Claim Adjustment Reason Codes - Palmetto GBA

ReasonCodesN140N141N142N143N144N146N147DescriptionAlert: You have not been designated as an authorized OCONUS providertherefore are not considered an appropriate appealing party. If thebeneficiary has appointed you, in writing, to act as his/herrepresentative and you disagree with the Dental Advisor's opinion, youmay appeal by submitting a copy of this letter, a signed statementexplaining the matter in which you disagree, and any relevantinformation to the subscriber's Dental insurance carrier within 90 daysfrom the date of this letter.Start: 10/31/2002 | Last Modified: 04/01/2007Notes: (Modified 4/1/07)The patient was not residing in a long-term care facility during all or partof the service dates billed.Start: 10/31/2002The original claim was denied. Resubmit a new claim, not a replacementclaim.Start: 10/31/2002The patient was not in a hospice program during all or part of theservice dates billed.Start: 10/31/2002The rate changed during the dates of service billed.Start: 10/31/2002Missing screening document.Start: 10/31/2002 | Last Modified: 08/01/2004Notes: (Modified 8/1/04) Related to N243Long term care case mix or per diem rate cannot be determinedbecause the patient ID number is missing, incomplete, or invalid on theassignment request.Start: 10/31/200251