT THE HIGHEST SUBDIVISION
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0246	FOURTH DIAGNOSIS CODE INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M50	Missing/incomplete/invalid revenue code(s).	4060	EMERGENCY DIAGNOSIS CODE NOT ON FILE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M54	Missing/incomplete/invalid total charges.	0272	PRIMARY DIAGNOSIS CODE INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M57	Missing/incomplete/invalid provider identifier.	7272	DIAGNOSIS 1 MUST BE A VALID CODE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M59	Missing/incomplete/invalid to date(s) of service.	0242	SECONDARY DIAGNOSIS CODE INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M64	Missing/incomplete/invalid other diagnosis.	4041	SECONDARY DIAGNOSIS CODE NOT ON FILE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M64	Missing/incomplete/invalid other diagnosis.	4042	THIRD DIAGNOSIS CODE NOT ON FILE OR INACTIVE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M64	Missing/incomplete/invalid other diagnosis.	4043	FOURTH DIAGNOSIS CODE NOT ON FILE OR INACTIVE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M64	Missing/incomplete/invalid other diagnosis.	4047	FIFTH DIAGNOSIS CODE NOT ON FILE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M64	Missing/incomplete/invalid other diagnosis.	4048	SIXTH DIAGNOSIS CODE NOT ON FILE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M64	Missing/incomplete/invalid other diagnosis.	4049	SEVENTH DIAGNOSIS CODE NOT ON FILE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M64	Missing/incomplete/invalid other diagnosis.	4050	EIGHTH DIAGNOSIS CODE NOT ON FILE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M64	Missing/incomplete/invalid other diagnosis.	4051	NINTH DIAGNOSIS CODE NOT ON FILE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	M64	Missing/incomplete/invalid other diagnosis.	4052	ADMITTING DIAGNOSIS CODE NOT ON FILE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.	MA63	Missing/incomplete/invalid principal diagnosis.	4040	PRIMARY DIAGNOSIS CODE NOT ON FILE
255	Diagnosis code.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	6302	MORE THAN THREE OFFICE VISITS MAY NOT BE BILLED WITH PREGNANCY DIAGNOSIS.
259	Frequency of service.	18	Duplicate claim/service.	N20	Service not payable with other service rendered on the same date.	5800	RESIDENTIAL SERVICES AND RESPITE ,PERSONAL CARE/COMPANION CARE NOT ALLOWED FOR  THE SAME DOS.
259	Frequency of service.	18	Duplicate claim/service.	N20	Service not payable with other service rendered on the same date.	5801	RESIDENTIAL SERVICES AND RESPITE ,PERSONAL CARE/COMPANION CARE NOT ALLOWED FOR  THE SAME DOS.
259	Frequency of service.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0436	TOTAL MEDICARE ALLOWED AMOUNT INVALID
259	Frequency of service.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.	N219	PAYMENT BASED ON PREVIOUS PAYER'S ALLOWED AMOUNT.	0436	TOTAL MEDICARE ALLOWED AMOUNT INVALID
259	Frequency of service.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.	N45	Payment based on authorized amount.	9400	THE NUMBER OF SERVICES EXCEED MEDICAL POLICY GUIDELINES.  PRIOR AUTHORIZATION R EQUIRED FOR ADDITIONAL SERVICES.
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N19	Procedure code incidental to primary procedure.	5604	PROCEDURE IS INCLUSIVE IN PRIMARY PROCEDURE.
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N19	Procedure code incidental to primary procedure.	5605	PROCEDURE IS INCLUSIVE IN PRIMARY PROCEDURE.
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5240	THIS PROCEDURE IS PART OF ANOTHER PROCEDURE PERFORMED ON THE SAME DAY.
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5241	THIS PROCEDURE IS PART OF ANOTHER PROCEDURE PERFORMED ON THE SAME DAY.
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5470	THIS PROCEDURE IS PART OF ANOTHER PROCEDURE PERFORMED ON THE SAME DAY
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5471	THIS PROCEDURE IS PART OF ANOTHER PROCEDURE PERFORMED ON THE SAME DAY
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5514	THIS PROCEDURE CANNOT BE BILLED IN ADDITION TO THE DELIVERY CODE BILLED
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5515	THIS PROCEDURE CANNOT BE BILLED IN ADDITION TO THE DELIVERY CODE BILLED
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5518	LOCAL ANESTHESIA PROCEDURES ARE COVERED IN THE TOTAL OB COST AND MAY NOT BE BIL LED SEPARATELY WITH A DELIVERY PROCEDURE CODE
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5519	LOCAL ANESTHESIA PROCEDURES ARE COVERED IN THE TOTAL OB COST AND MAY NOT BE BIL LED SEPARATELY WITH A DELIVERY PROCEDURE CODE
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5656	THIS PROCEDURE IS PART OF ANOTHER PROCEDURE PERFORMED ON THE SAME DAY
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5336	DENTAL RECEMENT OF CROWNS NOT ALLOWED WITHIN 180 DAYS OF CROWN.
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5462	THIS SERVICE IS INCLUDED IN THE FACILITY FEE (REVENUE CODE 450).
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N117	THIS SERVICE IS PAID ONLY ONCE IN A LIFETIME.	6045	DENTAL SERVICE LIMITED TO ONCE PER TOOTH/PER LIFETIME.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N117	THIS SERVICE IS PAID ONLY ONCE IN A LIFETIME.	6053	COMPREHENSIVE DENTAL EXAM MAY ONLY BE BILLED ONCE PER LIFETIME PER PROVIDER.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N20	Service not payable with other service rendered on the same date.	5511	PROCEDURE CODE IS LIMITED TO ONE PER RECIPIENT WITHIN 60 DAYS OF DELIVERY.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N20	Service not payable with other service rendered on the same date.	5790	PHYSICAL THERAPY ELECTRIC STIMULATION CONTRA
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N20	Service not payable with other service rendered on the same date.	5792	PHYSICAL THERAPY APPLIANCES CONTRA
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N20	Service not payable with other service rendered on the same date.	6643	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	5236	QUALIFYING PROCEDURE LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	5336	DENTAL RECEMENT OF CROWNS NOT ALLOWED WITHIN 180 DAYS OF CROWN.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	5510	PROCEDURE CODE IS LIMITED TO ONE PER RECIPIENT WITHIN SIXTY DAYS OF DELIVERY
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	5511	PROCEDURE CODE IS LIMITED TO ONE PER RECIPIENT WITHIN 60 DAYS OF DELIVERY.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6001	THIS AMBULANCE SERVICE PROCEDURE CODE IS LIMITED TO FOUR UNITS PER CALENDAR MON TH.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6010	INPATIENT/OUTPATIENT/ASC VISITS HAVE BEEN EXCEEDED FOR THE CALENDAR YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6020	HEARING AID REPAIR IS LIMITED TO TWO EVERY SIX MONTHS.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6021	MONAURAL HEARING AID BATTERIES ARE LIMITED TO ONE PACKAGE EVERY TWO MONTHS.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6022	MONAURAL EARMOLDS ARE LIMITED TO ONE EVERY FOUR MONTHS.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6023	HEARING AID REPAIR IS LIMITED TO ONCE EVERY SIX MONTHS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6024	THE PURCHASE OF A HEARING AID STETHOSCOPE IS LIMITED TO ONE EVERY TWO YEARS.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6025	EARMOLDS ARE LIMITED TO TWO EVERY FOUR MONTHS.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6026	BINAURAL HEARING AID BATTERIES ARE LIMITED TO TWO PACKAGES EVERY TWO MONTHS.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6041	THE CALENDAR YEAR LIMIT HAS BEEN EXCEEDED FOR THIS PROCEDURE
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6042	PROCEDURE LIMITED TO ONCE EVERY 30 DAYS.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6043	THE CALENDAR YEAR LIMIT HAS BEEN EXCEEDED FOR THIS PROCEDURE
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6044	EMERGENCY ORAL EXAM (D0140) LIMITED TO ONCE PER CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6046	PROCEDURE CODE LIMITED TO ONCE EVERY SIX MONTHS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6047	PROPHYLAXIS IS LIMITED TO ONCE EVERY 6 MONTHS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6048	FLUORIDE IS LIMITED TO ONCE EVERY 6  MONTHS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6049	PROCEDURE LIMITED TO TWO PER LIFETIME PER TOOTH.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6050	PROCEDURE CODE IS LIMITED TO ONE OCCURANCE EVERY SIX MONTHS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6051	FULL SERIES/PANORAMIC X-RAYS ARE LIMITED TO ONE EVERY THREE CALENDAR YEARS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6100	DME PROCEDURE LIMITED TO 60 PER CALENDAR MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6101	DME PROCEDURE LIMIT TO 20 PER CALENDAR MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6102	DME PROCEDURE LIMITED TO 1 PER 5 CALENDAR YEARS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6103	PROCEDURE IS LIMITED TO THIRTY (30) PER MONTH.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6104	DME PROCEDURE LIMITED TO 700 PER CALENDAR MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6105	DME CLOSED POUCH TOTAL LIMIT OF 60 PER CAL MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6106	PROCEDURE IS LIMITED TO 30 (THIRTY) PER MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6107	DME PROCEDURE LIMITED TO 40 PER CALENDAR MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6108	DME WC PRESSURE PAD TOTAL LIMIT OF 1 PER CAL YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6109	PROCEDURE CODE IS LIMTED TO 100 PER MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6110	THE LIMIT OF TWO UNITS PER MONTH HAS BEEN EXCEEDED FOR THIS PROCEDURE
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6111	THE LIMIT OF THREE UNITS PER MONTH HAS BEEN EXCEEDED FOR THIS PROCEDURE.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6112	THE LIMIT OF TWO UNITS PER MONTH HAS BEEN EXCEEDED FOR THIS PROCEDURE.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6113	DME CODES LIMITED TO THIRTY-ONE UNITS PER MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6114	DME PROCEDURE LIMITED TO 2 PER CALENDAR YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6115	MEDICAL SUPPLIES LIMIT IS $1,800.00 PER WAIVER YEAR, 02/22-02/21.  THE LIMIT HA S BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6116	DME PROCEDURE LIMITED TO 1 PER 4 CALENDAR YEARS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6117	DME PROCEDURE LIMITED TO 3 PER CALENDAR MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6118	THE LIMIT OF TWO UNITS PER MONTH HAS BEEN EXCEEDED FOR THIS PROCEDURE
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6119	PROCEDURE IS LIMITED TO 1 (ONE) EVERY TWO YEARS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6120	THIS PROCEDURE CODE IS LIMITED TO ONE PER MONTH.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6121	DME PROCEDURE LIMITED TO 1 PER CALENDAR YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6122	LEG BAGS ARE LIMITED TO TWO PER MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6123	DME PROCEDURE LIMITED TO 8 PER CALENDAR YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6124	DME PROCEDURE LIMITED TO 1 PER 3 CALENDAR YEARS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6125	DME PROCEDURE LIMITED TO 2 PER CALENDAR MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6126	DME PROCEDURE LIMITED TO 120 PER CALENDAR MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6150	VISION AND HEARING SCREENING ONE PER YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6151	INITIAL SCREENING IS LIMITED TO ONCE PER LIFETIME
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6152	EPSDT SCREENING LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6153	EPSDT SCREENING LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6155	EPSDT SCREENING LIMIT HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6183	THE ALLOWED EYE EXAM LIMITATION HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6184	THE ALLOWED FITTING LIMITATION HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6201	FAMILY PLANNING PERIODIC FOLLOW-UP IS LIMITED TO FOUR (4) VISITS PER YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6202	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6205	THIS PROCEDURE CODE IS LIMITED TO ONE EVERY CALENDAR YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6206	PROCEDURE CODE 11795 IS LIMITED TO ONE EVERY 365 DAYS AND PROCEDURE CODE 11977  CANNOT BE BILLED WITHIN 60 MONTHS OF INSERTION
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6208	PROCEDURE IS LIMITED TO ONE SERVICE EVERY 70 DAYS.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6240	HBO LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6241	HBO LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6242	HBO LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6243	HBO LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6244	HBO LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6245	HBO LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6246	HBO LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6247	HBO LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6248	HBO LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6249	HBO LIMIT HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6280	THE LIMIT FOR THESE SERVICES HAS BEEN REACHED FOR THE CALENDAR YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6281	OUTPATIENT VISITS HAVE BEEN EXCEEDED FOR THIS CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6282	INPATIENT DAYS HAVE BEEN EXEEDED FOR THIS CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6293	LAB ?DRUG SCREENING LIMIT OF 1 EVERY 7 DAYS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6300	THIS PROCEDURE IS LIMITED TO 12 UNITS EVERY 24 MONTHS.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6350	DME GESTATIONAL INSULIN LIMIT 4 BOXES PER MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6351	DME GESTATIONAL INSULIN LIMIT 2 BOXES PER MONTH
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6402	SCREENING MAMMOGRAPHY IS LIMITED TO ONE PER YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6403	THE LIMIT FOR THESE SERVICES HAS BEEN REACHED FOR THE CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6404	PROCEDURE IS LIMITED TO ONCE EVERY THIRTY(30) DAYS BY THE SAME BILLING PROVIDER
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6405	PROCEDURE CODE IS LIMITED TO ONE OCCURENCE EVERY SIX MONTHS
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6406	NEWBORN CODE MAY NOT BE BILLED MORE THAN ONCE
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6407	THE SAME PROVIDER MAY NOT BILL MORE THAN ONE NEW PATIENT OFFICE VISIT PER RECIP IENT IN A THREE YEAR PERIOD.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6409	REQUESTED INPATIENT HOSPITAL SERVICES EXCEED LIMIT OF 16
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6410	PHYSICIAN OFFICE VISIT LIMITATION HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6411	INITIAL CRITICAL CARE LIMITED TO ONE PER  DAY
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6413	REQUESTED INPATIENT HOSPITAL SERVICES EXCEED LIMIT OF 16
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6510	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6511	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6512	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6513	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6514	THIS PROCEDURE IS LIMITED TO 5 UNITS PER YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6515	THIS PROCEDURE IS LIMITED TO ONE EPISODE A YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6516	THIS PROCEDURE IS LIMITED TO 52 UNITS PER YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6517	THIS PROCEDURE IS LIMITED TO 10 (TEN) UNITS PER YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6518	PROCEDURE CODE IS LIMITED TO 104 UNITS A YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6519	PROCEDURE CODE IS LIMITED TO 104 TIMES PER YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6520	PROCEDURE CODE IS LIMITED TO 104 TIMES A YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6521	THIS PROCEDURE IS LIMITED TO 365 EPISODES A YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6522	THIS PROCEDURE IS LIMITED TO 52 UNITS A YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6523	BENEFITS HAVE BEEN EXCEEDED FOR THE CALDEAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6524	BENEFITS HAVE BEEN EXCEEDED FOR THE CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6525	BENEFITS HAVE BEEN EXCEEDED FOR THE CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6526	BENEFITS HAVE BEEN EXCEEDED FOR THE CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6527	BENEFITS HAVE BEEN EXCEEDEF FOR THE CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6528	BENEFITS HAVE BEEN EXCEEDED FOR THE CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6529	PROCEDURE IS LIMITED TO 260 UNITS A YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6530	PROCEDURE IS LIMITED TO 8 UNITS A YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6531	PROCEDURE CODE IS LIMITED TO 312 UNITS A YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6532	PROCEDURE IS LIMITED TO 1040 UNITS A YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6533	PROCEDURE IS LIMITED TO 1040 UNITS A YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6534	PROCEDURE IS LIMITED TO 2016 UNITS A YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6535	PROCEDURE IS LIMITED TO 130 UNITS A CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6536	PROCEDURE IS LIMITED TO 104 TIMES A CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6537	PROCEDURE IS LIMITED TO 365 TIMES A CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6538	YEARLY LIMIT FOR CRISIS INTERVENTION HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6539	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6540	PSYCHOTHERAPY SERVICES ARE LIMITED TO 12 (TWELVE) PER CALENDAR YEAR AT PLACE OF  SERVICE "21" (INPATIENT)
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6541	DIAGNOSTIC ASSESSMENTS ARE LIMITED TO ONE ENCOUNTER PER CALENDAR YEAR
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6542	PROCEDURE IS LIMITED TO 4160 UNITS A YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6610	DIALYSIS ULTRAFILTRATION CODES Z5256 AND Z5266 ARE LIMITED TO A TOTAL OF 3 PER  RECIPIENT.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6611	PROCEDURE CODE IS LIMITED TO 156 UNITS PER CALENDAR YEAR.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6612	PROCEDURE CODE IS LIMITED TO ONE UNIT PER CALENDAR MONTH.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6613	PROCEDURE CODE IS LIMITED TO 12 UNITS PER LIFETIME.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6630	THIS PROCEDURE CODE IS LIMITED TO ONE PER CALENDAR MONTH.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6640	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6641	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6642	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6643	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6644	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6647	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6670	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6673	PROCEDURE IS LIMITED TO ONE (1) EVERY TWO YEARS.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6999	UNITS ON THIS CLAIM HAVE BEEN SYSTEMATICALLY REDUCED TO MEET THE BENEFIT LIMIT
259	Frequency of service.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0436	TOTAL MEDICARE ALLOWED AMOUNT INVALID
259	Frequency of service.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N219	PAYMENT BASED ON PREVIOUS PAYER'S ALLOWED AMOUNT.	0436	TOTAL MEDICARE ALLOWED AMOUNT INVALID
259	Frequency of service.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	5511	PROCEDURE CODE IS LIMITED TO ONE PER RECIPIENT WITHIN 60 DAYS OF DELIVERY.
259	Frequency of service.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	6230	MORE THAN ONE MEDICAL ENCOUNTER (Z5298) CANNOT BE PAID ON THE SAME DATE OF SERV ICE.
259	Frequency of service.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N20	Service not payable with other service rendered on the same date.	6231	MORE THAN ONE DENTAL ENCOUNTER (D9430)CANNOT BE PAID ON THE SAME DATE OF SERVIC E.
259	Frequency of service.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N59	Please refer to your provider manual for additional program and provider information.	5511	PROCEDURE CODE IS LIMITED TO ONE PER RECIPIENT WITHIN 60 DAYS OF DELIVERY.
259	Frequency of service.	B14	Payment denied because only one visit or consultation per physician per day is covered.	N59	Please refer to your provider manual for additional program and provider information.	6408	PHYSICIAN IS LIMITED TO ONE VISIT PER DAY PER RECIPIENT
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5212	PROCEDURE CODE CANNOT BE BILLED ON THE SAME DAY WITH PROCEDURE CODES Z5181-Z518 5                                                                               6
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5213	PROCEDURE CODE CANNOT BE BILLED ON THE SAME DAY WITH PROCEDURE CODES Z5181-Z518 5                                                                               6
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5430	AN INITIAL VISIT WILL NOT BE PAID ON SAME DATE OF SERVICE ASAN ANNUAL, PERIODIC  OR HOME VISIT.
