Claim Adjustment Reason Codes - Palmetto GBA

ReasonDescriptionCodesM80 Not covered when performed during the same session/date as apreviously processed service for the patient.Start: 01/01/1997 | Last Modified: 10/31/2002Notes: (Modified 10/31/02)M81 You are required to code to the highest level of specificity.Start: 01/01/1997 | Last Modified: 02/01/2004Notes: (Modified 2/1/04)M82 Service is not covered when patient is under age 50.Start: 01/01/1997M83 Service is not covered unless the patient is classified as at high risk.Start: 01/01/1997M84 Medical code sets used must be the codes in effect at the time ofserviceStart: 01/01/1997 | Last Modified: 02/01/2004Notes: (Modified 2/1/04)M85 Subjected to review of physician evaluation and management services.Start: 01/01/1997M86 Service denied because payment already made for same/similarprocedure within set time frame.Start: 01/01/1997 | Last Modified: 06/30/2003Notes: (Modified 6/30/03)M87 Claim/service(s) subjected to CFO-CAP prepayment review.Start: 01/01/1997M89 Not covered more than once under age 40.Start: 01/01/1997M90 Not covered more than once in a 12 month period.Start: 01/01/199711