Claim Adjustment Reason Codes - Palmetto GBA

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ReasonCodesN339N340N341N342N343N344N345N346N347N348N349DescriptionMissing/incomplete/invalid similar illness or symptom date.Start: 12/02/2004Missing/incomplete/invalid subscriber birth date.Start: 12/02/2004Missing/incomplete/invalid surgery date.Start: 12/02/2004Missing/incomplete/invalid test performed date.Start: 12/02/2004Missing/incomplete/invalid Transcutaneous Electrical Nerve Stimulator(TENS) trial start date.Start: 12/02/2004Missing/incomplete/invalid Transcutaneous Electrical Nerve Stimulator(TENS) trial end date.Start: 12/02/2004Date range not valid with units submitted.Start: 03/30/2005Missing/incomplete/invalid oral cavity designation code.Start: 03/30/2005Your claim for a referred or purchased service cannot be paid becausepayment has already been made for this same service to anotherprovider by a payment contractor representing the payer.Start: 03/30/2005You chose that this service/supply/drug would be rendered/suppliedand billed by a different practitioner/supplier.Start: 08/01/2005The administration method and drug must be reported to adjudicate thisservice.Start: 08/01/200568
ReasonCodesN350N351N352N353N354DescriptionMissing/incomplete/invalid description of service for a Not OtherwiseClassified (NOC) code or for an Unlisted/By Report procedure.Start: 08/01/2005 | Last Modified: 07/01/2008Notes: (Modified 7/1/08)Service date outside of the approved treatment plan service dates.Start: 08/01/2005Alert: There are no scheduled payments for this service. Submit a claimfor each patient visit.Start: 08/01/2005 | Last Modified: 04/01/2007Notes: (Modified 4/1/07)Alert: Benefits have been estimated, when the actual services have beenrendered, additional payment will be considered based on the submittedclaim.Start: 08/01/2005 | Last Modified: 04/01/2007Notes: (Modified 4/1/07)Incomplete/invalid invoiceStart: 08/01/200569
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Medicare Specific Remark CodesLast
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ReasonCodesM20M21M22M23M24M25Descri
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ReasonDescriptionCodesM29 Missing o
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ReasonCodesM50M51M52M53M54M55M56M59
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ReasonCodesM112M113M114M115M116M117
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ReasonCodesM127M129M130M131M132M133
Page 18 and 19: ReasonCodesMA01MA02MA04MA07MA08MA09
Page 30 and 31: ReasonDescriptionCodesMA108 Paper c
Page 32 and 33: ReasonCodesMA125MA126MA128MA130MA13
Page 34 and 35: ReasonCodesN10N11N12N13N15N16N19N20
Page 44 and 45: ReasonCodesN103N104N105N106N107Desc
Page 46 and 47: ReasonCodesN115N116N117N118N119Desc
Page 48 and 49: ReasonCodesN125DescriptionPayment h
Page 50 and 51: ReasonCodesN137N138N139DescriptionA
Page 52 and 53: ReasonCodesN148N149N150N151N152N153
Page 70 and 71: ReasonCodesN355DescriptionAlert: Th
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Claim Adjustment Reason Codes - Palmetto GBA

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