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5431	AN INITIAL VISIT WILL NOT BE PAID ON SAME DATE OF SERVICE ASAN ANNUAL, PERIODIC  OR HOME VISIT.
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5432	PRENATAL VISIT NOT COVERED FOR THE SAME DATE OF SERVICE OF FAMILY PLANNING.
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5433	PRENATAL VISIT NOT COVERED FOR THE SAME DATE OF SERVICE OF FAMILY PLANNING.
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5504	POSTPARTUM VISIT WILL NOT BE PAID ON THE SAME DAY AS PRENATAL VISIT
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5505	POSTPARTUM VISIT WILL NOT BE PAID ON THE SAME DAY AS PRENATAL VISIT
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	6230	MORE THAN ONE MEDICAL ENCOUNTER (Z5298) CANNOT BE PAID ON THE SAME DATE OF SERV ICE.
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	6412	ER AND CRITICAL CARE CODE ONE PER CLAIM.
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	6643	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N362	THE NUMBER OF DAYS OR UNITS OF SERVICE EXCEEDS OUR ACCEPTABLE MAXIMUM.	5817	REVENUE CODES 170 -171 MUST NOT EXCEED 10 UNITS UNDER MOTHER'S NUMBER.
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	6514	THIS PROCEDURE IS LIMITED TO 5 UNITS PER YEAR.
259	Frequency of service.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	6643	THE YEARLY LIMIT FOR THIS PROCEDURE HAS BEEN EXCEEDED.
275	Claim.	141	Claim adjustment because the claim spans eligible and ineligible periods of coverage.	N61	Rebill services on separate claims.	2057	RECIPIENT PARTIALLY ELIGIBILE - HEADER
275	Claim.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N61	Rebill services on separate claims.	2057	RECIPIENT PARTIALLY ELIGIBILE - HEADER
283	Medicare worksheet.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA112	Missing/incomplete/invalid group practice information.	0900	PROVIDER TYPE SPECIALITY GROUP NOT FOUND
283	Medicare worksheet.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA112	Missing/incomplete/invalid group practice information.	0901	GROUP NUMBER NOT FOUND IN PROVIDER GROUP TABLE
283	Medicare worksheet.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	MA112	Missing/incomplete/invalid group practice information.	0900	PROVIDER TYPE SPECIALITY GROUP NOT FOUND
283	Medicare worksheet.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	MA112	Missing/incomplete/invalid group practice information.	0901	GROUP NUMBER NOT FOUND IN PROVIDER GROUP TABLE
286	Other payer's Explanation of Benefits/payment information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0227	THIRD PARTY PAYMENT AMOUNT INVALID
286	Other payer's Explanation of Benefits/payment information.	23	Payment adjusted because charges have been paid by another payer.	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0227	THIRD PARTY PAYMENT AMOUNT INVALID
286	Other payer's Explanation of Benefits/payment information.	109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.	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.hhs.gov.	2509	FILE CLAIM WITH MEDICARE
361	Is there other insurance?	22	Payment adjusted because this care may be covered by another payer per coordination of benefits.	N4	Missing/incomplete/invalid prior insurance carrier EOB.	2510	HMO CO-PAY/RECIPIENT HAS TPL
400	Claim is out of balance	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M52	Missing/incomplete/invalid from date(s) of service.	0508	TOTAL CHARGE DOES NOT EQUAL THE SUM OF ALL DETAILS
400	Claim is out of balance	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M54	Missing/incomplete/invalid total charges.	0271	INVALID TOTAL CLAIM CHARGE
400	Claim is out of balance	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M54	Missing/incomplete/invalid total charges.	0508	TOTAL CHARGE DOES NOT EQUAL THE SUM OF ALL DETAILS
402	Amount must be greater than zero	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M54	Missing/incomplete/invalid total charges.	0270	MISSING TOTAL CLAIM CHARGE
402	Amount must be greater than zero	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M79	Missing/incomplete/invalid charge.	0268	BILLED AMOUNT INVALID
402	Amount must be greater than zero	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M79	Missing/incomplete/invalid charge.	0269	DETAIL BILLED AMOUNT MISSING OR INVALID FORMAT
402	Amount must be greater than zero	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M79	Missing/incomplete/invalid charge.	0270	MISSING TOTAL CLAIM CHARGE
402	Amount must be greater than zero	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N75	Missing/incomplete/invalid tooth surface information.	0268	BILLED AMOUNT INVALID
421	Medical review attachment/information for service(s)	17	Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	2800	STERILIZATION DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREME NTS.
421	Medical review attachment/information for service(s)	17	Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	2801	HYSTERECTOMY DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREMEN TS.
421	Medical review attachment/information for service(s)	17	Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	2802	ABORTION DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREMENTS.
421	Medical review attachment/information for service(s)	17	Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever	N59	Please refer to your provider manual for additional program and provider information.	2800	STERILIZATION DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREME NTS.
421	Medical review attachment/information for service(s)	17	Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever	N59	Please refer to your provider manual for additional program and provider information.	2801	HYSTERECTOMY DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREMEN TS.
421	Medical review attachment/information for service(s)	17	Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever	N59	Please refer to your provider manual for additional program and provider information.	2802	ABORTION DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREMENTS.
421	Medical review attachment/information for service(s)	226	Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	2800	STERILIZATION DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREME NTS.
421	Medical review attachment/information for service(s)	226	Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	2801	HYSTERECTOMY DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREMEN TS.
421	Medical review attachment/information for service(s)	226	Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete.	N288	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER TAXONOMY.	2802	ABORTION DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREMENTS.
421	Medical review attachment/information for service(s)	226	Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete.	N59	Please refer to your provider manual for additional program and provider information.	2800	STERILIZATION DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREME NTS.
421	Medical review attachment/information for service(s)	226	Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete.	N59	Please refer to your provider manual for additional program and provider information.	2801	HYSTERECTOMY DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREMEN TS.
421	Medical review attachment/information for service(s)	226	Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete.	N59	Please refer to your provider manual for additional program and provider information.	2802	ABORTION DENIED BECAUSE DOCUMENTATION DOES NOT MEET HHS/MEDICAID REQUIREMENTS.
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.	M57	Missing/incomplete/invalid provider identifier.	7269	MODIFIER NOT VALID FOR THIS PROCEDURE
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0251	FIRST MODIFIER INVALID FOR DATE OF SERVICE
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.	M78	Missing/incomplete/invalid HCPCS modifier.	0252	SECOND MODIFIER INVALID FOR DATE OF SERVICE
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.	M78	Missing/incomplete/invalid HCPCS modifier.	0253	THIRD MODIFIER INVALID FOR DATE OF SERVICE
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.	M78	Missing/incomplete/invalid HCPCS modifier.	4097	INVALID/MISSING MODIFIER FOR THIS PROCEDURE
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.	M78	Missing/incomplete/invalid HCPCS modifier.	5811	HEARING AND VISION SCREENING REQUIRE EP MODIFIER.
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.	M78	Missing/incomplete/invalid HCPCS modifier.	7270	INVALID MODIFIER/PROCEDURE CODE COMBINATION
453	Procedure Code Modifier(s) for Service(s) Rendered	18	Duplicate claim/service.	M86	SERVICE DENIED BECAUSE PAYMENT ALREADY MADE FOR SAME/SIMILAR PROCEDURE WITHIN SET TIME FRAME.	6677	PROCEDURE CODE CANNOT BE BILLED MORE THAN SIX(6) TIMES WITH THE SAME MODIFIER.
453	Procedure Code Modifier(s) for Service(s) Rendered	B18	PAYMENT ADJUSTED BECAUSE THIS PROCEDURE CODES/MODIFIER WAS INVALID ON THE DATE OF SERVICE	M78	Missing/incomplete/invalid HCPCS modifier.	5811	HEARING AND VISION SCREENING REQUIRE EP MODIFIER.
453	Procedure Code Modifier(s) for Service(s) Rendered	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5750	PROCEDURE NOT COVERED WHEN BILLED WITH 76805, 76810 OR 76816 ON THE SAME DAY
453	Procedure Code Modifier(s) for Service(s) Rendered	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5751	PROCEDURE NOT COVERED WHEN BILLED WITH 76805, 76810 OR 76816 ON THE SAME DAY
453	Procedure Code Modifier(s) for Service(s) Rendered	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5752	PROCEDURE NOT COVERED WHEN BILLED WITH 76805 ON THE SAME DAY
453	Procedure Code Modifier(s) for Service(s) Rendered	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N20	Service not payable with other service rendered on the same date.	5753	PROCEDURE NOT COVERED WHEN BILLED WITH 76805 ON THE SAME DAY
453	Procedure Code Modifier(s) for Service(s) Rendered	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	6207	THESE NORPLANT SERVICES MUST BE BILLED USING THE APPROPRIATE COMBINATION CODE O NLY.
454	Procedure code for services rendered.	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.	M144	Pre-/post-operative care payment is included in the allowance for the surgery/procedure.	7222	PROCEDURE DOES NOT REQUIRE AN ASSISTANT SURGEON
454	Procedure code for services rendered.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0234	PROCEDURE CODE MISSING
454	Procedure code for services rendered.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0235	PROCEDURE CODE NOT IN VALID FORMAT
454	Procedure code for services rendered.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0571	SURGICAL PROCEDURE MISSING
454	Procedure code for services rendered.	96	Non-covered charge(s).	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4013	PROCEDURE CODE IS NO LONGER VALID
454	Procedure code for services rendered.	96	Non-covered charge(s).	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	4032	PROCEDURE CODE IS MISSING/NOT ON FILE
454	Procedure code for services rendered.	96	Non-covered charge(s).	N56	Procedure code billed is not correct/valid for the services billed or the date of service billed.	4046	DATE OF SERVICE BEFORE PROCEDURE IS PAYABLE
454	Procedure code for services rendered.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6203	THIS PROCEDURE IS LIMITED TO ONE PER POSTPARTUM PERIOD.
454	Procedure code for services rendered.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	3307	FQHC/PBRHC FFS/ENCOUNTER PROCEDURE CONFLICT
454	Procedure code for services rendered.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.	N257	MISSING/INCOMPLETE/INVALID BILLING PROVIDER/SUPPLIER PRIMARY IDENTIFIER.	1001	BILLING PROVIDER NOT ENROLLED FOR DATES OF SERVICE
455	Revenue code for services rendered.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0339	REVENUE CODE IS MISSING
455	Revenue code for services rendered.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	0339	REVENUE CODE IS MISSING
455	Revenue code for services rendered.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	0340	REVENUE CODE IS INVALID
455	Revenue code for services rendered.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4059	REVENUE CODE NOT ON FILE
455	Revenue code for services rendered.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M50	Missing/incomplete/invalid revenue code(s).	4225	INVALID INPATIENT REVENUE CODE
455	Revenue code for services rendered.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N65	Procedure code or procedure rate count cannot be determined, or was not on file, for the date of service/provider.	4059	REVENUE CODE NOT ON FILE
455	Revenue code for services rendered.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	M50	Missing/incomplete/invalid revenue code(s).	3302	PROCEDURE AND REVENUE CODE COMBINATION NOT VALID
455	Revenue code for services rendered.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	M76	Missing/incomplete/invalid diagnosis or condition.	3300	NEONATAL REVENUE - DIAGNOSIS CODE MISMATCH
456	Covered Day(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M52	Missing/incomplete/invalid from date(s) of service.	0397	HEADER STMT COVERS PERIOD "THROUGH" DATE MISSING
456	Covered Day(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M52	Missing/incomplete/invalid from date(s) of service.	0398	STATEMENT COVERS PERIOD "THROUGH" DATE INVALID
456	Covered Day(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA32	Missing/incomplete/invalid number of covered days during the billing period.	0282	MISSING COVERED DAYS
456	Covered Day(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA43	Missing/incomplete/invalid patient status.	0282	MISSING COVERED DAYS
457	Non-Covered Day(s)	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5332	THIS X-RAY PROCEDURE MAY NOT BE BILLED WITHIN 30 (THIRTY) DAYS OF A ROOT CANAL
457	Non-Covered Day(s)	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	5333	THIS X-RAY PROCEDURE MAY NOT BE BILLED WITHIN 30 (THIRTY) DAYS OF A ROOT CANAL
457	Non-Covered Day(s)	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5646	POST-OPERATIVE CARE IS INCLUDED IN THE SURGERY FEE AND CANNOT BE BILLED SEPARAT ELY.
457	Non-Covered Day(s)	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5647	POST-OPERATIVE PHYSICIAN SERVICES FOR THE SAME DIAGNOSIS MAY NOT BE BILLED WITH IN 62 DAYS OF SURGERY
457	Non-Covered Day(s)	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6209	PROCEDURE LIMITED TO ONE SERVICE DURING 60 (SIXTY) DAY POSTPARTUM PERIOD.
457	Non-Covered Day(s)	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M67	MISSING/INCOMPLETE/INVALID OTHER PROCEDURE CODE(S)	0822	SURGICAL REVENUE CODE REQUIRES ICD9 SURGERY CODE
457	Non-Covered Day(s)	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.	N59	Please refer to your provider manual for additional program and provider information.	6209	PROCEDURE LIMITED TO ONE SERVICE DURING 60 (SIXTY) DAY POSTPARTUM PERIOD.
458	Coinsurance Day(s)	2	Coinsurance Amount	MA34	Missing/incomplete/invalid number of coinsurance days during the billing period.	0817	INVALID COINSURANCE DAYS
458	Coinsurance Day(s)	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	MA35	Missing/incomplete/invalid number of lifetime reserve days.	0818	LIFETIME RESERVE DAYS NOT NUMERIC
459	Lifetime Reserve Day(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA35	Missing/incomplete/invalid number of lifetime reserve days.	0809	VERIFY LIFETIME RESERVE AND COINS DAYS TO COV DAYS
459	Lifetime Reserve Day(s)	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	MA35	Missing/incomplete/invalid number of lifetime reserve days.	0819	LIFETIME RESERVE DAYS > MAX ALLOWED
460	NUBC Condition Code(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0471	CONDITION CODE 8-24 INVALID
460	NUBC Condition Code(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	0284	PRIMARY CONDITION CODE INVALID
460	NUBC Condition Code(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	0285	SECOND CONDITON CODE INVALID
460	NUBC Condition Code(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	0286	THIRD CONDITION CODE INVALID
460	NUBC Condition Code(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	0287	FOURTH CONDITION CODE INVALID
460	NUBC Condition Code(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	0288	FIFTH CONDITION CODE INVALID
460	NUBC Condition Code(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	0289	SIXTH CONDITION CODE INVALID
460	NUBC Condition Code(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	0290	SEVENTH CONDITION CODE INVALID
460	NUBC Condition Code(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M44	Missing/incomplete/invalid condition code.	0471	CONDITION CODE 8-24 INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0293	THIRD OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0295	DATE FOR PRIMARY OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0296	DATE FOR PRIMARY OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0297	DATE FOR SECOND OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0298	DATE FOR SECOND OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0299	DATE FOR THIRD OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0300	DATE FOR THIRD OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0301	DATE FOR FOURTH OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0302	DATE FOR FOURTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0411	DATE FOR FIFTH OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0412	DATE FOR FIFTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0413	DATE FOR SIXTH OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0414	DATE FOR SIXTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0415	DATE FOR SEVENTH OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0416	DATE FOR SEVENTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0417	DATE FOR EIGHTH OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0418	DATE FOR EIGHTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0465	DATE FOR OCCURRENCE CODE 9-24 MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0466	DATE FOR OCCURRENCE CODE 9-24 INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0467	OCCURRENCE SPAN CODE 9-24 INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M46	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN CODE.	0467	OCCURRENCE SPAN CODE 9-24 INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0295	DATE FOR PRIMARY OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0296	DATE FOR PRIMARY OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0297	DATE FOR SECOND OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0298	DATE FOR SECOND OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0299	DATE FOR THIRD OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0300	DATE FOR THIRD OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0301	DATE FOR FOURTH OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0302	DATE FOR FOURTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0411	DATE FOR FIFTH OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0412	DATE FOR FIFTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0413	DATE FOR SIXTH OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0414	DATE FOR SIXTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0415	DATE FOR SEVENTH OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0416	DATE FOR SEVENTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0417	DATE FOR EIGHTH OCCURRENCE CODE MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0418	DATE FOR EIGHTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0465	DATE FOR OCCURRENCE CODE 9-24 MISSING
461	NUBC Occurrence Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N299	MISSING/INCOMPLETE/INVALID OCCURRENCE DATE(S).	0466	DATE FOR OCCURRENCE CODE 9-24 INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M44	Missing/incomplete/invalid condition code.	0291	PRIMARY OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0292	SECOND OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0294	FOURTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0406	SIXTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0407	SEVENTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0408	EIGHTH OCCURRENCE CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0409	FIRST OCCURRENCE SPAN CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0410	SECOND OCCURRENCE SPAN CODE INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0467	OCCURRENCE SPAN CODE 9-24 INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M46	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN CODE.	0467	OCCURRENCE SPAN CODE 9-24 INVALID
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.	M53	Missing/incomplete/invalid days or units of service.	0405	FIFTH OCCURRENCE CODE INVALID
462	NUBC Occurrence Span Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0470	TO DATE OF SERVICE FOR SPAN CODE 3-24 MISSING
462	NUBC Occurrence Span Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0419	FROM DTE OF SERV FOR FIRST OCCUR SPAN CODE MISSING
462	NUBC Occurrence Span Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M45	MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).	0468	FROM DATE OF SERVICE FOR SPAN CODE 3-24 MISSING
462	NUBC Occurrence Span Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M46	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN CODE.	0469	FROM DATE OF SERVICE FOR SPAN CODE 3-24 INVALID
462	NUBC Occurrence Span Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N300	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN DATE(S).	0468	FROM DATE OF SERVICE FOR SPAN CODE 3-24 MISSING
462	NUBC Occurrence Span Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N300	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN DATE(S).	0469	FROM DATE OF SERVICE FOR SPAN CODE 3-24 INVALID
462	NUBC Occurrence Span Code(s) and Date(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	N300	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN DATE(S).	0470	TO DATE OF SERVICE FOR SPAN CODE 3-24 MISSING
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0421	TO DTE OF SERV FOR FIRST OCCUR SPAN CODE MISSING
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0422	TO DTE OF SERV FOR FIRST OCCUR SPAN CODE INVALID
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0423	FROM DAT OF SERV FOR 2ND OCCUR SPAN CODE MISSING
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0424	FROM DTE OF SERV FOR 2ND OCCUR SPAN CODE INVALID
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0425	TO DTE OF SERV FOR 2ND OCCUR SPAN CODE MISSING
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0426	TO DTE OF SERV FOR 2ND OCCUR SPAN CODE INVALID
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	M100	We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.	0470	TO DATE OF SERVICE FOR SPAN CODE 3-24 MISSING
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	M44	Missing/incomplete/invalid condition code.	0472	TO DATE OF SERVICE FOR SPAN CODE 3-24 INVALID
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	M46	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN CODE.	0420	FROM DTE OF SERV FOR FIRST OCCUR SPAN CODE INVALID
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	M46	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN CODE.	0469	FROM DATE OF SERVICE FOR SPAN CODE 3-24 INVALID
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	N300	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN DATE(S).	0469	FROM DATE OF SERVICE FOR SPAN CODE 3-24 INVALID
462	NUBC Occurrence Span Code(s) and Date(s)	92	Claim Paid in full.	N300	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN DATE(S).	0470	TO DATE OF SERVICE FOR SPAN CODE 3-24 MISSING
462	NUBC Occurrence Span Code(s) and Date(s)	A1	Claim/Service denied.	M46	MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN CODE.	0420	FROM DTE OF SERV FOR FIRST OCCUR SPAN CODE INVALID
463	NUBC Value Code(s) and/or Amount(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M49	Missing/incomplete/invalid value code(s) or amount(s).	0461	VALUE CODE IS INVALID
463	NUBC Value Code(s) and/or Amount(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M49	Missing/incomplete/invalid value code(s) or amount(s).	0462	VALUE CODE AMOUNT IS MISSING
463	NUBC Value Code(s) and/or Amount(s)	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M49	Missing/incomplete/invalid value code(s) or amount(s).	0463	VALUE CODE AMOUNT IS INVALID
474	Procedure code and patient gender mismatch	7	The procedure code is inconsistent with the patient's gender.	N22	This procedure code was added/changed because it more accurately describes the services rendered.	7213	PROCEDURE IS INVALID FOR PATIENT'S SEX
476	Missing or invalid units of service	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M51	MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).	0573	TOTAL DAYS ON CLAIM CONFLICT WITH DATES SHOWN
476	Missing or invalid units of service	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M53	Missing/incomplete/invalid days or units of service.	0233	UNITS OF SERVICE MISSING
476	Missing or invalid units of service	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M53	Missing/incomplete/invalid days or units of service.	0260	UNITS OF SERVICE NOT IN VALID FORMAT
476	Missing or invalid units of service	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M53	Missing/incomplete/invalid days or units of service.	0400	DETAIL UNITS OF SERVICE MUST BE GREATER THAN ZERO
476	Missing or invalid units of service	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA32	Missing/incomplete/invalid number of covered days during the billing period.	0283	COVERED DAYS INVALID
476	Missing or invalid units of service	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA32	Missing/incomplete/invalid number of covered days during the billing period.	0400	DETAIL UNITS OF SERVICE MUST BE GREATER THAN ZERO
476	Missing or invalid units of service	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	MA32	Missing/incomplete/invalid number of covered days during the billing period.	0573	TOTAL DAYS ON CLAIM CONFLICT WITH DATES SHOWN
477	Diagnosis code pointer is missing or invalid	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M58	Missing/incomplete/invalid claim information.  Resubmit claim after corrections.	0224	DIAGNOSIS TREATMENT INDICATOR INVALID
477	Diagnosis code pointer is missing or invalid	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	0223	MISSING DIAGNOSIS INDICATOR
477	Diagnosis code pointer is missing or invalid	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate	M76	Missing/incomplete/invalid diagnosis or condition.	0224	DIAGNOSIS TREATMENT INDICATOR INVALID
483	Maximum coverage amount met or exceeded for benefit period.	119	Benefit maximum for this time period or occurrence has been reached.	M139	Denied services exceed the coverage limit for the demonstration.	6284	MEPD FISCAL YEAR DOLLAR LIMIT
483	Maximum coverage amount met or exceeded for benefit period.	119	Benefit maximum for this time period or occurrence has been reached.	N59	Please refer to your provider manual for additional program and provider information.	6260	NUMBER OF HOME HEALTH VISITS EXCEED LIMIT
516	Adjudication or Payment Date	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M59	Missing/incomplete/invalid to date(s) of service.	0814	DETAIL TO DATE OF SERVICE > ICN DATE
562	Entitys National Provider Identifier (NPI)	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N257	MISSING/INCOMPLETE/INVALID BILLING PROVIDER/SUPPLIER PRIMARY IDENTIFIER.	1927	BILLING PROVIDER - NPI MISSING OR INVALID - AN NPI NUMBER IS REQUIRED AND WAS N OT SUBMITTED OR THENPI SUBMITTED DOES NOT MATCH THE NPI ON FILE.
