Claim Adjustment Reason Codes - Palmetto GBA

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ReasonCodesM112M113M114M115M116M117DescriptionReimbursement for this item is based on the single payment amountrequired under the DMEPOS Competitive Bidding Program for the areawhere the patient resides.Start: 01/01/1997 | Last Modified: 11/05/2007Notes: (Modified 11/5/07)Our records indicate that this patient began using this item/service priorto the current contract period for the DMEPOS Competitive BiddingProgram.Start: 01/01/1997 | Last Modified: 11/05/2007Notes: (Modified 11/5/07)This service was processed in accordance with rules and guidelinesunder the DMEPOS Competitive Bidding Program or a DemonstrationProject. For more information regarding these projects, contact yourlocal contractor.Start: 01/01/1997 | Last Modified: 11/05/2007Notes: (Modified 8/1/06, 11/5/07)This item is denied when provided to this patient by a non-contract ornon-demonstration supplier.Start: 01/01/1997 | Last Modified: 11/05/2007Notes: (Modified 11/5/2007)Paid under the Competitive Bidding Demonstration project. Project isending, and future services may not be paid under this project.Start: 01/01/1997 | Last Modified: 02/01/2004Notes: (Modified 2/1/04)Not covered unless submitted via electronic claim.Start: 01/01/1997 | Last Modified: 06/30/2003Notes: (Modified 6/30/03)14
ReasonCodesM118M119M121M122M123M124M125M126DescriptionLetter to follow containing further information.Start: 01/01/1997 | Last Modified: 11/01/2009Notes: (Modified 4/1/07, 11/1/09)Missing/incomplete/invalid/ deactivated/withdrawn National Drug Code(NDC).Start: 01/01/1997 | Last Modified: 04/01/2007Notes: (Modified 2/28/03, 4/1/04)We pay for this service only when performed with a coveredcryosurgical ablation.Start: 01/01/1997Missing/incomplete/invalid level of subluxation.Start: 01/01/1997 | Last Modified: 02/28/2006Notes: (Modified 2/28/03)Missing/incomplete/invalid name, strength, or dosage of the drugfurnished.Start: 01/01/1997 | Last Modified: 02/28/2003Notes: (Modified 2/28/03)Missing indication of whether the patient owns the equipment thatrequires the part or supply.Start: 01/01/1997 | Last Modified: 02/28/2003Notes: (Modified 2/28/03) Related to N230Missing/incomplete/invalid information on the period of time for whichthe service/supply/equipment will be needed.Start: 01/01/1997 | Last Modified: 02/28/2003Notes: (Modified 2/28/03)Missing/incomplete/invalid individual lab codes included in the test.Start: 01/01/1997 | Last Modified: 02/28/2003Notes: (Modified 2/28/03)15
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ReasonCodesN355DescriptionAlert: Th
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Claim Adjustment Reason Codes - Palmetto GBA

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