EOB Codes and Descriptions - Kymmis.com

KENTUCKY EOB/ESC CROSSWALK TO HIPAAKYEOB283284285MEDICAID DESCRIPTIONMMIS EXCEPTIONCODE(S)HIPAAADJ RSNCODESOUR RECORDS INDICATE RECIPIENT HASMEDICARE PART B, PLEASE BILL MEDICARE. 283 109OUR RECORDS INDICATE THAT THISRECIPIENT IS ELIGIBLE FOR HOSPICECOVERAGE BY MEDICARE. PLEASE BILLMEDICARE FIRST. 284 109REGIONAL ANESTHESIA PROCEDURECODES MAY NOT BE BILLED USING TYPE OFSERVICE 07, MODIFIER AG, OR MORE THANONE UNIT OF SERVICE PER DATE OFSERVICE. 185 4HIPAA ADJ RSN CODEDESCRIPTIONClaim not covered by thispayer/contractor. You must sendthe claim to the correctpayer/contractor.Claim not covered by thispayer/contractor. You must sendthe claim to the correctpayer/contractor.The procedure code isinconsistent with the modifierused or a required modifier ismissing.HIPAA HIPAA REMARK CODEREMARKDESCRIPTIONOur records indicate that we shouldbe the third payer for this claim. Wecannot process this claim until wehave received payment informationfrom the primary and secondaryMA64 payers.Secondary payment cannot beconsidered without the identity of orpayment information from theprimary payer. The information wasMA04 either not reported or was illegible.Our records indicate that we shouldbe the third payer for this claim. Wecannot process this claim until wehave received payment informationfrom the primary and secondaryMA64 payers.Secondary payment cannot beconsidered without the identity of orpayment information from theprimary payer. The information wasMA04 either not reported or was illegible.Did not indicate whether we are theprimary or secondary payer. Refer toItem 11 in the HCFA-1500MA83 instructions for assistance.N56Procedure code billed is notcorrect/valid for the services billed orthe date of service billed.286287288289290THIS PROCEDURE CODE IS LIMITED TO ONEUNIT OF SERVICE PER DATE OF SERVICE. 186, 635 57PROFESSIONAL COMPONENT REVENUECODE MUST BE BILLED WITH THECORRESPONDING TECHNICAL COMPONENTREVENUE CODE. 187 107PROFESSIONAL COMPONENT REVENUECODE MUST BE BILLED WITHCORRESPONDING TECHNICAL REVENUECODE. CHARGES MOVED TO NON-COVERED. 187 107RENDERING PROVIDER NUMBER MISSINGOR INVALID . 289 B7248, 249, 250, 251, 252, 253,PENDING CONFIRMATION OF RECIPIENT 254, 259, 290, 291, 310, 399,ELIGIBILITY.494 133Payment denied/reduced becausethe payer deems the informationsubmitted does not support thislevel of service, this manyservices, this length of service,this dosage, or this day's supply.Claim/service denied because therelated or qualifying claim/servicewas not previously paid oridentified on this claim.Claim/service denied because therelated or qualifying claim/servicewas not previously paid oridentified on this claim.This provider was notcertified/eligible to be paid for thisprocedure/ service on this date ofservice.The disposition of thisclaim/service is pending furtherreview.M63M66M66M57We do not pay for more than one ofthese on the same day.Our records indicate that you billeddiagnostic tests subject to pricelimitations and the procedure codesubmitted includes a professionalcomponent. Only the technicalcomponent is subject to pricelimitations. Please submit thetechnical and professionalcomponents of this service asseparate line items.Our records indicate that you billeddiagnostic tests subject to pricelimitations and the procedure codesubmitted includes a professionalcomponent. Only the technicalcomponent is subject to pricelimitations. Please submit thetechnical and professionalcomponents of this service asseparate line items.Missing/incomplete/invalid provideridentifier.291292293PENDING POSSIBLE OTHER INSURANCEINVOLVEMENT. 291, 462, 467 22CLAIM SUSPENDED FOR BUY-IN ELIGIBILITYREVIEW. 292 133CLAIM SUSPENDED FOR ELIGIBILITYREVIEW. 910 133Payment adjusted because thiscare may be covered by anotherpayer per coordination of benefits.The disposition of thisclaim/service is pending furtherreview.The disposition of thisclaim/service is pending furtherreview.294KENPAC RECIPIENT. REFERRING PROVIDERNUMBER IS MISSING OR IS NOT THEKENPAC PRIMARY PHYSICIAN/CLINICNUMBER FOR THE DATE(S) OF SERVICE. 290 38Services not provided orauthorized by designated(network/primary care) providers.M68Missing/incomplete/invalid attendingor referring physician identification.Page 16 of 46 Date: 3/30/2005