562	Entitys National Provider Identifier (NPI)	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1928	NPI REQUIRED HEALTHCARE=Y PREMING PROV
562	Entitys National Provider Identifier (NPI)	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1931	NPI REQUIRED HEALTHCARE=Y RENDERING PROV
562	Entitys National Provider Identifier (NPI)	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1934	DTL NPI REQUIRED HEALTHCARE=Y PERFORMING PROV
562	Entitys National Provider Identifier (NPI)	206	National Provider Identifier - missing	N257	MISSING/INCOMPLETE/INVALID BILLING PROVIDER/SUPPLIER PRIMARY IDENTIFIER.	1927	BILLING PROVIDER - NPI MISSING OR INVALID - AN NPI NUMBER IS REQUIRED AND WAS N OT SUBMITTED OR THENPI SUBMITTED DOES NOT MATCH THE NPI ON FILE.
562	Entitys National Provider Identifier (NPI)	206	National Provider Identifier - missing	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1928	NPI REQUIRED HEALTHCARE=Y PREMING PROV
562	Entitys National Provider Identifier (NPI)	206	National Provider Identifier - missing	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1931	NPI REQUIRED HEALTHCARE=Y RENDERING PROV
562	Entitys National Provider Identifier (NPI)	206	National Provider Identifier - missing	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1934	DTL NPI REQUIRED HEALTHCARE=Y PERFORMING PROV
562	Entitys National Provider Identifier (NPI)	A2	Contractual adjustment.	N257	MISSING/INCOMPLETE/INVALID BILLING PROVIDER/SUPPLIER PRIMARY IDENTIFIER.	1927	BILLING PROVIDER - NPI MISSING OR INVALID - AN NPI NUMBER IS REQUIRED AND WAS N OT SUBMITTED OR THENPI SUBMITTED DOES NOT MATCH THE NPI ON FILE.
562	Entitys National Provider Identifier (NPI)	A2	Contractual adjustment.	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1928	NPI REQUIRED HEALTHCARE=Y PREMING PROV
562	Entitys National Provider Identifier (NPI)	A2	Contractual adjustment.	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1931	NPI REQUIRED HEALTHCARE=Y RENDERING PROV
562	Entitys National Provider Identifier (NPI)	A2	Contractual adjustment.	N290	MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.	1934	DTL NPI REQUIRED HEALTHCARE=Y PERFORMING PROV
583	Line Item Charge Amount	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M54	Missing/incomplete/invalid total charges.	0801	DTL RATE * DTL UNITS NOT EQUAL DTL BILLED AMOUNT
583	Line Item Charge Amount	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M79	Missing/incomplete/invalid charge.	0801	DTL RATE * DTL UNITS NOT EQUAL DTL BILLED AMOUNT
585	Line Item Denied Charge or Non-covered Charge	96	Non-covered charge(s).	M79	Missing/incomplete/invalid charge.	0805	NONCOVERED CHARGE IS NOT NUMERIC
585	Line Item Denied Charge or Non-covered Charge	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M79	Missing/incomplete/invalid charge.	0805	NONCOVERED CHARGE IS NOT NUMERIC
591	Medicare Paid at 100% Amount	42	Charges exceed our fee schedule or maximum allowable amount.	N14	Payment based on a contractual amount or agreement, fee schedule, or maximum allowable amount.	3303	MEDICARE PAID AMOUNT EQUAL 100%
591	Medicare Paid at 100% Amount	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	N14	Payment based on a contractual amount or agreement, fee schedule, or maximum allowable amount.	3303	MEDICARE PAID AMOUNT EQUAL 100%
626	Pregnancy Indicator	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.	M57	Missing/incomplete/invalid provider identifier.	0208	PREGNANCY INDICATOR INVALID
626	Pregnancy Indicator	A2	Contractual adjustment.	M57	Missing/incomplete/invalid provider identifier.	0208	PREGNANCY INDICATOR INVALID
639	Responsibility Amount	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M52	Missing/incomplete/invalid from date(s) of service.	0811	HEADER FROM DATE OF SERVICE > ICN DATE
644	Service Line Rate	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M53	Missing/incomplete/invalid days or units of service.	0800	DETAIL RATE NOT NUMERIC
644	Service Line Rate	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	M79	Missing/incomplete/invalid charge.	0800	DETAIL RATE NOT NUMERIC
655	Total Medicare Paid Amount	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	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.	0806	MEDICARE PAID AMOUNT MISSING OR INVALID
666	Surgical Procedure Code	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.	N382	Missing/incomplete/invalid patient identifier.	0823	RECIPIENT CHECK DIGIT IS MISSING OR INVALID
725	NUBC Value Code(s)	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5218	SUPPLY CODE CANNOT BE BILLED WITH LAB OR OFFICE VISIT
725	NUBC Value Code(s)	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N59	Please refer to your provider manual for additional program and provider information.	5219	SUPPLY CODE HAS BEEN PAID IN HISTORY, CANNOT BILL A LAB OR OFFICE VISIT
1	For more detailed information, see remittance advice.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			8251	HP INITIATED VOID DUE TO CHANGE IN PROVIDER ID OR SERVICE LOCATION INFORMATION.
1	For more detailed information, see remittance advice.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			8990	THIS CLAIM ELECTRONICALLY CREATED TO REPROCESS A DENIED PAPER CLAIM.  THE CLAIM IMAGE IS LOCATED WITH ELECTRONIC CLAIMS - NOT WITH PAPER CLAIMS.
1	For more detailed information, see remittance advice.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			8991	SYSTEM ERROR  - DETAIL MEDICARE AMOUNTS.  A SYSTEM ERROR RESULTED IN THE DELETI ON OF MEDICARE DETAIL AMOUNTS.  THE DATA ARE UNRECOVERABLE.  PLEASE RESUBMIT YO UR CLAIM.  WE APOLOGIZE FOR THE INCONVENIENCE.
1	For more detailed information, see remittance advice.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			8992	CLAIM MODIFIED POST-PROCESSING.  DETAIL DATES MODIFIED TO REFLECT SERVICE PERIO D.
1	For more detailed information, see remittance advice.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			8993	CLAIM MODIFIED POST-PROCESSING.  PERFORMING PROVIDER RESTORED TO SUBMITTED VALU E.
1	For more detailed information, see remittance advice.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			8994	CLAIM MODIFIED POST-PROCESSING.  RECIPIENT ID AND CHECK DIGIT RESTORED TO SUBMI TTED VALUE.
1	For more detailed information, see remittance advice.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			0609	PART A CROSSOVER SPANS 20020501
1	For more detailed information, see remittance advice.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.			1006	FACILITY PROV NOT ELIG AT SERV LOC FOR PROG BILLED
1	For more detailed information, see remittance advice.	A2	Contractual adjustment.			0609	PART A CROSSOVER SPANS 20020501
100	Pre-certification penalty taken.	63	Correction to a prior claim.			8101	SAVE FOR FUTURE USE.
100	Pre-certification penalty taken.	63	Correction to a prior claim.			8102	SAVE FOR FUTURE USE.
100	Pre-certification penalty taken.	63	Correction to a prior claim.			8103	SAVE FOR FUTURE USE.
100	Pre-certification penalty taken.	63	Correction to a prior claim.			8105	SAVE FOR FUTURE USE.
100	Pre-certification penalty taken.	63	Correction to a prior claim.			8106	SAVE FOR FUTURE USE.
100	Pre-certification penalty taken.	63	Correction to a prior claim.			8107	SAVE FOR FUTURE USE.
101	Claim was processed as adjustment to previous claim.	100	PAYMENT MADE TO PATIENT/INSURED/RESPONSIBLE PARTY/EMPLOYER.			8090	AGENCY REQUESTED REFUND DUE TO ACCOUNTS RECEIVABLE
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8070	PROVIDER SENT REFUND DUE TO MEDICAID FRAUD.
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8071	PROVIDER SENT REFUND PAYMENT DUE TO MEDICAID FRAUD.
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8072	PROVIDER SENT REFUND DUE TO AUTO LIABILITY.
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8073	PROVIDER SENT REFUND DUE TO WORKERS COMP.
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8074	PROVIDER SENT REFUND FOR CLAIM NOT IN HISTORY.
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8075	PROVIDER SENT REFUND DUE TO MISCELLANEOUS OR UNSPECIFIED ERROR.
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8079	CONVERTED CLAIM WAS GENERATED FOR A FULL REFUND
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8080	CONVERTED CLAIM WAS GENERATED FOR A PARTIAL REFUND
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8093	AGENCY REQUESTED REFUND DUE TO CLAIMS PROCESSING ERROR
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8095	AGENCY REQUESTED REFUND DUE TO MEDICARE
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8150	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO CALL CENTER
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8151	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO CLAIMS RESOLUTION
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8152	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO DHS/CHILD WELFARE
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8153	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO DHS/DDSD
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8155	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO FINANCIAL MANAGEMENT REVIEW
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8156	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO FQHC
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8157	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO KEYING ERROR
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			8158	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO MEDICAL REVIEW
101	Claim was processed as adjustment to previous claim.	123	Payer refund due to overpayment.			9992	REFUND AMOUNT GREATER THAN ADJUSTED AMOUNT
101	Claim was processed as adjustment to previous claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			9011	CLAIM TREATED AS AN ADJUSTMENT. NO MEDICAID ID ON THE CLAIM.
101	Claim was processed as adjustment to previous claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			9012	CLAIM TREATED AS AN ADJUSTMENT. CROSSOVER CLAIM WITH NO MEDICARE PROVIDER NUMB
101	Claim was processed as adjustment to previous claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			9013	CLAIM TREATED AS AN ADJUSTMENT. HEADER KEY SECTION OF CLAIM IS MISSING.
101	Claim was processed as adjustment to previous claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			9014	CLAIM TREATED AS AN ADJUSTMENT. CLAIM LACKS ORIGINAL ICN.
101	Claim was processed as adjustment to previous claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			9015	CLAIM TREATED AS AN ADJUSTMENT. BENEFICIARY NOT FOUND ON T_RE_BASE.
101	Claim was processed as adjustment to previous claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			9016	CLAIM TREATED AS AN ADJUSTMENT. BILLING PROVIDER NOT FOUND ON T_PR_PROV.
101	Claim was processed as adjustment to previous claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			9017	CLAIM TREATED AS AN ADJUSTMENT. ORIGINAL ICN NOT FOUND ON T_HIST_DIRECTORY.
101	Claim was processed as adjustment to previous claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			9018	CLAIM TREATED AS AN ADJUSTMENT. CLAIM HAS ALREADY BEEN ADJUSTED.
101	Claim was processed as adjustment to previous claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			9019	CLAIM TREATED AS AN ADJUSTMENT. CLAIM IS SCHEDULED TO BE ADJUSTED BY ANOTHER PR
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8168	AGENCY INITIATED ADJUSTMENT DUE TO RATE CHANGE
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8213	INCOME PENSION TRUST RECOVERIES
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8215	ABSENT PARENTS
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8216	TPL ERROR
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8217	DUE TO MISCELLANEOUS OR UNSPECIFIED REASON
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8240	ADJUSTMENT GENERATED DUE TO SURS REVIEW
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8241	ADJUSTMENT GENERATED DUE TO CHANGE IN PATIENT LIABILITY
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8242	ADJUSTMENT GENERATED DUE TO RATE CHANGE
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8246	POINT OF SALE REVERSAL
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9991	REFUND AMOUNT LESS THAN ADJUSTED AMOUNT
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9992	REFUND AMOUNT GREATER THAN ADJUSTED AMOUNT
101	Claim was processed as adjustment to previous claim.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9995	ADJUSTMENT DETAIL MANUALLY DENIED
101	Claim was processed as adjustment to previous claim.	63	Correction to a prior claim.			8140	AGENCY INITIATED OFFSET OF OUT-PATIENT CLAIM DUE TO PAID IN-PATIENT CLAIM
101	Claim was processed as adjustment to previous claim.	63	Correction to a prior claim.			8168	AGENCY INITIATED ADJUSTMENT DUE TO RATE CHANGE
101	Claim was processed as adjustment to previous claim.	63	Correction to a prior claim.			8184	MASS ADJUSTMENT - PROCEDURE CODE RATE CHANGE
101	Claim was processed as adjustment to previous claim.	63	Correction to a prior claim.			8517	THIS CLAIM ADJUSTMENT DUE TO A PROVIDER SUBMITTED REQUEST
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8030	PROVIDER REQUESTED OFFSET DUE TO BILLING ERROR.
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8031	PROVIDER REQUESTED OFFSET DUE TO OTHER INSURANCE.
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8032	PROVIDER REQUESTED OFFSET DUE MEDICARE.
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8033	PROVIDER REQUESTED OFFSET DUE TO PATIENT LIABILITY.
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8034	PROVIDER REQUESTED OFFSET DUE TO SPENDDOWN.
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8035	PROVIDER REQUESTED OFFSET DUE TO AUTO LIABILITY.
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8036	PROVIDER REQUESTED OFFSET DUE TO WORKERS COMP
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8037	PROVIDER REQUESTED CLAIM VOID DUE TO BILLING ERROR.
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8038	PROVIDER REQUESTED OFFSET DUE TO MISCELLANEOUS OR UNSPECIFIED ERROR
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8136	EDS INITIATED ADJUSTMENTS DUE TO PROCESSING ERROR
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8250	EDS INITIATED ADJUSTMENTS DUE TO PROCESSING ERROR
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8422	AS THE RESULT OF A COST SETTLEMENT REVIEW, AN ACCOUNTS RECEIVABLE HAS BEEN ESTA BLISHED. THE AMOUNT WILL BE DEDUCTED FROM YOUR PAYMENTS.
