Claim Adjustment Reason Codes - Palmetto GBA
Claim Adjustment Reason Codes - Palmetto GBA
Claim Adjustment Reason Codes - Palmetto GBA
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
<strong>Reason</strong><strong>Codes</strong>N43N45N46N47N48N49N50N51N52N53N54N55DescriptionBed hold or leave days exceeded.Start: 01/01/2000Payment based on authorized amount.Start: 01/01/2000Missing/incomplete/invalid admission hour.Start: 01/01/2000<strong>Claim</strong> conflicts with another inpatient stay.Start: 01/01/2000<strong>Claim</strong> information does not agree with information received from otherinsurance carrier.Start: 01/01/2000Court ordered coverage information needs validation.Start: 01/01/2000Missing/incomplete/invalid discharge information.Start: 01/01/2000 | Last Modified: 02/28/2003Notes: (Modified 2/28/03)Electronic interchange agreement not on file for provider/submitter.Start: 01/01/2000Patient not enrolled in the billing provider's managed care plan on thedate of service.Start: 01/01/2000Missing/incomplete/invalid point of pick-up address.Start: 01/01/2000 | Last Modified: 02/28/2003Notes: (Modified 2/28/03)<strong>Claim</strong> information is inconsistent with pre-certified/authorized services.Start: 01/01/2000Procedures for billing with group/referring/performing providers werenot followed.Start: 01/01/200037
Change language