Claim Adjustment Reason Codes - Palmetto GBA

ReasonCodesN172N173N174N175N176N177N178N179DescriptionThe patient is not liable for the denied/adjusted charge(s) for receivingany updated service/item.Start: 02/28/2003No qualifying hospital stay dates were provided for this episode of care.Start: 02/28/2003This is not a covered service/procedure/ equipment/bed, howeverpatient liability is limited to amounts shown in the adjustments undergroup 'PR'.Start: 02/28/2003Missing review organization approval.Start: 02/28/2003 | Last Modified: 02/29/2008Notes: (Modified 8/1/04, 2/29/08) Related to N241Services provided aboard a ship are covered only when the ship is ofUnited States registry and is in United States waters. In addition, adoctor licensed to practice in the United States must provide theservice.Start: 02/28/2003Alert: We did not send this claim to patient's other insurer. They haveindicated no additional payment can be made.Start: 02/28/2003 | Last Modified: 04/01/2007Notes: (Modified 6/30/03, 4/1/07)Missing pre-operative photos or visual field results.Start: 02/28/2003 | Last Modified: 08/01/2004Notes: (Modified 8/1/04) Related to N244Additional information has been requested from the member. Thecharges will be reconsidered upon receipt of that information.Start: 02/28/200354