101	Claim was processed as adjustment to previous claim.	88	Adjustment amount represents collection against receivable created in prior overpayment.			9991	REFUND AMOUNT LESS THAN ADJUSTED AMOUNT
101	Claim was processed as adjustment to previous claim.	A2	Contractual adjustment.			8213	INCOME PENSION TRUST RECOVERIES
101	Claim was processed as adjustment to previous claim.	A2	Contractual adjustment.			8215	ABSENT PARENTS
101	Claim was processed as adjustment to previous claim.	A2	Contractual adjustment.			8216	TPL ERROR
101	Claim was processed as adjustment to previous claim.	A2	Contractual adjustment.			8217	DUE TO MISCELLANEOUS OR UNSPECIFIED REASON
101	Claim was processed as adjustment to previous claim.	A2	Contractual adjustment.			8240	ADJUSTMENT GENERATED DUE TO SURS REVIEW
101	Claim was processed as adjustment to previous claim.	A2	Contractual adjustment.			8241	ADJUSTMENT GENERATED DUE TO CHANGE IN PATIENT LIABILITY
101	Claim was processed as adjustment to previous claim.	A2	Contractual adjustment.			8242	ADJUSTMENT GENERATED DUE TO RATE CHANGE
101	Claim was processed as adjustment to previous claim.	A2	Contractual adjustment.			8243	ADJUSTMENT GENERATED DUE TO RECIPIENT DATE OF DEATH
101	Claim was processed as adjustment to previous claim.	A2	Contractual adjustment.			8246	POINT OF SALE REVERSAL
101	Claim was processed as adjustment to previous claim.	A2	Contractual adjustment.			9995	ADJUSTMENT DETAIL MANUALLY DENIED
104	Processed according to plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8188	MASS ADJUSTMENT - VOID TRANSACTIONS
104	Processed according to plan provisions.	A2	Contractual adjustment.			8188	MASS ADJUSTMENT - VOID TRANSACTIONS
106	This amount is not entity's responsibility.	104	Managed care withholding.			8057	SAVE FOR FUTURE USE.
107	Processed according to contract/plan provisions.	10	The diagnosis is inconsistent with the patient's gender.			4028	BPA-RP-DIAG - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	10	The diagnosis is inconsistent with the patient's gender.			4031	BPA-PC-DIAG - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	107	The related or qualifying claim/service was not identified on this claim.			0646	PT RESPONSIBILITY MUST BE GT ZERO
107	Processed according to contract/plan provisions.	107	The related or qualifying claim/service was not identified on this claim.			0647	OTHER PAYER AMOUNT MUST BE GT ZERO
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.			5260	BATTERIES MAY NOT BE PURCAHSED WITHIN 60 (SIXTY) DAYS OF PURCHASE OF HEARING AI D
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.			5261	BATTERIES MAY NOT BE PURCAHSED WITHIN 60 (SIXTY) DAYS OF PURCHASE OF HEARING AI D
107	Processed according to contract/plan provisions.	119	Benefit maximum for this time period or occurrence has been reached.			6310	THE QUANTITY DISPENSED EXCEEDS THE MAXIMUM QUANTITY ALLOWED FOR THE DRUG CODE P RESCRIBED.
107	Processed according to contract/plan provisions.	133	The disposition of this claim/service is pending further review.			7000	CLAIM FAILED A PRODUR ALERT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0267	DUPLICATE TOOTH SURFACES SUBMITTED ON DETAIL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0682	ADJ - ORIGINAL CLAIM HAS ALREADY BEEN ADJUSTED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0683	ADJ - ORIG CLM ADJUSTMENT ALREADY IN PROGRESS
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0688	CANNOT ADJUST THIS CLAIM DUE TO PHP TERMINATION.  VOID THIS CLAIM AND RESUBMIT  A NEW CLAIM.
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0689	ADJ - ORIGINAL CLAIM CANNOT BE ADJUSTED - NCCI
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0833	CO-INSURANCE AMOUNT DOES NOT BALANCE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0835	MEDICARE DATA NOT FOUND - FORMAT ERROR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0923	RULE OVERLAP IDENTIFIED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1070	ATTENDING PROVIDER ID NOT ON FILE - HDR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1071	OPERATING PROVIDER ID NOT ON FILE - HDR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1072	ATTENDING PROVIDER ID NOT ON FILE - DTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1073	OPERATING PROVIDER ID NOT ON FILE - DTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1081	REFERRING PROV NOT ENROLLED SVC LOC HDR-PHYS-DNTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1082	REFERRING PROV NOT ENROLLED SVC LOC DTL-PHYS-DNTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1083	REFERRING PROV NOT ENROLLED AT SVC LOC - HDR - UB
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1084	ATTENDING PROV - NOT ENROLLED AT SVC LOC - HDR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1085	OPERATING PROV - NOT ENROLLED AT SVC LOC - HDR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1086	REFERRING PROV - NOT ENROLLED AT SVC LOC - DTL-UB
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1087	ATTENDING PROV - NOT ENROLLED AT SVC LOC - DTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1088	OPERATING PROV - NOT ENROLLED AT SVC LOC - DTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1091	REFER PROV STATUS NOT VALID FOR DOS HDR-PHYS-DNTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1092	REFER PROV STATUS NOT VALID FOR DOS DTL-PHYS-DNTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1093	REFERRING PROV STATUS NOT VALID FOR DOS - HDR - UB
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1094	ATTENDING PROV - STATUS NOT VALID FOR DOS - HDR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1095	OPERATING PROV - STATUS NOT VALID FOR DOS - HDR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1096	REFERRING PROV - STATUS NOT VALID FOR DOS - DTL-UB
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1097	ATTENDING PROV - STATUS NOT VALID FOR DOS - DTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1098	OPERATING PROV - STATUS NOT VALID FOR DOS - DTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1954	ATTENDING PROVIDER - MULTIPLE SVC LOC - DTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1955	OPERATING PROVIDER - MULTIPLE SVC LOC - DTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1956	ATTENDING PROV - MULTIPLE SVC LOC - HDR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1957	OPERATING PROV - MULTIPLE SVC LOC - HDR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1963	ATTENDING PROVIDER - NPI REQUIRED - HDR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1964	OPERATING PROVIDER- NPI REQUIRED - HDR
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1965	ATTENDING PROVIDER- NPI REQUIRED - DTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1966	OPERATING PROVIDER- NPI REQUIRED - DTL
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1970	INVALID ATTENDING PROVIDER OVERRIDE SPECIFIED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1971	INVALID DTL ATTENDING PROVIDER OVERRIDE SPECIFIED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1972	INVALID OTHER PROVIDER 1 OVERRIDE SPECIFIED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1973	INVALID DTL OTHER PROVIDER 1 OVERRIDE SPECIFIED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			2806	PREGNANCY INDICATOR IS INVALID FOR RECIPIENT SEX
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			3105	DAW 1 - BRAND WITH GENERIC EQUIVALENT REQUIRES OVERRIDE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4017	BPA-RP-DRG - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4018	BPA-RP-DRG - PERF PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4023	BPA-RP-NDC - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4025	BPA-RP-NDC - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4026	BPA-RP-NDC - MAX UNIT RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4028	BPA-RP-DIAG - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4030	BPA-RP-DIAG - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4031	BPA-PC-DIAG - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4034	BPA-RP-PROC - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4035	BPA-RP-PROC - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4036	BPA-RP-PROC - PLACE OF SERVICE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4044	BPA-RR-DIAG - NO RULE FOR ASSOC AGE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4045	BPA-RR - NO RULE FOR BENEFIT PLAN
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4067	ICD9 PROCEDURE CODE IS NOT COVERED
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4068	BPA-RR - NO RULE CURR BILL PROV CONTRACT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4070	BPA-RR-PROC -  MODIFIER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4072	BPA-RR-DRG - NO RULE FOR ADMIT OR HDR DIAGNOSIS
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4076	BPA-RP-NDC - FAMILY PLANNING IND RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4094	BPA-PC-REV -  PROV COUNTY RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4145	BPA-PC-DRG - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4146	BPA-PC-DRG - PERF PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4158	BPA-PC-DRG - CURR PROV CONTRACT RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4190	BPA-RP-DRG - ANY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4191	BPA-PC-DRG - ANY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4192	BPA-RP-DRG - OTHER DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4231	BPA-PC-NDC - MAX UNIT RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4255	BPA-PC-DRG - ADMIT DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4256	BPA-RP-PROC - MODIFIER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4257	BPA-PC-PROC - MODIFIER RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4258	BPA-PC-DRG -  OCCURRENCE CODE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4500	BPA-RR-NDC - ALGI RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4501	BPA-RR-NDC - NO RULE FOR DISP AS WRITTEN IND
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4502	BPA-RP-PROC - EPSDT REFERRAL RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4503	BPA-PC-PROC - EPSDT REFERRAL RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4504	BPA-RP-NDC - ALGI RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4505	BPA-RR-PROC - NO RULE FOR URBAN/RURAL IND
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4506	BPA-PC-DIAG - PERF PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4508	BPA-PC-PROC - PERF PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4509	BPA-PC-REV - PERF PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4511	BPA-RP-DIAG - PERF PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4514	BPA-RP-PROC - PERF PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4515	BPA-RP-REV - PERF PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4516	BPA-PC-DIAG - BILL PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4517	BPA-PC-NDC - BILL PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4518	BPA-PC-ICD9 - BILL PROV ALL PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4526	BPA-PC-PROC -  PROV COUNTY RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4534	BPA-RP-DRG - EMERGENCY DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4541	BPA-RP-DIAG - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4542	BPA-RP-DRG - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4545	BPA-RP-PROC - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4546	BPA-RP-REV - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4547	BPA-PC-DIAG - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4548	BPA-PC-DRG - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4551	BPA-PC-PROC - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4552	BPA-PC-REV - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4553	BPA-RR-DIAG - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4554	BPA-RR-DRG - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4556	BPA-RR-NDC - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4557	BPA-RR-PROC - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4558	BPA-RR-REV - REFER PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4559	BPA-RP-DRG - SECONDARY HDR DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4563	BPA-RR - NO RULE CURR PERF PROV CONTRACT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4711	BPA-PC-DIAG - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4712	BPA-PC-DRG - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4713	BPA-PC-NDC - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4714	BPA-PC-PROC - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4715	BPA-PC-REV - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4721	BPA-RP-DRG - ADMIT DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4722	BPA-RP-DRG - PRIMARY HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4755	BPA-PC-PROC - CURRENT BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4766	BPA-RP-ICD9 - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4775	BPA-PC-NDC - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4776	BPA-PC-DIAG - BILL PROV PRIMARY PT/PS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4803	BPA-PC-NDC - NO CONTRACT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4805	BPA-PC-DRG - NO CONTRACT
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4831	BPA-RR - NO REIMB RULE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4875	BPA-PC-DRG - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4881	BPA-PC-DRG - PLACE OF SERVICE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4882	BPA-RP-DRG - NO COVERAGE
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4884	BPA-RP-DRG - AGE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4886	BPA-RP-DRG - CLAIM TYPE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4887	BPA-RP-DRG - PLACE OF SERVICE RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4904	BPA-RP-DRG - OTHER HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4917	BPA-PC-DRG - OTHER HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4953	BPA-RR-DRG - OTHER DTL DIAG RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4980	BPA-RP-PROC - BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4983	BPA-RR-DRG - OTHER HDR DIAGNOSIS RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4990	BPA-PC-PROC - BENEFIT PLAN RESTRICTION
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			6310	THE QUANTITY DISPENSED EXCEEDS THE MAXIMUM QUANTITY ALLOWED FOR THE DRUG CODE P RESCRIBED.
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			7503	CONFLICT CODE ON RESPONSE CLAIM DOES NOT MATCH
107	Processed according to contract/plan provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			7504	MISSING / INVALID INTERVENTION CODE
107	Processed according to contract/plan provisions.	175	PAYMENT DENIED BECAUSE THE PRESCRIPTION IS INCOMPLETE			7001	INFORMATIONAL PRODUR ALERT
107	Processed according to contract/plan provisions.	2	Coinsurance Amount			0434	MEDICARE COINSURANCE AMOUNT INVALID
107	Processed according to contract/plan provisions.	2	Coinsurance Amount			0451	NO CROSSOVER COINSURANCE OR DEDUCTIBLE DUE
107	Processed according to contract/plan provisions.	2	Coinsurance Amount			0833	CO-INSURANCE AMOUNT DOES NOT BALANCE
107	Processed according to contract/plan provisions.	38	Services not provided or authorized by designated (network/primary care) providers.			1821	MEDICAL LOCKIN - RECIPIENT LOCKED IN TO OTHER PROVIDER
107	Processed according to contract/plan provisions.	38	Services not provided or authorized by designated (network/primary care) providers.			1822	MEDICAL LOCKIN - LOCKIN DATES OVERLAP CLAIM DATES
107	Processed according to contract/plan provisions.	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			4070	BPA-RR-PROC -  MODIFIER RESTRICTION
107	Processed according to contract/plan provisions.	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			4256	BPA-RP-PROC - MODIFIER RESTRICTION
107	Processed according to contract/plan provisions.	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			4257	BPA-PC-PROC - MODIFIER RESTRICTION
107	Processed according to contract/plan provisions.	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			8553	THIS SERVICE REQUIRES THE USE OF A MODIFIER TO INDICATE ANATOMICAL SITE, DISTIN CT PROCEDURE, STAGED PROCEDURE OR REPEAT PROCEDURE.
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7501	DOSE DISPENSED ON THE RESPONSE CLAIM IS THE SAME AS ON THE ORIGINAL CLAIM
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7502	DRUG DISPENSED ON THE RESPONSE CLAIM IS THE SAME AS ON THE ORIGINAL CLAIM
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7505	MISSING/INVALID PRODUR OUTCOME CODE.  PLEASE USE 1A-1G, 2A OR 2B.
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7506	CLAIM CONTAINS A NON-OVERRIDEABLE ALERT
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7507	VALID OUTCOME CODE OF NOT FILLED RECEIVED.  RESPONSE ACCEPTED, CLAIM REJECTED
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7508	QUANTITY DISPENSED ON RESPONSE CLAIM SAME AS ORIGINAL CLAIM
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7510	OUTCOME CODE INDICATES PRESCRIPTION WAS "FILLED AS IS", BUT CHANGES WERE DETECT ED ON THE RESPONSE CLAIM FOR EITHER THE DAYS SUPPLY, QUANTITY, OR NDC
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7520	DD ProDUR alert; Unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7521	DD ProDUR alert; major severity; requires provider override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7522	DD ProDUR alert; moderate severity; requires provider override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7523	DD ProDUR alert; minor severity; requires provider override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7524	DD ProDUR alert; unspecified severity; requires provider override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7525	HD ProDUR alert; Unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7526	HD ProDUR alert; major severity; requires provider override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7527	HD ProDUR alert; moderate severity; requires provider override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7528	HD ProDUR alert; minor severity; requires provider override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7529	HD ProDUR alert; unspecified severity; requires provider override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7530	ER ProDUR alert; Unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7531	ER ProDUR alert; major severity; requires PA override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7532	ER ProDUR alert; moderate severity; requires PA override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7533	ER ProDUR alert; minor severity; requires PA override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7534	ER ProDUR alert; unspecified severity; requires PA override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7535	TD ProDUR alert; Unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7536	TD ProDUR alert; major severity; requires PA override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7537	TD ProDUR alert; moderate severity; requires PA override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7538	TD ProDUR alert; minor severity; requires PA override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7539	TD ProDUR alert; unspecified severity; requires PA override
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7540	PG ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7541	PG ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7542	PG ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7543	PG ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7544	PA ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7545	PA ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7546	PA ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7547	PA ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7548	LD ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7549	LD ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7550	LD ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7551	LD ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7552	MX ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7553	MX ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7554	MX ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7555	MX ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7556	MN ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7557	MN ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7558	MN ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7559	MN ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7560	DA ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7561	DA ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7562	DA ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7563	DA ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7564	LR ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7565	LR ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7566	LR ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7567	LR ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7568	ID ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7569	ID ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7570	ID ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7571	ID ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7572	DC/MC ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7573	DC/MC ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7574	DC/MC ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7575	DC/MC ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	5	The procedure code/bill type is inconsistent with the place of service.			4036	BPA-RP-PROC - PLACE OF SERVICE RESTRICTION
107	Processed according to contract/plan provisions.	57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's			5900	NCCI-MUE - QUANTITY BILLED EXCEEDS MAXIMUM QUANTITY ALLOWED.
107	Processed according to contract/plan provisions.	57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's			5910	NCCI - THIS PROCEDURE SHOULD NOT BE BILLED IN CONJUNCTION WITH ANOTHER PROCEDUR E ON THIS CLAIM.
107	Processed according to contract/plan provisions.	57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's			5911	NCCI - THIS PROCEDURE SHOULD NOT BE BILLED IN CONJUNCTION WITH A PROCEDURE ON A NOTHER CLAIM.
107	Processed according to contract/plan provisions.	57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's			5912	NCCI - THIS PROCEDURE SHOULD NOT BE BILLED IN CONJUNCTION WITH A PROCEDURE ON A NOTHER CLAIM.
107	Processed according to contract/plan provisions.	57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's			5920	NCCI - THIS PROCEDURE SHOULD NOT BE BILLED IN CONJUNCTION WITH ANOTHER PROCEDUR E ON THIS CLAIM.
107	Processed according to contract/plan provisions.	57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's			5921	NCCI - THIS PROCEDURE SHOULD NOT BE BILLED IN CONJUNCTION WITH A PROCEDURE ON A NOTHER CLAIM.
107	Processed according to contract/plan provisions.	57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's			5922	NCCI - THIS PROCEDURE SHOULD NOT BE BILLED IN CONJUNCTION WITH A PROCEDURE ON A NOTHER CLAIM.
107	Processed according to contract/plan provisions.	57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's			5930	NCCI- SVC IS A DUPE OF A SVC PREVIOUSLY BILLED.
