Claim Adjustment Reason Codes - Palmetto GBA

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ReasonCodesMA17MA18MA19MA20MA21MA22MA23DescriptionWe are the primary payer and have paid at the primary rate. You mustcontact the patient's other insurer to refund any excess it may have paiddue to its erroneous primary payment.Start: 01/01/1997Alert: The claim information is also being forwarded to the patient'ssupplemental insurer. Send any questions regarding supplementalbenefits to them.Start: 01/01/1997 | Last Modified: 04/01/2007Notes: (Modified 4/1/07)Alert: Information was not sent to the Medigap insurer due toincorrect/invalid information you submitted concerning that insurer.Please verify your information and submit your secondary claim directlyto that insurer.Start: 01/01/1997 | Last Modified: 04/01/2007Notes: (Modified 4/1/07)Skilled Nursing Facility (SNF) stay not covered when care is primarilyrelated to the use of an urethral catheter for convenience or the controlof incontinence.Start: 01/01/1997 | Last Modified: 06/30/2003Notes: (Modified 6/30/03)SSA records indicate mismatch with name and sex.Start: 01/01/1997Payment of less than $1.00 suppressed.Start: 01/01/1997Demand bill approved as result of medical review.Start: 01/01/199720
ReasonCodesMA24MA25MA26MA27MA28MA30MA31DescriptionChristian Science Sanitarium/ Skilled Nursing Facility (SNF) bill in thesame benefit period.Start: 01/01/1997 | Last Modified: 06/30/2003Notes: (Modified 6/30/03)A patient may not elect to change a hospice provider more than once ina benefit period.Start: 01/01/1997Alert: Our records indicate that you were previously informed of thisrule.Start: 01/01/1997 | Last Modified: 04/01/2007Notes: (Modified 4/1/07)Missing/incomplete/invalid entitlement number or name shown on theclaim.Start: 01/01/1997 | Last Modified: 02/28/2003Notes: (Modified 2/28/03)Alert: Receipt of this notice by a physician or supplier who did notaccept assignment is for information only and does not make thephysician or supplier a party to the determination. No additional rightsto appeal this decision, above those rights already provided for byregulation/instruction, are conferred by receipt of this notice.Start: 01/01/1997 | Last Modified: 04/01/2007Notes: (Modified 4/1/07)Missing/incomplete/invalid type of bill.Start: 01/01/1997 | Last Modified: 02/28/2003Notes: (Modified 2/28/03)Missing/incomplete/invalid beginning and ending dates of the periodbilled.Start: 01/01/1997 | Last Modified: 02/28/2003Notes: (Modified 2/28/03)21
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Claim Adjustment Reason Codes - Palmetto GBA

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