Claim Adjustment Reason Codes - Palmetto GBA

ReasonCodesN67N68N69N70DescriptionProfessional provider services not paid separately. Included in facilitypayment under a demonstration project. Apply to that facility forpayment, or resubmit your claim if: the facility notifies you the patientwas excluded from this demonstration; or if you furnished theseservices in another location on the date of the patient's admission ordischarge from a demonstration hospital. If services were furnished in afacility not involved in the demonstration on the same date the patientwas discharged from or admitted to a demonstration facility, you mustreport the provider ID number for the non-demonstration facility on thenew claim.Start: 01/01/2000Prior payment being cancelled as we were subsequently notified thispatient was covered by a demonstration project in this site of service.Professional services were included in the payment made to the facility.You must contact the facility for your payment. Prior payment made toyou by the patient or another insurer for this claim must be refunded tothe payer within 30 days.Start: 01/01/2000PPS (Prospective Payment System) code changed by claims processingsystem. Insufficient visits or therapies.Start: 01/01/2000 | Last Modified: 06/30/2003Notes: (Modified 6/30/03)Consolidated billing and payment applies.Start: 01/01/2000 | Last Modified: 11/05/2007Notes: (Modified 2/28/02, 11/5/07)39