107	Processed according to contract/plan provisions.	6	The procedure code is inconsistent with the patient's age.			2806	PREGNANCY INDICATOR IS INVALID FOR RECIPIENT SEX
107	Processed according to contract/plan provisions.	6	The procedure code is inconsistent with the patient's age.			4034	BPA-RP-PROC - AGE RESTRICTION
107	Processed according to contract/plan provisions.	6	The procedure code is inconsistent with the patient's age.			4714	BPA-PC-PROC - AGE RESTRICTION
107	Processed according to contract/plan provisions.	6	The procedure code is inconsistent with the patient's age.			4715	BPA-PC-REV - AGE RESTRICTION
107	Processed according to contract/plan provisions.	6	The procedure code is inconsistent with the patient's age.			4721	BPA-RP-DRG - ADMIT DIAG RESTRICTION
107	Processed according to contract/plan provisions.	6	The procedure code is inconsistent with the patient's age.			7002	CLAIM DENIED FOR PRODUR REASONS
107	Processed according to contract/plan provisions.	6	The procedure code is inconsistent with the patient's age.			7003	PRODUR ALERT REQUIRES PA FOR OVERRIDE
107	Processed according to contract/plan provisions.	6	The procedure code is inconsistent with the patient's age.			7004	NON-OVERRIDEABLE PRODUR ALERT
107	Processed according to contract/plan provisions.	6	The procedure code is inconsistent with the patient's age.			7503	CONFLICT CODE ON RESPONSE CLAIM DOES NOT MATCH
107	Processed according to contract/plan provisions.	7	The procedure code is inconsistent with the patient's gender.			4035	BPA-RP-PROC - GENDER RESTRICTION
107	Processed according to contract/plan provisions.	9	The diagnosis is inconsistent with the patient's age.			4030	BPA-RP-DIAG - AGE RESTRICTION
107	Processed according to contract/plan provisions.	9	The diagnosis is inconsistent with the patient's age.			4044	BPA-RR-DIAG - NO RULE FOR ASSOC AGE
107	Processed according to contract/plan provisions.	9	The diagnosis is inconsistent with the patient's age.			4711	BPA-PC-DIAG - AGE RESTRICTION
107	Processed according to contract/plan provisions.	9	The diagnosis is inconsistent with the patient's age.			4766	BPA-RP-ICD9 - AGE RESTRICTION
107	Processed according to contract/plan provisions.	92	Claim Paid in full.			9800	CUTBACK - CLAIM PROCESSED AS AN ENCOUNTER.
107	Processed according to contract/plan provisions.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.			3320	SERVICE INCLUDED IN FACILITY FEE
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7501	DOSE DISPENSED ON THE RESPONSE CLAIM IS THE SAME AS ON THE ORIGINAL CLAIM
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7502	DRUG DISPENSED ON THE RESPONSE CLAIM IS THE SAME AS ON THE ORIGINAL CLAIM
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7505	MISSING/INVALID PRODUR OUTCOME CODE.  PLEASE USE 1A-1G, 2A OR 2B.
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7506	CLAIM CONTAINS A NON-OVERRIDEABLE ALERT
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7507	VALID OUTCOME CODE OF NOT FILLED RECEIVED.  RESPONSE ACCEPTED, CLAIM REJECTED
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7508	QUANTITY DISPENSED ON RESPONSE CLAIM SAME AS ORIGINAL CLAIM
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7510	OUTCOME CODE INDICATES PRESCRIPTION WAS "FILLED AS IS", BUT CHANGES WERE DETECT ED ON THE RESPONSE CLAIM FOR EITHER THE DAYS SUPPLY, QUANTITY, OR NDC
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7520	DD ProDUR alert; Unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7521	DD ProDUR alert; major severity; requires provider override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7522	DD ProDUR alert; moderate severity; requires provider override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7523	DD ProDUR alert; minor severity; requires provider override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7524	DD ProDUR alert; unspecified severity; requires provider override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7525	HD ProDUR alert; Unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7526	HD ProDUR alert; major severity; requires provider override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7527	HD ProDUR alert; moderate severity; requires provider override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7528	HD ProDUR alert; minor severity; requires provider override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7529	HD ProDUR alert; unspecified severity; requires provider override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7530	ER ProDUR alert; Unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7531	ER ProDUR alert; major severity; requires PA override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7532	ER ProDUR alert; moderate severity; requires PA override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7533	ER ProDUR alert; minor severity; requires PA override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7534	ER ProDUR alert; unspecified severity; requires PA override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7535	TD ProDUR alert; Unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7536	TD ProDUR alert; major severity; requires PA override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7537	TD ProDUR alert; moderate severity; requires PA override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7538	TD ProDUR alert; minor severity; requires PA override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7539	TD ProDUR alert; unspecified severity; requires PA override
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7540	PG ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7541	PG ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7542	PG ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7543	PG ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7544	PA ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7545	PA ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7546	PA ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7547	PA ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7548	LD ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7549	LD ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7550	LD ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7551	LD ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7552	MX ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7553	MX ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7554	MX ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7555	MX ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7556	MN ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7557	MN ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7558	MN ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7559	MN ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7560	DA ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7561	DA ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7562	DA ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7563	DA ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7564	LR ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7565	LR ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7566	LR ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7567	LR ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7568	ID ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7569	ID ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7570	ID ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7571	ID ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7572	DC/MC ProDUR alert; unspecified
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7573	DC/MC ProDUR alert; major severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7574	DC/MC ProDUR alert; moderate severity;
107	Processed according to contract/plan provisions.	A2	Contractual adjustment.			7575	DC/MC ProDUR alert; minor severity;
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			5215	DME PROCEDURE - LIMIT 400 PER CAL MO
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			5216	COMBINATION VACCINES/SINGLE COMPONENT CONTRA
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			5217	SINGLE COMPONENT/COMBINATION VACCINES CONTRA
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			5653	SURGERY/CASTING & STRAPPING CONTRA
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6060	DENTAL BITEWING X-RAYS - LIMIT 1 PER 6 CAL MO
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6061	DENTAL PROCEDURE LIMIT - 1 PER DATE OF SERVICE
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6127	DME PROCEDURE LIMITED TO 400 PER CALENDAR MONTH
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6145	DME NON-INSULIN PROC LIMIT OF 2 PER 3 CAL MO
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6146	DME NON-INSULIN PROC LIMIT OF 1 PER 3 CAL MO
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6147	DME INSULIN PROC LIMIT OF 4 PER CAL MO
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6148	DME INSULIN PROC LIMIT OF 3 PER CAL MO
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6149	DME INSULIN PROC LIMIT OF 2 PER CAL MO
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6304	OBSTETRICAL CARE LIMIT FOR SPECIALTY 921
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6543	PSYCHOLOGY/REHAB - PSYCHOLOGY DX TESTING
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6544	PSYCHOLOGY/REHAB - NEUROPSYCHOLOGY DX TESTING
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6545	PSYCHOLOGY/REHAB - MENTAL HEALTH DX TESTING
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6546	PSYCHOLOGY/REHAB - PPSYCHOLOGY LIMIT 52 A YEAR
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6547	PSYCHOLOGY/REHAB - INDIVIDUAL THERAPY 1 PER WEEK
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6548	PSYCHOLOGY/REHAB - GROUP THERAPY 1 PER WEEK
107	Processed according to contract/plan provisions.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			6661	PACE GLOBAL FEE LIMITED TO ONE PER MONTH
107	Processed according to contract/plan provisions.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			4068	BPA-RR - NO RULE CURR BILL PROV CONTRACT
107	Processed according to contract/plan provisions.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			4094	BPA-PC-REV -  PROV COUNTY RESTRICTION
107	Processed according to contract/plan provisions.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			4526	BPA-PC-PROC -  PROV COUNTY RESTRICTION
107	Processed according to contract/plan provisions.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			4563	BPA-RR - NO RULE CURR PERF PROV CONTRACT
108	Coverage has been canceled for this entity.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.			1813	PROVIDER SUSPENDED FOR OUTSTANDING CREDIT BALANCE
109	Entity not eligible.	30	Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.			2002	RECIPIENT NOT ELIGIBLE FOR HEADER DATE OF SERVICE
109	Entity not eligible.	30	Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.			2009	RECIPIENT INELIGIBLE ON DATE OF SERVICE
109	Entity not eligible.	6	The procedure code is inconsistent with the patient's age.			1806	EPSDT REFERRED SVCS RESTRICTED TO RECIPIENTS UNDER
109	Entity not eligible.	6	The procedure code is inconsistent with the patient's age.			1812	RECIPIENT / ADMIT AGE GREATER THAN 21
109	Entity not eligible.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			1814	BILLING PROVIDER NOT VALID FOR DATES OF SERVICE
117	Claim requires signature-on-file indicator.	29	The time limit for filing has expired.			0556	SERVICE(S) PAST THE MAXIMUM MEDICAID FILING LIMIT
121	Service line number greater than maximum allowable for payer.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0247	MAXIMUM NUMBER OF CLAIM DETAILS EXCEEDED
122	Missing/invalid data prevents payer from processing claim.	1	DEDUCTIBLE AMOUNT			0922	TABLE ENTRY MISSING T_MCARE_DEDUCTIBLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0904	GROUP NUMBER NOT FOUND IN MODIFIER GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0907	GROUP NUMBER NOT FOUND IN DRUG GROUP TABLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0910	BENEFIT PLAN GROUP NOT FOUND
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0911	INTERNAL PROCESSING ERROR - CONTACT HP
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0912	INTERNAL ERROR-DOLLAR DISTRIBUTION
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0920	DRUG THERAPEUTIC CLASS GROUP NOT FOUND
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0922	TABLE ENTRY MISSING T_MCARE_DEDUCTIBLE
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			2054	UNABLE TO DETERMINE FUND CODE - DETAIL
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			2055	UNABLE TO DETERMINE AID CAT OR COUNTY
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			3102	ONLINE PA PROCESS TIMEOUT OR INTERFACE PROBLEM
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			3103	ONLINE PA PROCESS RESPONSE FROM HID HAD ERRORS
122	Missing/invalid data prevents payer from processing claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			3310	DISPENSING FEE NOT LOCATED
122	Missing/invalid data prevents payer from processing claim.	6	The procedure code is inconsistent with the patient's age.			3102	ONLINE PA PROCESS TIMEOUT OR INTERFACE PROBLEM
122	Missing/invalid data prevents payer from processing claim.	6	The procedure code is inconsistent with the patient's age.			3103	ONLINE PA PROCESS RESPONSE FROM HID HAD ERRORS
122	Missing/invalid data prevents payer from processing claim.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			0907	GROUP NUMBER NOT FOUND IN DRUG GROUP TABLE
142	Entity's license/certification number.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.			1026	PRESCRIBING PHYSICIAN LICENSE NUMBER NOT ON FILE
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1902	TAXONOMY IS INVALID REFERRING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1903	TAXONOMY IS INVALID: FACILITY PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1905	TAXONOMY IS INVALID: OTHER PROVIDER 2
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1908	TAXONOMY IS NOT VALID FOR REFERRING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1909	TAXONOMY IS NOT VALID FOR FACILITY PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1911	TAXONOMY IS NOT VALID FOR OTHER PROVIDER 2
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1914	TAXONOMY IS MISSING: REFERRING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1915	TAXONOMY IS MISSING: FACILITY PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1917	TAXONOMY IS MISSING: OTHER PROVIDER 2
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1918	TAXONOMY IS INVALID: DTL OTHER PROVIDER 2
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1920	TAXONOMY IS INVALID: DTL REFERRING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1922	TAXONOMY IS MISSING: DTL REFERRING PROVIDER
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1923	TAXONOMY IS MISSING: DTL OTHER PROVIDER 2
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1924	TAXONOMY IS NOT VALID FOR DTL OTHER PROVIDER 2
145	Entity's specialty code.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1926	TAXONOMY IS NOT VALID FOR DTL REFERRING PROVIDER
145	Entity's specialty code.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.			1809	REFERRING PROVIDER-NO SCREENING SPECIALTY FOR DOS
145	Entity's specialty code.	A2	Contractual adjustment.			1902	TAXONOMY IS INVALID REFERRING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.			1903	TAXONOMY IS INVALID: FACILITY PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.			1905	TAXONOMY IS INVALID: OTHER PROVIDER 2
145	Entity's specialty code.	A2	Contractual adjustment.			1908	TAXONOMY IS NOT VALID FOR REFERRING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.			1909	TAXONOMY IS NOT VALID FOR FACILITY PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.			1911	TAXONOMY IS NOT VALID FOR OTHER PROVIDER 2
145	Entity's specialty code.	A2	Contractual adjustment.			1914	TAXONOMY IS MISSING: REFERRING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.			1915	TAXONOMY IS MISSING: FACILITY PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.			1917	TAXONOMY IS MISSING: OTHER PROVIDER 2
145	Entity's specialty code.	A2	Contractual adjustment.			1918	TAXONOMY IS INVALID: DTL OTHER PROVIDER 2
145	Entity's specialty code.	A2	Contractual adjustment.			1920	TAXONOMY IS INVALID: DTL REFERRING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.			1922	TAXONOMY IS MISSING: DTL REFERRING PROVIDER
145	Entity's specialty code.	A2	Contractual adjustment.			1923	TAXONOMY IS MISSING: DTL OTHER PROVIDER 2
145	Entity's specialty code.	A2	Contractual adjustment.			1924	TAXONOMY IS NOT VALID FOR DTL OTHER PROVIDER 2
145	Entity's specialty code.	A2	Contractual adjustment.			1926	TAXONOMY IS NOT VALID FOR DTL REFERRING PROVIDER
15	One or more originally submitted procedure code have been modified.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			7217	PROCEDURE CODE HAS BEEN REBUNDLED
15	One or more originally submitted procedure code have been modified.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			7218	PROCEDURE ADDED DUE TO REBUNDLING
15	One or more originally submitted procedure code have been modified.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			7238	PROCEDURE ADDED DUE TO DUPLICATE REBUNDLING
15	One or more originally submitted procedure code have been modified.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			7245	PROCEDURE ADDED DUE TO NEW VISIT FREQUENCY CODE REPLACEMENT
15	One or more originally submitted procedure code have been modified.	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			7256	MODIFIER 51 INVALID FOR PRIMARY PROCEDURE
15	One or more originally submitted procedure code have been modified.	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			7257	MODIFIER 51 MISSING FOR NON-PRIMARY PROCEDURE
153	Entity's id number.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			7268	PROVIDER IS REQUIRED FOR HISTORY PROCEDURES
158	Entity's date of birth	14	The date of birth follows the date of service.			2805	DOS PRIOR TO DOB
158	Entity's date of birth	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			7278	INVALID DATE (DATE OF BIRTH)
164	Entity's contract/member number.	57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's			0829	DAYS SUPPLY > 3 FOR EMERGENCY PHARMACY CLAIM
164	Entity's contract/member number.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			0824	UNBORN RECIPIENT PENDING ELIGIBILITY VERIFICATION
171	Other insurance coverage information (health, liability, auto, etc.).	88	Adjustment amount represents collection against receivable created in prior overpayment.			8128	AGENCY INITIATED OFFSET DUE TO MEDICARE
171	Other insurance coverage information (health, liability, auto, etc.).	88	Adjustment amount represents collection against receivable created in prior overpayment.			8235	AGENCY INITIATED OFFSET DUE TO THIRD PARTY COVERAGE
171	Other insurance coverage information (health, liability, auto, etc.).	88	Adjustment amount represents collection against receivable created in prior overpayment.			8989	AGENCY INITIATED OFFSET DUE TO MEDICARE
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0241	ACCIDENT INDICATOR IS INVALID
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0536	BILLED DATE IS PRIOR TO DATES OF SERVICE
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0568	DISCHARGE DATE IS LESS THAN ADMIT DATE
187	Date(s) of service.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1019	MULTIPLE RATES FOR LEVEL OF CARE - RATE CHANGE OVERLAPS SERVICE DATES; SPLIT BI LL.
20	Accepted for processing.	100	PAYMENT MADE TO PATIENT/INSURED/RESPONSIBLE PARTY/EMPLOYER.			0545	PHARMACY CLAIM FILED BEYOND 365-DAY FILING
20	Accepted for processing.	101	Predetermination: anticipated payment upon completion of services or claim adjudication.			3599	MANUAL PRICING REQUIRED
20	Accepted for processing.	123	Payer refund due to overpayment.			8225	CAPITATION - DEATH OF RECIPIENT
20	Accepted for processing.	123	Payer refund due to overpayment.			8226	CAPITATION - RECIPIENT INCARCERATED
20	Accepted for processing.	123	Payer refund due to overpayment.			8300	A PAYOUT HAS BEEN ESTABLISHED FOR THE PROVIDER.  THE REIMBURSEMENT IS INCLUDED  IN THE CHECKWRITE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8301	A PAYOUT HAS BEEN ESTABLISHED FOR THE PROVIDER.  THE REIMBURSEMENT HAS BEEN EXC LUDED FROM THE CHECKWRITE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8302	A PAYOUT IS DUE TO THE PROVIDER AS A RESULT OF OVER REFUND.  THE REIMBURSEMENT  IS INCLUDED IN THE CHECKWRITE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8303	A PAYOUT IS DUE TO THE PROVIDER AS A RESULT OF OVER PAYMENT.  THE REIMBURSEMENT HAS BEEN EXCLUDED FROM THE CHECKWRITE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8304	PAYOUT DUE TO ADVANCE.  PAYMENT INCLUDED IN CHECKWRITE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8305	PAYOUT DUE TO ADVANCE.  PAYMENT EXCLUDED FROM CHECKWRITE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8306	CHECK RECEIVED BY EDS FOR CLAIM ADJUSTMENT ON A PREVIOUSLY ADJUSTED CLAIM.  AMO UNT OF REFUND BEING RETURNED TO PROVIDER.
20	Accepted for processing.	123	Payer refund due to overpayment.			8307	PAYOUT EXCLUDED FROM CHECKWRITE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8435	AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED DUE TO PATIENT LIABILITY ERROR.
20	Accepted for processing.	123	Payer refund due to overpayment.			8436	AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED DUE TO PATIENT SPENDDOWN ERROR.
20	Accepted for processing.	123	Payer refund due to overpayment.			8437	AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED DUE TO PHARMACY DIVISION REVIEW.
20	Accepted for processing.	123	Payer refund due to overpayment.			8438	AS THE RESULT OF A SURS AUDIT, AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED. THE  AMOUNT WILL BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	123	Payer refund due to overpayment.			8439	AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED DUE TO THIRD PARTY LIABILITY.
20	Accepted for processing.	123	Payer refund due to overpayment.			8440	SAVE FOR FUTURE USE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8441	SAVE FOR FUTURE USE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8442	SAVE FOR FUTURE USE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8444	SAVE FOR FUTURE USE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8445	SAVE FOR FUTURE USE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8446	SAVE FOR FUTURE USE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8448	SAVE FOR FUTURE USE.
20	Accepted for processing.	123	Payer refund due to overpayment.			8451	DUE TO AN ADJUSTMENT SUBMITTED BY PROVIDER FOR A CLAIM TOO OLD TO PROCESS, AN A CCOUNT RECEIVABLE HAS BEEN ESTABLISHED. THE AMOUNT WILL BE DEDUCTED FROM YOUR P AYMENTS.
20	Accepted for processing.	123	Payer refund due to overpayment.			8511	DECREASE TO ORIGINAL LIEN AMOUNT RECEIVED BY LIEN HOLDER.
