Claim Adjustment Reason Codes - Palmetto GBA

ReasonCodesMA125MA126MA128MA130MA131MA132MA133MA134N1DescriptionPer legislation governing this program, payment constitutes payment infull.Start: 01/01/1997Pancreas transplant not covered unless kidney transplant performed.Start: 10/12/2001Missing/incomplete/invalid FDA approval number.Start: 10/12/2001 | Last Modified: 03/30/2005Notes: (Modified 2/28/03, 3/30/05)Your claim contains incomplete and/or invalid information, and noappeal rights are afforded because the claim is unprocessable. Pleasesubmit a new claim with the complete/correct information.Start: 10/12/2001Physician already paid for services in conjunction with thisdemonstration claim. You must have the physician withdraw that claimand refund the payment before we can process your claim.Start: 10/12/2001Adjustment to the pre-demonstration rate.Start: 10/12/2001Claim overlaps inpatient stay. Rebill only those services renderedoutside the inpatient stay.Start: 10/12/2001Missing/incomplete/invalid provider number of the facility where thepatient resides.Start: 10/12/2001Alert: You may appeal this decision in writing within the required timelimits following receipt of this notice by following the instructionsincluded in your contract or plan benefit documents.Start: 01/01/2000 | Last Modified: 04/01/2007Notes: (Modified 2/28/03, 4/1/07)32