20	Accepted for processing.	123	Payer refund due to overpayment.			8512	DECREASE TO ORIGINAL LIEN AMOUNT DUE TO PAYMENT RECEIVED.
20	Accepted for processing.	123	Payer refund due to overpayment.			8514	RELEASE OF LIEN RECEIVED BY LIEN HOLDER.
20	Accepted for processing.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			3317	CLAIM QUANTITY EXCEEDS NDC MAX UNITS
20	Accepted for processing.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			8048	SAVE FOR FUTURE USE.
20	Accepted for processing.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			8068	PROVIDER SENT REFUND PAYMENT DUE TO SURS REVIEW.
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.			3321	NO PRICING SEGMENT ON FILE - CONTACT MYERS AND STAUFFER AT 1-800-591-1183.
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.			3800	SERVICE COVERAGE HAS NOT BEEN DETERMINED
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.			4127	CANNOT PRIORITIZE RECIPIENT'S PROGRAMS
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.			6674	CLAIM STILL IN PROCESS.  PLEASE DO NOT REBILL.
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.			7289	SMARTSUSPENSE MONITOR
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.			7509	REVIEW CLAIMS FOR THIS PROVIDER
20	Accepted for processing.	133	The disposition of this claim/service is pending further review.			8998	CLAIM BEING REVIEWED
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			2590	SYSTEM ERROR - COULD NOT ASSIGN TPL INPUT CODE
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			2591	SYSTEM ERROR - COULD NOT ASSIGN TPL INPUT CODE
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			3800	SERVICE COVERAGE HAS NOT BEEN DETERMINED
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			3997	BPA-RR-DRG - ANY HDR DIAGNOSIS RESTRICTION
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			7500	REVIEW CLAIM FOR PAY-TO- PROVIDER
20	Accepted for processing.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			9500	COVERED DAYS ON THIS CLAIM HAVE BEEN SYSTEMATICALLY REDUCED TO MEET THE ALLOWED
20	Accepted for processing.	18	Duplicate claim/service.			6674	CLAIM STILL IN PROCESS.  PLEASE DO NOT REBILL.
20	Accepted for processing.	199	Revenue code and Procedure code do not match.			3301	BILL EMERGENCY PROCEDURE/REVENUE TOGETHER
20	Accepted for processing.	23	Payment adjusted because charges have been paid by another payer.			8220	FULL REFUND
20	Accepted for processing.	23	Payment adjusted because charges have been paid by another payer.			8221	PARTIAL REFUND
20	Accepted for processing.	23	Payment adjusted because charges have been paid by another payer.			8222	SAVE FOR FUTURE USE
20	Accepted for processing.	29	The time limit for filing has expired.			8411	SAVE FOR FUTURE USE
20	Accepted for processing.	30	Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.			8330	PAYOUT DUE TO ELIGIBILITY NOT ON FILE.
20	Accepted for processing.	35	Benefit maximum has been reached.			7260	MORE THAN 40 LINES WERE ELIGIBLE FOR CLAIMCHECK PROCESSING
20	Accepted for processing.	38	Services not provided or authorized by designated (network/primary care) providers.			1823	WAIVER ASSIGNMENT DATES OVERLAP CLAIM DATES
20	Accepted for processing.	38	Services not provided or authorized by designated (network/primary care) providers.			1824	LTC ASSIGNMENT DATES OVERLAP CLAIM DATES
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			4195	PROCEDURE RESTRICTION FOR COVERED REV CODE
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			4200	CLAIM PRICED AT ZERO
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			4967	GENDER RESTRICTION FOR COVERED REV CODE
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7240	SMARTSUSPENSE SUSPEND
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8230	CAPITATION - INCORRECT RATE CATEGORY
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8231	CAPITATION - DEMOGRAPHIC CHANGE
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8232	CAPITATION - OTHER
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8233	SAVE FOR FUTURE USE.
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8234	SAVE FOR FUTURE USE.
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8321	PAYOUT DUE TO PATIENT SPENDDOWN ERROR
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8322	PAYOUT DUE TO ENHANCED RATE-OUT OF STATE RTC SERVICES
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8323	PAYOUT DUE TO NON-EMERGENCY TRANSPORTATION
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8324	PAYOUT DUE TO OTHER PROGRAM.
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8325	PAYOUT DUE TO GAS  SURCHARGE.
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8326	PAYOUT DUE TO CORRECTION TO ACCOUNTS RECEIVABLE PROCESSED.
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8328	PAYOUT DUE TO DHS/DDSD AUDIT
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8329	PAYOUT PROCESSED FROM STATE ONLY FUNDS
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8331	PAYOUT DUE TO CLAIM TOO OLD TO PROCESS
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8332	PAYOUT DUE TO MISCELLANEOUS OR UNSPECIFIED REASON.
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8428	AS THE RESULT OF A FINANCIAL MANAGEMENT REVIEW, AN ACCOUNTS RECEIVABLE HAS BEEN  ESTABLISHED. THE AMOUNT WILL BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			8510	CYCLE ACTIVITY
20	Accepted for processing.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.			8327	PAYOUT DUE TO DHS/DDSD SUPPORTED LIVING PROGRAM AUDIT.
20	Accepted for processing.	6	The procedure code is inconsistent with the patient's age.			4164	INACTIVE DRUG
20	Accepted for processing.	6	The procedure code is inconsistent with the patient's age.			7200	MISCELLANEOUS CLAIMCHECK ERROR
20	Accepted for processing.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.			3001	PA NOT FOUND ON DATABASE
20	Accepted for processing.	63	Correction to a prior claim.			4131	NO BENEFIT PLANS ASSOCIATED TO PAYER
20	Accepted for processing.	63	Correction to a prior claim.			8000	PROVIDER REQUESTED ADDITIONAL PAYMENT DUE TO BILLING ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8001	PROVIDER REQUESTED ADDITIONAL PAYMENT DUE TO CHANGE IN OTHER.
20	Accepted for processing.	63	Correction to a prior claim.			8002	PROVIDER REQUESTED ADDITIONAL PAYMENT DUE TO CHANGE IN MEDICARE.
20	Accepted for processing.	63	Correction to a prior claim.			8003	PROVIDER REQUESTED ADDITIONAL PAYMENT DUE TO KEYING ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8004	PROVIDER REQUESTED ADDITIONAL PAYMENT DUE TO PATIENT LIABILITY.
20	Accepted for processing.	63	Correction to a prior claim.			8005	PROVIDER REQUESTED ADDITIONAL PAYMENT DUE TO SPENDDOWN.
20	Accepted for processing.	63	Correction to a prior claim.			8006	PROVIDER REQUESTED ADDITIONAL PAYMENT DUE TO MISCELLANEOUS ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8007	PROVIDER REQUESTED CLAIM ADJUSTMENT DUE TO BILLING ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8008	PROVIDER REQUESTED CLAIM ADJUSTMENT DUE TO MISC. OR UNSPECIFIED ERROR
20	Accepted for processing.	63	Correction to a prior claim.			8019	PROVIDER REQUESTED A FULL OFFSET DUE TO A MISCELLANEOUS OR UNSPECIFIED ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8020	SURS INITIATED A FULL OFFSET DUE TO A DUPLICATE PAYMENT.
20	Accepted for processing.	63	Correction to a prior claim.			8021	SURS INITIATED A FULL OFFSET DUE TO WRONG PROVIDER.
20	Accepted for processing.	63	Correction to a prior claim.			8022	SURS INITIATED A FULL OFFSET DUE TO WRONG RECIPIENT NUMBER.
20	Accepted for processing.	63	Correction to a prior claim.			8023	SURS INITIATED A FULL OFFSET DUE TO WRONG NDC/PROCEDURE CODE/MODIFIER CODE
20	Accepted for processing.	63	Correction to a prior claim.			8024	SURS INITIATED A FULL OFFSET DUE TO WRONG UNITS OF SERVICE.
20	Accepted for processing.	63	Correction to a prior claim.			8025	SURS INITIATED A FULL OFFSET DUE TO WRONG PATIENT LIABILITY AMOUNT.
20	Accepted for processing.	63	Correction to a prior claim.			8026	SURS INITIATED A FULL OFFSET DUE TO PAYMENT IN FULL FROM ANOTHER  INSURANCE.
20	Accepted for processing.	63	Correction to a prior claim.			8027	SURS INITIATED A FULL OFFSET DUE TO PAYMENT IN FULL FROM MEDICARE.
20	Accepted for processing.	63	Correction to a prior claim.			8028	SURS INITIATED A FULL OFFSET DUE TO WRONG DATE(S) OF SERVICE.
20	Accepted for processing.	63	Correction to a prior claim.			8039	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8040	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8041	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8042	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8043	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8045	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8046	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8047	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8049	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8050	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8059	PROVIDER SENT A FULL REFUND DUE TO MISCELLANEOUS OR UNSPECIFIED ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8060	PROVIDER SENT REFUND DUE TO BILLING ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8061	PROVIDER SENT REFUND DUE TO CLAIMS PROCESSING ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8062	PROVIDER SENT REFUND DUE TO DUPLICATE PAYMENT.
20	Accepted for processing.	63	Correction to a prior claim.			8063	PROVIDER SENT REFUND DUE TO EFT DEPOSIT ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8064	PROVIDER SENT REFUND DUE TO MEDICARE.
20	Accepted for processing.	63	Correction to a prior claim.			8065	PROVIDER SENT REFUND DUE TO OFMQ REVIEW.
20	Accepted for processing.	63	Correction to a prior claim.			8066	PROVIDER SENT REFUND DUE TO OTHER INSURANCE.
20	Accepted for processing.	63	Correction to a prior claim.			8067	PROVIDER SENT REFUND DUE TO SURS REVIEW.
20	Accepted for processing.	63	Correction to a prior claim.			8069	PROVIDER SENT REFUND DUE TO LEGAL SETTLEMENT.
20	Accepted for processing.	63	Correction to a prior claim.			8081	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8082	NON-CLAIM SPECIFIC REFUND DUE TO BILLING ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8083	NON-CLAIM SPECIFIC REFUND DUE TO OTHER INSURANCE.
20	Accepted for processing.	63	Correction to a prior claim.			8084	NON-CLAIM SPECIFIC REFUND DUE TO SURS.
20	Accepted for processing.	63	Correction to a prior claim.			8085	NON-CLAIM SPECIFIC REFUND DUE TO MISC OR UNSPECIFIED ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8086	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8087	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8099	AGENCY REQUESTED REFUND DUE TO LEGAL SETTLEMENT
20	Accepted for processing.	63	Correction to a prior claim.			8100	AGENCY REQUESTED REFUND DUE TO MEDICAID FRAUD.
20	Accepted for processing.	63	Correction to a prior claim.			8104	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8119	AGENCY INITIATED OFFSET DUE TO DISPROPORTIONATE SHARE ADJUS
20	Accepted for processing.	63	Correction to a prior claim.			8120	AGENCY INITIATED OFFSET DUE TO DRUG REBATE.
20	Accepted for processing.	63	Correction to a prior claim.			8121	AGENCY INITIATED OFFSET DUE TO FINANCIAL MANAGEMENT DIVISION REVIEW
20	Accepted for processing.	63	Correction to a prior claim.			8122	AGENCY INITIATED OFFSET DUE TO FQHC
20	Accepted for processing.	63	Correction to a prior claim.			8123	AGENCY INITIATED OFFSET DUE TO JUVENILE JUSTICE.
20	Accepted for processing.	63	Correction to a prior claim.			8124	AGENCY INITIATED OFFSET DUE TO KEYING ERROR
20	Accepted for processing.	63	Correction to a prior claim.			8125	AGENCY INITIATED OFFSET DUE TO LEGAL SETTLEMENT.
20	Accepted for processing.	63	Correction to a prior claim.			8126	AGENCY INITIATED OFFSET DUE TO MEDICAID FRAUD.
20	Accepted for processing.	63	Correction to a prior claim.			8127	AGENCY INITIATED OFFSET DUE TO MEDICAL REVIEW.
20	Accepted for processing.	63	Correction to a prior claim.			8141	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8142	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8143	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8144	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8145	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8146	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8147	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8159	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO MEDICAL AUTHORIZATION
20	Accepted for processing.	63	Correction to a prior claim.			8160	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO MEDICARE
20	Accepted for processing.	63	Correction to a prior claim.			8161	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO OTHER INSURANCE
20	Accepted for processing.	63	Correction to a prior claim.			8162	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO PATIENT LIABILITY.
20	Accepted for processing.	63	Correction to a prior claim.			8163	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO PROCESSING ERROR
20	Accepted for processing.	63	Correction to a prior claim.			8164	AGENCY INITIATED ADDITIONAL PAYMENT DUE TO RATE CHANGE
20	Accepted for processing.	63	Correction to a prior claim.			8165	AGENCY INITIATED ADDTNL PYMNT DUE TO MISC OR UNSPEC ERROR
20	Accepted for processing.	63	Correction to a prior claim.			8166	EDS INITIATED ADDITIONAL PAYMENT DUE TO PROCESSING ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8167	EDS INITIATED ADJUSTMENTS DUE TO PROCESSING ERROR.
20	Accepted for processing.	63	Correction to a prior claim.			8179	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8180	MASS ADJUSTMENT - INPATIENT HOSPITAL RATE CHANGE.
20	Accepted for processing.	63	Correction to a prior claim.			8181	MASS ADJUSTMENT - OUTPATIENT HOSPITAL RATE CHANGE
20	Accepted for processing.	63	Correction to a prior claim.			8182	MASS ADJUSTMENT- INDIAN HOSPITAL RATE CHANGE.
20	Accepted for processing.	63	Correction to a prior claim.			8183	MASS ADJUSTMENT - RURAL HEALTH CLINIC RATE CHANGE.
20	Accepted for processing.	63	Correction to a prior claim.			8185	MASS ADJUSTMENT - RETROACTIVE RATE CHANGE.
20	Accepted for processing.	63	Correction to a prior claim.			8186	MASS ADJUSTMENT PROVIDER BILLING ERROR (RATE CHANGE).
20	Accepted for processing.	63	Correction to a prior claim.			8187	MASS ADJUSTMENT - OTHER REQUEST
20	Accepted for processing.	63	Correction to a prior claim.			8199	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8200	CORRECTION TO A PRIOR CLAIM
20	Accepted for processing.	63	Correction to a prior claim.			8201	DUPLICATE PAYMENT
20	Accepted for processing.	63	Correction to a prior claim.			8202	CLAIM BILLED IN ERROR
20	Accepted for processing.	63	Correction to a prior claim.			8203	BILLED UNDER WRONG RECIPIENT
20	Accepted for processing.	63	Correction to a prior claim.			8204	PRIMARY INSURANCE PAYMENT RECEIVED
20	Accepted for processing.	63	Correction to a prior claim.			8205	PROVIDER TO REBILL
20	Accepted for processing.	63	Correction to a prior claim.			8206	DUE TO MEDICARE PRIMARY
20	Accepted for processing.	63	Correction to a prior claim.			8207	RECOUPMENT OTHER
20	Accepted for processing.	63	Correction to a prior claim.			8223	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8224	SAVE FOR FUTURE USE.
20	Accepted for processing.	63	Correction to a prior claim.			8229	CAPITATION - FAMILY PLANNING
20	Accepted for processing.	63	Correction to a prior claim.			8299	ADJUSTMENT TO CROSSOVER PAID PRIOR TO AIM IMPLEMENTATION DATE.  THIS CLAIM HAS  BEEN MANUALLY PRICED USING THE MEDICARE COINSURANCE, DEDUCTIBLE, AND PSYCHE RED
20	Accepted for processing.	85	Interest amount.			8336	RETROACTIVE INTEREST PAYMENT
20	Accepted for processing.	85	Interest amount.			8410	SAVE FOR FUTURE USE
20	Accepted for processing.	85	Interest amount.			8431	AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED DUE TO MANAGED CARE ADJUSTMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8400	ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED .  THE AMOUNT WILL BE DEDUCTED FROM YO UR FUTURE PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8401	DUE TO A CHECK ADVANCE, AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED. THE AMOUNT  WILL BE DEDUCTED FROM YOUR FUTURE PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8402	DUE TO AN IRS LIEN, AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED. THE AMOUNT WIL L BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8403	DUE TO A GARNISHMENT, AN  ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED. THE AMOUNT  WILL BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8404	DUE TO A LIABILITY & CASUALTY LIEN, AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED . THE AMOUNT WILL BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8405	DUE TO A LIEN, AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED. THE AMOUNT WILL BE  DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8406	DUE TO TAX ASSESSMENT (31%), AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED. THE A MOUNT WILL BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8407	RELEASE OF LIEN RECEIVED BY LIEN HOLDER
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8408	DECREASE TO ORIGINAL LIEN AMOUNT.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8409	INCREASE TO ORIGINAL LIEN AMOUNT
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8412	SAVE FOR FUTURE USE
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8413	SAVE FOR FUTURE USE
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8414	SAVE FOR FUTURE USE
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8415	SAVE FOR FUTURE USE .
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8419	SAVE FOR FUTURE USE
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8420	AS THE RESULT OF AN AUDIT DIVISION REVIEW, AN ACCOUNTS RECEIVABLE HAS BEEN ESTA BLISHED. THE AMOUNT WILL BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8421	AS THE RESULT OF CLAIMS PROCESSING ERROR, AN ACCOUNTS RECEIVABLE HAS BEEN ESTAB LISHED. THE AMOUNT WILL BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8424	AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED DUE TO DHS/CHILD WELFARE.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8427	AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED DUE TO DRUG REBATE..
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8429	AS THE RESULT OF A LEGAL SETTLEMENT, AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHE D. THE AMOUNT WILL BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8430	AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED DUE TO LONG TERM CARE FACILITY CLAI M PROCESSING ERROR.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8432	AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED DUE TO MEDICAID FRAUD.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8433	AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED DUE TO MEDICAL DIVISION REVIEW.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8434	AS THE RESULT OF AN OFMQ REVIEW, AN ACCOUNTS RECEIVABLE HAS BEEN ESTABLISHED. T HE AMOUNT WILL BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8443	SAVE FOR FUTURE USE.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8447	SAVE FOR FUTURE USE.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8449	SAVE FOR FUTURE USE.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8500	PAYMENT WITHHELD DUE TO A LIEN THAT WAS ESTABLISHED FROM A COURT ORDER.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8501	PAYMENT WITHHELD DUE TO AN IRS LEVY ESTABLISHED.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8502	PAYMENT WITHHELD DUE TO A LIEN THAT WAS ESTABLISHED FROM OTHER LEGAL ENTITY.
20	Accepted for processing.	88	Adjustment amount represents collection against receivable created in prior overpayment.			8513	INCREASE TO ORIGINAL LIEN AMOUNT RECEIVED BY LIEN HOLDER.
20	Accepted for processing.	92	Claim Paid in full.			0435	MEDICARE BLOOD DEDUCTIBLE AMOUNT INVALID
20	Accepted for processing.	92	Claim Paid in full.			0565	HEADER PAID AMOUNT IS GREATER THAN BILLED AMOUNT
20	Accepted for processing.	92	Claim Paid in full.			2011	PHARMCY MEDICAL/NON-MEDICAL SUPPL. AND ROUTINE DME
20	Accepted for processing.	92	Claim Paid in full.			3010	OUT OF STATE PROVIDER REQUIRES PRIOR AUTHORIZATION
20	Accepted for processing.	92	Claim Paid in full.			3021	DRG REQUIRES PA
20	Accepted for processing.	92	Claim Paid in full.			4015	PASARR ASSESSMENT PROCEDURE FOR REVIEW
20	Accepted for processing.	92	Claim Paid in full.			4027	DIAGNOSIS CODE NOT COVERED FOR DATE OF SERVICE
20	Accepted for processing.	92	Claim Paid in full.			4099	DRG NOT ON FILE
20	Accepted for processing.	92	Claim Paid in full.			4113	UNIT DOSE PACKAGING COVERED FOR LTC RESIDENTS ONLY
20	Accepted for processing.	92	Claim Paid in full.			4132	DRG GROUPER UNABLE TO ASSIGN DRG FOR PRICING
20	Accepted for processing.	92	Claim Paid in full.			4200	CLAIM PRICED AT ZERO
20	Accepted for processing.	92	Claim Paid in full.			7287	DIAGNOSIS IS ELIGIBLE FOR WORKER'S COMPENSATION/AUTO PAYOR
20	Accepted for processing.	96	Non-covered charge(s).			4164	INACTIVE DRUG
20	Accepted for processing.	A1	Claim/Service denied.			8515	THIS CLAIM HAS BEEN DENIED DUE TO A POS REVERSAL TRANSACTION.
20	Accepted for processing.	A2	Contractual adjustment.			0545	PHARMACY CLAIM FILED BEYOND 365-DAY FILING
20	Accepted for processing.	A2	Contractual adjustment.			4195	PROCEDURE RESTRICTION FOR COVERED REV CODE
20	Accepted for processing.	A2	Contractual adjustment.			4967	GENDER RESTRICTION FOR COVERED REV CODE
20	Accepted for processing.	A2	Contractual adjustment.			7240	SMARTSUSPENSE SUSPEND
20	Accepted for processing.	A2	Contractual adjustment.			8230	CAPITATION - INCORRECT RATE CATEGORY
20	Accepted for processing.	A2	Contractual adjustment.			8231	CAPITATION - DEMOGRAPHIC CHANGE
20	Accepted for processing.	A2	Contractual adjustment.			8232	CAPITATION - OTHER
20	Accepted for processing.	A2	Contractual adjustment.			8233	SAVE FOR FUTURE USE.
20	Accepted for processing.	A2	Contractual adjustment.			8234	SAVE FOR FUTURE USE.
20	Accepted for processing.	A2	Contractual adjustment.			8321	PAYOUT DUE TO PATIENT SPENDDOWN ERROR
20	Accepted for processing.	A2	Contractual adjustment.			8322	PAYOUT DUE TO ENHANCED RATE-OUT OF STATE RTC SERVICES
20	Accepted for processing.	A2	Contractual adjustment.			8323	PAYOUT DUE TO NON-EMERGENCY TRANSPORTATION
20	Accepted for processing.	A2	Contractual adjustment.			8324	PAYOUT DUE TO OTHER PROGRAM.
20	Accepted for processing.	A2	Contractual adjustment.			8325	PAYOUT DUE TO GAS  SURCHARGE.
20	Accepted for processing.	A2	Contractual adjustment.			8326	PAYOUT DUE TO CORRECTION TO ACCOUNTS RECEIVABLE PROCESSED.
20	Accepted for processing.	A2	Contractual adjustment.			8328	PAYOUT DUE TO DHS/DDSD AUDIT
20	Accepted for processing.	A2	Contractual adjustment.			8329	PAYOUT PROCESSED FROM STATE ONLY FUNDS
20	Accepted for processing.	A2	Contractual adjustment.			8331	PAYOUT DUE TO CLAIM TOO OLD TO PROCESS
20	Accepted for processing.	A2	Contractual adjustment.			8332	PAYOUT DUE TO MISCELLANEOUS OR UNSPECIFIED REASON.
20	Accepted for processing.	A2	Contractual adjustment.			8428	AS THE RESULT OF A FINANCIAL MANAGEMENT REVIEW, AN ACCOUNTS RECEIVABLE HAS BEEN  ESTABLISHED. THE AMOUNT WILL BE DEDUCTED FROM YOUR PAYMENTS.
20	Accepted for processing.	A2	Contractual adjustment.			8510	CYCLE ACTIVITY
20	Accepted for processing.	B13	Previously paid. Payment for this claim/service may have been provided in a previous payment.			8399	THIS ACTION IS THE RESULT OF A STOP PAYMENT.  A MANUAL CHECK HAS BEEN ISSUED.
20	Accepted for processing.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			4131	NO BENEFIT PLANS ASSOCIATED TO PAYER
21	Missing or invalid information.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			0210	BRAND MEDICALLY NECESSARY INDICATOR INVALID
21	Missing or invalid information.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			3322	DAW CODE NOT ALLOWED WITH NDC SUMITTED
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0311	PRIMARY DIAGNOSIS PRESENT ON ADMISSION INDICATOR INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0312	SECOND DIAGNOSIS PRESENT ON ADMISSION INDICATOR INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0313	THIRD DIAGNOSIS PRESENT ON ADMISSION INDICATOR INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0314	FOURTH DIAGNOSIS PRESENT ON ADMISSION INDICATOR INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0315	FIFTH DIAGNOSIS PRESENT ON ADMISSION INDICATOR INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0316	SIXTH DIAGNOSIS PRESENT ON ADMISSION INDICATOR INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0317	SEVENTH DIAGNOSIS PRESENT ON ADMISSION INDICATOR INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0318	EIGHTH DIAGNOSIS PRESENT ON ADMISSION INDICATOR INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0319	NINTH DIAGNOSIS PRESENT ON ADMISSION INDICATOR INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0320	DIAGNOSIS 10-24 PRESENT ON ADMISSION INDICATOR INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0363	PRINCIPAL ICD9 PROCEDURE CODE IS INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0366	FIRST OTHER PROCEDURE CODE INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0372	THIRD OTHER PROCEDURE CODE INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0375	FOURTH OTHER PROCEDURE CODE INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0378	FIFTH OTHER PROCEDURE CODE INVALID
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0581	SPAN THRU DATE LESS THAN SPAN FROM DATE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0605	FROM DATE IS AFTER TO DATE FOR SPAN OCC. 3-24
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			1058	NO PAY TO PROVIDER RECORD FOR CROSSOVER CLAIM
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			3360	DIAGNOSIS 10-24 REQUIRES PRESENT ON ADMISSION INDICATOR
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4053	PRINCIPAL PROCEDURE CODE NOT ON FILE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4128	ICD9 PROCEDURE 7-24 NOT ON FILE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4237	INVALID TYPE OF LEAVE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4240	THIS PROCEDURE MUST BE BILLED SEPARATELY EACH DATE
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4274	INVALID PRESCRIPTION QUALIFIER CODE, MUST EQUAL XZ
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4275	DRUG UNIT PRICE IS NOT NUMERIC
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4276	DRUG UNIT PRICE IS ZERO
21	Missing or invalid information.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			7263	DOS REQUIRED FOR PROCEDURE
21	Missing or invalid information.	18	Duplicate claim/service.			5658	A CARDIOLOGIST OR A RADIOLOGIST CANNOT BILL THIS PROCEDURE CODE ON THE SAME DAY
21	Missing or invalid information.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			4000	MORE THAN TWO SURGICAL UNITS ON THE CLAIM
21	Missing or invalid information.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			4095	NONSURGICAL SERVICES ARE NOT REIMBURSED INDIVIDUAL
21	Missing or invalid information.	A2	Contractual adjustment.			4000	MORE THAN TWO SURGICAL UNITS ON THE CLAIM
21	Missing or invalid information.	A2	Contractual adjustment.			4095	NONSURGICAL SERVICES ARE NOT REIMBURSED INDIVIDUAL
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0908	GROUP NUMBER NOT FOUND IN VALUE GROUP TABLE
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4277	PROCEDURE REQUIRES NDC
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4282	PROCEDURE MUST BE SUBMITTED ON PAPER WITH APPROPRIATE NDC, DRUG DESCRIPTION, AN D ACTUAL DOSE GIVEN.
218	NDC number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4283	MANUAL PRICE NON-CLASSIFIED PROCEDURE
218	NDC number.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			0908	GROUP NUMBER NOT FOUND IN VALUE GROUP TABLE
221	Drug days supply and dosage.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			0831	MEDICARE HDR PAID AMNT NOT EQUAL SUM OF DTL PAID
221	Drug days supply and dosage.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0211	INVALID REFILL INDICATOR VALUE
221	Drug days supply and dosage.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			3311	REFILL NUMBER EXCEEDS MAXIMUM ALLOWED
221	Drug days supply and dosage.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4165	Max Day Restriction for Covered NDC
221	Drug days supply and dosage.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			3311	REFILL NUMBER EXCEEDS MAXIMUM ALLOWED
25	Entity not approved.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.			2603	RECIPIENT LOCK-IN TO SPECIFIC PRESCRIBING PROVIDER
252	Authorization/certification number.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			3101	ONLINE PA DENIED BY HID, NDC REQUIRES PA
252	Authorization/certification number.	6	The procedure code is inconsistent with the patient's age.			3101	ONLINE PA DENIED BY HID, NDC REQUIRES PA
254	Primary diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			4039	DIAGNOSIS CANNOT BE USED AS THE PRINCIPAL DIAGNOSIS
255	Diagnosis code.	11	The diagnosis is inconsistent with the procedure.			7277	PROCEDURE LINE DIAGNOSIS MUST BE A VALID CODE
255	Diagnosis code.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4236	INVALID USE OF EMERGENCY DIAGNOSIS CODE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			0244	THIRD DIAGNOSIS CODE INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			0355	FIFTH DIAGNOSIS CODE INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			0356	SIXTH DIAGNOSIS CODE INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			0357	SEVENTH DIAGNOSIS CODE INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			0358	EIGHTH DIAGNOSIS CODE INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			0359	NINTH DIAGNOSIS CODE INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			0360	ADMITTING DIAGNOSIS MISSING
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			0361	ADMITTING DIAGNOSIS CODE INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			0362	EMERGENCY DIAGNOSIS CODE IS INVALID
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			0458	THE DIAGNOSIS CODE IN SEQUENCE 10-24 IS IN AN INVALID FORMAT
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			7273	DIAGNOSIS 2 MUST BE A VALID CODE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			7274	DIAGNOSIS 3 MUST BE A VALID CODE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			7275	DIAGNOSIS 4 MUST BE A VALID CODE
255	Diagnosis code.	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			7276	DIAGNOSIS MUST BE A VALID CODE
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.			5770	INDEPENDENT RURAL HEALTH CLINICS CANNOT BE PAID FOR MORE THAN ONE SERVICE PER D AY.
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.			6312	MONTHLY SCRIPT LIMIT EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.			6313	MONTHLY SCRIPT LIMIT EXCEEDED - BRANDED DRUG
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.			6314	MONTHLY SCRIPT LIMIT EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.			6315	MONTHLY SCRIPT LIMIT EXCEEDED
259	Frequency of service.	119	Benefit maximum for this time period or occurrence has been reached.			6316	MONTHLY BRAND SCRIPT LIMIT EXCEEDED
259	Frequency of service.	18	Duplicate claim/service.			5404	EPSDT VISIT HAS BEEN PAID FOR THIS RECIPIENT FOR THE SAME DATE OF SERVICE.
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.			5416	VISUAL FIELDS/TONOMETRY IS COVERED IN THE COMPLETE EYE EXAM
259	Frequency of service.	97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.			5417	VISUAL FIELDS/TONOMETRY IS COVERED IN THE COMPLETE EYE EXAM
26	Entity not found.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.			1037	FACILITY PROVIDER I.D. NOT ON FILE
26	Entity not found.	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.			1808	REFERRING PROVIDER IS MISSING OR NOT ON FILE
283	Medicare worksheet.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			0827	NON COVERED AMOUNT IS GREATER THAN COVERED AMOUNT
283	Medicare worksheet.	96	Non-covered charge(s).			0827	NON COVERED AMOUNT IS GREATER THAN COVERED AMOUNT
286	Other payer's Explanation of Benefits/payment information.	109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.			2500	RECIPIENT COVERED BY MEDICARE A (NO ATTACHMENT)
286	Other payer's Explanation of Benefits/payment information.	109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.			2501	RECIPIENT COVERED BY MEDICARE A (WITH ATTACHMENT
286	Other payer's Explanation of Benefits/payment information.	109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.			2502	RECIPIENT COVERED BY MEDICARE B (NO ATTACHMENT)
286	Other payer's Explanation of Benefits/payment information.	109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.			2503	RECIPIENT COVERED BY MEDICARE B (WITH ATTACHMENT)
286	Other payer's Explanation of Benefits/payment information.	109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.			2514	RECIPIENT COVERED BY MEDICARE(A AND B), NO MED D)
286	Other payer's Explanation of Benefits/payment information.	109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.			2550	RECIPIENT ENROLLED IN MEDICARE ADVANTAGE PLAN
294	Supporting documentation.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4233	DIAGNOSIS REQUIRES ADDITIONAL DOCUMENTATION
361	Is there other insurance?	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			0832	OTHER PAYER AMOUNT PAID QUALIFIER INVALID
361	Is there other insurance?	22	Payment adjusted because this care may be covered by another payer per coordination of benefits.			2511	HMO CO-PAY/RECIPIENT HAS MEDICARE
453	Procedure Code Modifier(s) for Service(s) Rendered	133	The disposition of this claim/service is pending further review.			4010	MODIFIER REQUIRES MEDICAL REVIEW
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			4011	INVALID MODIFIER COMBINATION
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			4245	FOURTH MODIFIER INVALID FOR DATE OF SERVICE
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			7258	REVIEW MODIFIER 51
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			7290	MODIFIER 51 DELETED FOR PRIMARY PROCEDURE
453	Procedure Code Modifier(s) for Service(s) Rendered	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			7291	MODIFIER 51 ADDED FOR NON-PRIMARY PROCEDURE
453	Procedure Code Modifier(s) for Service(s) Rendered	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			5812	POST-CATARACT FOLLOW-UP CARE HAS BEEN PAID TO THE SURGEON ORPOST-CATARACT FOLLO W-UP CARE CANNOT BE PAID UNTIL THE SURGEON HAS BEEN PAID. CONTACT THE SURGEON
453	Procedure Code Modifier(s) for Service(s) Rendered	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			5813	POST-CATARACT FOLLOW-UP CARE HAS BEEN PAID TO THE SURGEON ORPOST-CATARACT FOLLO W-UP CARE CANNOT BE PAID UNTIL THE SURGEON HAS BEEN PAID. CONTACT THE SURGEON
454	Procedure code for services rendered.	4	The procedure code is inconsistent with the modifier used or a required modifier is missing.			7223	PROCEDURE MAY NOT REQUIRE AN ASSISTANT SURGEON
454	Procedure code for services rendered.	96	Non-covered charge(s).			7207	PROCEDURE IS CLASSIFIED AS A COSMETIC PROCEDURE
454	Procedure code for services rendered.	96	Non-covered charge(s).			7208	PROCEDURE IS AN UNLISTED PROCEDURE
454	Procedure code for services rendered.	96	Non-covered charge(s).			7209	PROCEDURE IS CLASSIFIED AS EXPERIMENTAL
454	Procedure code for services rendered.	96	Non-covered charge(s).			7210	PROCEDURE IS CLASSIFIED AS OBSOLETE
454	Procedure code for services rendered.	96	Non-covered charge(s).			7261	INVALID PROCEDURE CODE
457	Non-Covered Day(s)	119	Benefit maximum for this time period or occurrence has been reached.			5434	PROCEDURE LIMITED TO ONE SERVICE DURING 60 (SIXTY) DAY POSTPARTUM PERIOD.
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.			0245	MISSING OCCURRENCE CODE
461	NUBC Occurrence Code(s) and Date(s)	129	Payment denied - Prior processing information appears incorrect.			0464	OCCURRENCE CODE 9-24 INVALID
474	Procedure code and patient gender mismatch	7	The procedure code is inconsistent with the patient's gender.			3319	NDC IS INAPPROPRIATE FOR RECIPIENT SEX
474	Procedure code and patient gender mismatch	7	The procedure code is inconsistent with the patient's gender.			7205	PROCEDURE IS NOT INDICATED FOR A MALE
474	Procedure code and patient gender mismatch	7	The procedure code is inconsistent with the patient's gender.			7206	PROCEDURE IS NOT INDICATED FOR A FEMALE
475	Procedure code not valid for patient age	6	The procedure code is inconsistent with the patient's age.			3318	NDC NOT APPROPRIATE FOR RECIPIENT AGE.
475	Procedure code not valid for patient age	6	The procedure code is inconsistent with the patient's age.			7201	PROCEDURE IS A NEWBORN PROCEDURE; AGE SHOULD BE LESS THAN 1 YEAR
475	Procedure code not valid for patient age	6	The procedure code is inconsistent with the patient's age.			7202	PROCEDURE IS A PEDIATRIC PROCEDURE; AGE SHOULD BE 1-17 YEARS
475	Procedure code not valid for patient age	6	The procedure code is inconsistent with the patient's age.			7203	PROCEDURE IS A MATERNITY PROCEDURE; AGE SHOULD BE 12-55 YEARS
475	Procedure code not valid for patient age	6	The procedure code is inconsistent with the patient's age.			7204	PROCEDURE IS AN ADULT PROCEDURE; AGE SHOULD BE OVER 14 YEARS
475	Procedure code not valid for patient age	6	The procedure code is inconsistent with the patient's age.			7211	PROCEDURE IS INVALID FOR PATIENT'S AGE
476	Missing or invalid units of service	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4262	NDC QUANTITY UNITS IS NOT NUMERIC
476	Missing or invalid units of service	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4263	NDC QUANTITY UNITS IS ZERO
50	Claim waiting for internal provider verification.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			1049	BILLING PROVIDER ENROLLMENT STATUS INVALID
52	Investigating existence of other insurance coverage.	22	Payment adjusted because this care may be covered by another payer per coordination of benefits.			2512	HMO CO-PAY/NO TPL OR MEDICARE COVERAGE
52	Investigating existence of other insurance coverage.	B20	Payment adjusted because procedure/service was partially or fully furnished by another provider.			7251	PROCEDURE IS ELIGIBLE FOR WORKER'S COMPENSATION/AUTO PAYOR
52	Investigating existence of other insurance coverage.	B20	Payment adjusted because procedure/service was partially or fully furnished by another provider.			7252	DIAGNOSIS 1 HAS BEEN DETECTED AS BEING ELIGIBLE FOR THIRD PARTY PAYOR BY CLAIMC
52	Investigating existence of other insurance coverage.	B20	Payment adjusted because procedure/service was partially or fully furnished by another provider.			7253	DIAGNOSIS 2 HAS BEEN DETECTED AS BEING ELIGIBLE FOR THIRD PARTY PAYOR BY CLAIMC
52	Investigating existence of other insurance coverage.	B20	Payment adjusted because procedure/service was partially or fully furnished by another provider.			7254	DIAGNOSIS 3 HAS BEEN DETECTED AS BEING ELIGIBLE FOR THIRD PARTY PAYOR BY CLAIMC
52	Investigating existence of other insurance coverage.	B20	Payment adjusted because procedure/service was partially or fully furnished by another provider.			7255	DIAGNOSIS 4 HAS BEEN DETECTED AS BEING ELIGIBLE FOR THIRD PARTY PAYOR BY CLAIMC
52	Investigating existence of other insurance coverage.	B20	Payment adjusted because procedure/service was partially or fully furnished by another provider.			7285	PROCEDURE IS ELIGIBLE FOR WORKER'S COMPENSATION/AUTO PAYOR
52	Investigating existence of other insurance coverage.	B20	Payment adjusted because procedure/service was partially or fully furnished by another provider.			7286	DIAGNOSIS IS ELIGIBLE FOR WORKER'S COMPENSATION/AUTO PAYOR
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5000	OUR RECORDS SHOW THIS SERVICE HAS ALREADY BEEN PAID FOR THE DATE OF SERVICE BIL LED.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5001	OUR RECORDS SHOW THIS SERVICE HAS ALREADY BEEN PAID FOR THE DATE OF SERVICE BIL LED.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5002	OUR RECORDS SHOW THIS SERVICE HAS ALREADY BEEN PAID FOR THE DATE OF SERVICE BIL LED.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5005	DENTAL DUPLICATE EXACT
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5006	OUR RECORDS SHOW THIS SERVICE HAS ALREADY BEEN PAID FOR THE DATE OF SERVICE BIL LED.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5010	OUR RECORDS SHOW THIS SERVICE FOR THE DATE(S) OF SERVICE BILLED IS A DUPLICATE.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5011	OUR RECORDS SHOW THIS SERVICE FOR THE DATE(S) OF SERVICE BILLED IS A DUPLICATE.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5012	OUR RECORDS SHOW THIS SERVICE FOR THE DATE(S) OF SERVICE BILLED IS A DUPLICATE.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5013	OUR RECORDS SHOW THIS SERVICE FOR THE DATE(S) OF SERVICE BILLED IS A DUPLICATE.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5014	OUR RECORDS SHOW THIS SERVICE FOR THE DATE(S) OF SERVICE BILLED IS A DUPLICATE.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5015	OUR RECORDS SHOW THIS SERVICE FOR THE DATE(S) OF SERVICE BILLED IS A DUPLICATE.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5016	OUR RECORDS SHOW THIS SERVICE FOR THE DATE(S) OF SERVICE BILLED IS A DUPLICATE.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5017	OUR RECORDS SHOW THIS SERVICE FOR THE DATE(S) OF SERVICE BILLED IS A DUPLICATE.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5018	OUR RECORDS SHOW THIS SERVICE FOR THE DATE(S) OF SERVICE BILLED IS A DUPLICATE.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5020	SUSPECT DUPLICATE OF ANOTHER PHARMACY CLAIM.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5021	EXACT DUPLICATE OF ANOTHER PHARMACY CLAIM.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5022	DUPLICATE RX NUMBER FOR SAME DATE OF SERVICE.
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5339	NOT USED
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5340	ORAL EVALUATION < 3 YRS (D0145) CONTRA
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5341	NOT USED
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			5655	MULTIPLE SURGERY CONTRAS
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			6040	PERIAPICAL XRAYS - LIMIT 5 PER CAL YEAR
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			6054	ORAL EVALUATION < 3 YRS (D0145)
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			6056	FLOURIDE VARNISH < 3YRS - LIMIT 3 PER CAL YEAR
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			6057	FLOURIDE VARNISH < 3YRS - LIMIT 6 TOTAL
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			6058	FLOURIDE VARNISH > 3YRS - LIMIT 1 PER CAL YEAR
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			6210	RADIOLOGY - LEVONORGESTREL IU LIMIT - 1 PER 5 YRS
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			7233	DUPLICATE DENIED - INCLUDES UNILATERAL OR BILATERAL
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			7234	DENIED DUPLICATE - IS BILATERAL
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			7235	DENIED DUPLICATE - CAN ONLY BE DONE XX TIMES IN LIFETIME
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			7236	DENIED DUPLICATE - CAN ONLY BE DONE XX TIMES IN A DAY
54	Duplicate of a previously processed claim/line.	18	Duplicate claim/service.			7237	DENIED DUPLICATE (REBUNDLED)
54	Duplicate of a previously processed claim/line.	197	Precertification/authorization/notification absent.			6600	RADIOLOGY - PROCEDURE REQUIRES PRIOR AUTHORIZATION
54	Duplicate of a previously processed claim/line.	B5	Payment adjusted because coverage/program guidelines were not met or were exceeded.			5654	CASTING & STRAPPING/SURGERY CONTRA
55	Claim assigned to an approver/analyst.	11	The diagnosis is inconsistent with the procedure.			7243	DIAGNOSIS TO PROCEDURE COMPARISON PROCEDURE SUSPENDED
553	Covered Amount	57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's			0828	RECIPIENT NUMBER MISSING OR INVALID
562	Entitys National Provider Identifier (NPI)	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1929	NPI REQUIRED HEALTHCARE=Y REFERRING PROV
562	Entitys National Provider Identifier (NPI)	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1930	NPI REQUIRED HEALTHCARE=Y FACILITY PROV
562	Entitys National Provider Identifier (NPI)	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1932	NPI REQUIRED: OTHER PROVIDER 2 (HEALTHCARE)
562	Entitys National Provider Identifier (NPI)	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1933	NPI REQUIRED: DTL OTHER PROVIDER 2 (HEALTHCARE)
562	Entitys National Provider Identifier (NPI)	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			1935	DTL NPI REQUIRED HEALTHCARE=Y REFERRING PROV
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1936	INVALID BILLING PROVIDER SPECIFIED
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1937	INVALID PREFORMING PROVIDER SPECIFIED
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1938	INVALID REFERRING PROVIDER SPECIFIED
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1939	INVALID FACILITY PROVIDER SPECIFIED
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1940	INVALID RENDERING PROVIDER SPECIFIED
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1941	INVALID OTHER PROVIDER SPECIFIED
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1942	INVALID DTL OTHER PROVIDER SPECIFIED
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1943	INVALID DTL PREFORMING PROVIDER SPECIFIED
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1944	INVALID DTL REFERRING PROVIDER SPECIFIED
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1945	MULTIPLE SERVICE LOCATIONS FOR BILLING PROVIDER
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1946	MULT SAK PROV LOCS FOR PERFORMING PROV SPEC
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1947	MULTIPLE SERVICE LOCATIONS FOR REFERRING PROVIDER
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1948	MULTIPLE SERVICE LOCATIONS FOR FACILITY PROVIDER
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1949	MULTIPLE SERVICE LOCATIONS FOR RENDERING PROVIDER
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1950	MULTIPLE SERVICE LOCATIONS FOR OTHER PROVIDER 2
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1951	MULTIPLE SERVICE LOCS FOR DTL OTHER PROVIDER 2
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1952	MULTIPLE SERVICE LOCS FOR DTL PERFORMING PROVIDER
562	Entitys National Provider Identifier (NPI)	47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.			1953	MULTIPLE SERVICE LOCS FOR DTL REFERRING PROVIDER
562	Entitys National Provider Identifier (NPI)	52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.			1995	MMIS FACILITY PROVIDER ID NOT ENROLLED
562	Entitys National Provider Identifier (NPI)	92	Claim Paid in full.			1999	PROVIDER ID IS INVALID, IS NOT ON FILE OR NAME/NUMBER DISAGREE.
562	Entitys National Provider Identifier (NPI)	A2	Contractual adjustment.			1929	NPI REQUIRED HEALTHCARE=Y REFERRING PROV
562	Entitys National Provider Identifier (NPI)	A2	Contractual adjustment.			1930	NPI REQUIRED HEALTHCARE=Y FACILITY PROV
562	Entitys National Provider Identifier (NPI)	A2	Contractual adjustment.			1932	NPI REQUIRED: OTHER PROVIDER 2 (HEALTHCARE)
562	Entitys National Provider Identifier (NPI)	A2	Contractual adjustment.			1933	NPI REQUIRED: DTL OTHER PROVIDER 2 (HEALTHCARE)
562	Entitys National Provider Identifier (NPI)	A2	Contractual adjustment.			1935	DTL NPI REQUIRED HEALTHCARE=Y REFERRING PROV
562	Entitys National Provider Identifier (NPI)	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			1996	THE RENDERING PROVIDER IS NOT ENROLLED IN THE MEDICAID PROGRAM.
562	Entitys National Provider Identifier (NPI)	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			1999	PROVIDER ID IS INVALID, IS NOT ON FILE OR NAME/NUMBER DISAGREE.
565	Estimated Claim Due Amount	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			3306	HEADER PAID AMOUNT EXCEEDS SPECIFIED DOLLAR AMOUNT
639	Responsibility Amount	1	DEDUCTIBLE AMOUNT			0810	INVALID DEDUCTIBLE AMT - SKILLED NURSING FACILITY
639	Responsibility Amount	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			0810	INVALID DEDUCTIBLE AMT - SKILLED NURSING FACILITY
65	Claim/line has been paid.	142	Claim adjusted by the monthly Medicaid patient liability amount.			9922	PAYMENT REDUCED DUE TO PATIENT LIABILITY DEDUCTION.
65	Claim/line has been paid.	142	Claim adjusted by the monthly Medicaid patient liability amount.			9996	PAYMENT REDUCED DUE TO PATIENT LIABILITY DEDUCTION.
65	Claim/line has been paid.	142	Claim adjusted by the monthly Medicaid patient liability amount.			9997	PERSONAL RESOURCES DEDUCTED FROM THE CLAIM ARE A RESULT OF PREVIOUS RESOURCES C OLLECTED FOR THE RECIPIENT IN THE SAME MONTH.
65	Claim/line has been paid.	23	Payment adjusted because charges have been paid by another payer.			9907	TPL AMOUNT APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9508	PRICING ADJUSTMENT - MEDICARE PART B DETAIL 2 PRICING APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9908	PRICING ADJUSTMENT - PHARMACY PRICING APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9911	PRICING ADJUSTMENT - LONG TERM CARE PRICING APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9916	PRICING ADJUSTMENT - UCC RATE PRICING APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9917	PRICING ADJUSTMENT - PREVAILING FEE PRICING APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9918	PRICING ADJUSTMENT - MAX FEE PRICING APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9919	PRICING ADJUSTMENT - PROVIDER LOC PRICING APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9921	PRICING ADJUSTMENT - PA PRICING APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9930	PRICING ADJUSTMENT - ENCOUNTER RATE PRICING APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9935	PRICING ADJUSTMENT - MAX FLAT FEE PRICING APPLIED
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9998	CLAIM WAS PRICED IN ACCORDANCE WITH MEDICAID POLICY
65	Claim/line has been paid.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			9999	PROCESSED PER MEDICAID POLICY
65	Claim/line has been paid.	91	Dispensing fee adjustment.			9910	PHARMACY DISPENSING FEE APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9501	PRICING ADJUSTMENT - MEDICARE IP PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9502	PRICING ADJUSTMENT - MEDICARE PART B HEADER PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9503	PRICING ADJUSTMENT - MEDICARE HEADER PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9504	PRICING ADJUSTMENT - MEDICARE HEADER COINSURANCE + DEDUCTIBLE PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9505	PRICING ADJUSTMENT - MEDICARE LONG TERM CARE PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9506	PRICING ADJUSTMENT - MEDICARE DETAIL COINSURANCE + DEDUCTIBLE PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9507	PRICING ADJUSTMENT - MEDICARE PART B DETAIL 1 PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9907	TPL AMOUNT APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9908	PRICING ADJUSTMENT - PHARMACY PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9911	PRICING ADJUSTMENT - LONG TERM CARE PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9916	PRICING ADJUSTMENT - UCC RATE PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9917	PRICING ADJUSTMENT - PREVAILING FEE PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9918	PRICING ADJUSTMENT - MAX FEE PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9919	PRICING ADJUSTMENT - PROVIDER LOC PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9921	PRICING ADJUSTMENT - PA PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9930	PRICING ADJUSTMENT - ENCOUNTER RATE PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9935	PRICING ADJUSTMENT - MAX FLAT FEE PRICING APPLIED
65	Claim/line has been paid.	92	Claim Paid in full.			9998	CLAIM WAS PRICED IN ACCORDANCE WITH MEDICAID POLICY
65	Claim/line has been paid.	92	Claim Paid in full.			9999	PROCESSED PER MEDICAID POLICY
659	Unit or Basis for Measurement Code	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			4261	INVALID UNIT OF MEASURE VALUE
68	Partial payment made for this claim.	3	Co-payment Amount			9001	REIMBURSEMENT REDUCED BY THE RECIPIENT'S CO-PAYMENT AMOUNT.
70	Payment reflects contract provisions.	11	The diagnosis is inconsistent with the procedure.			7242	DIAGNOSIS TO PROCEDURE COMPARISON PROCEDURE DENIED
70	Payment reflects contract provisions.	11	The diagnosis is inconsistent with the procedure.			7281	DIAGNOSIS TO PROCEDURE COMPARISON PROCEDURE
70	Payment reflects contract provisions.	11	The diagnosis is inconsistent with the procedure.			7282	INTENSITY OF PROCEDURE WAS FOUND TO BE HIGHER THAN EXPECTED BASED ON DIAGNOSIS
70	Payment reflects contract provisions.	133	The disposition of this claim/service is pending further review.			7284	PROCEDURE SHOULD BE REVIEWED AS POSSIBLE DUPLICATE COMPONENT
70	Payment reflects contract provisions.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			7244	MEDICAL VISIT DENIED
70	Payment reflects contract provisions.	18	Duplicate claim/service.			7249	PROCEDURE SHOULD BE REVIEWED AS POSSIBLE MULTIPLE COMPONENT
70	Payment reflects contract provisions.	18	Duplicate claim/service.			7250	PROCEDURE SHOULD BE REVIEWED AS POSSIBLE DUPLICATE COMPONENT
70	Payment reflects contract provisions.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			7283	PROCEDURE SHOULD BE REVIEWED AS POSSIBLE MULTIPLE COMPONENT
70	Payment reflects contract provisions.	A2	Contractual adjustment.			7283	PROCEDURE SHOULD BE REVIEWED AS POSSIBLE MULTIPLE COMPONENT
70	Payment reflects contract provisions.	B13	Previously paid. Payment for this claim/service may have been provided in a previous payment.			7220	PROCEDURE IS WITHIN THE NUMBER OF DAYS PRE-OP RANGE
72	Claim contains split payment.	35	Benefit maximum has been reached.			7259	SPLIT DECISION WAS RENDERED ON EXPANSION OF UNITS
78	Duplicate of an existing claim/line, awaiting processing.	119	Benefit maximum for this time period or occurrence has been reached.			5652	ONLY ONE INITIAL NICU PROCEDURE MAY BE BILLED PER HOSPITAL STAY.
8	No payment due to contract/plan provisions.	18	Duplicate claim/service.			6672	OUR RECORDS INDICATE THAT THIS SERVICE HAS ALREADY BEEN PERFORMED ON THIS PATIE NT
84	Service not authorized.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			3312	DAYS SUPPLY IS GREATER THAN MAXIMUM DAYS SUPPLY
84	Service not authorized.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			8550	THIS SERVICE IS NOT COVERED BY MEDICAID
84	Service not authorized.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			8551	THIS DRUG IS NOT AVAILABLE AS AN INJECTABLE
84	Service not authorized.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			8552	THIS DRUG IS CURRENTLY ON THE ALABAMA MEDICAID PHYSICIAN DRUG LIST (APPENDIX H) .
84	Service not authorized.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.			3002	NDC REQUIRES PA
84	Service not authorized.	62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.			3312	DAYS SUPPLY IS GREATER THAN MAXIMUM DAYS SUPPLY
88	Entity not eligible for benefits for submitted dates of service.	45	Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.			0506	DATE DISPENSED AFTER ICN DATE
88	Entity not eligible for benefits for submitted dates of service.	6	The procedure code is inconsistent with the patient's age.			3304	NON-COVERED SVC FOR RECIPIENT < 6 MONTHS OLD
88	Entity not eligible for benefits for submitted dates of service.	A2	Contractual adjustment.			0506	DATE DISPENSED AFTER ICN DATE
88	Entity not eligible for benefits for submitted dates of service.	B7	This provider was not certified/eligible to be paid for this procedure/service on this date of service.			4203	DENIAL MODIFIER SUBMITTED ON CLAIM
9	No payment will be made for this claim.	125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.			0837	CLAIM DATES OVERLAP PLAN EFFECTIVE DATES
9	No payment will be made for this claim.	16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate			7241	SMARTSUSPENSE DENIAL
9	No payment will be made for this claim.	30	Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.			0505	NO PAYMENT MADE-TPL IS MORE THAN THE ALLOWED AMOUNT.
9	No payment will be made for this claim.	30	Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.			9003	NO PAYMENT MADE-TPL IS MORE THAN THE ALLOWED AMOUNT.
93	Entity is not selected primary care provider.	109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.			1816	MATERNITY CARE MUST BE PERFORMED BY DISTRICT PROV
93	Entity is not selected primary care provider.	38	Services not provided or authorized by designated (network/primary care) providers.			1816	MATERNITY CARE MUST BE PERFORMED BY DISTRICT PROV
97	Patient eligibility not found with entity.	38	Services not provided or authorized by designated (network/primary care) providers.			1818	WAIVER PROVIDER MISMATCH
							Last Updated on 07/24/2012