EOB Codes and Descriptions - Kymmis.com

KENTUCKY EOB/ESC CROSSWALK TO HIPAAKYEOBMEDICAID DESCRIPTIONMMIS EXCEPTIONCODE(S)HIPAAADJ RSNCODESHIPAA ADJ RSN CODEDESCRIPTIONHIPAAREMARKHIPAA REMARK CODEDESCRIPTION059CLAIM/DETAIL DENIED. NET BILLED CHARGEMISSING OR INVALID. 059 16Claim/service lacks informationwhich is needed for adjudication.Additional information is suppliedusing remittance advice remarkscodes whenever appropriate.060 CLAIM DENIED. LOCATION CODE INVALID. 060 A1 Claim denied charges. N79061 PAID IN FULL BY MEDICAID. 061 92 Claim Paid in full. MA125M54M58Missing/incomplete/ invalid totalcharges.Service billed is not campatible withpatient location information.Missing/incomplete/ invalid claiminformation. Resubmit claim aftercorrections.Per legislation governing thisprogram, payment constitutespayment in full.062063CLAIM DENIED. THE HOUR OF ADMISSION ISMISSING OR INVALID. 062 16CLAIM DENIED. AN 8-DIGIT LONG TERMCARE FACILITY NUMBER MUST BE ENTEREDIN FORM LOCATOR #11. 063 62Claim/service lacks informationwhich is needed for adjudication.Additional information is suppliedusing remittance advice remarkscodes whenever appropriate.Payment denied/reduced forabsence of, or exceeded, precertification/authorization.N46N77Missing/incomplete/ invalidadmission hour.Missing/incomplete/ invaliddesignated provider number.064Claim/service lacks informationwhich is needed for adjudication.Additional information is suppliedusing remittance advice remarks16 codes whenever appropriate.THE TIME OF PICK UP IS BEFORE THE TIMEOF CALL IN. 064 A1 Claim denied charges.065 DESTINATION CODE IS MISSING/INVALID. 065 A1 Claim denied charges. N157Payment denied/reduced forPRO STICKER/INDICATOR MISSING ORabsence of, or exceeded, precertification066 INVALID 066 62/authorization.M49067 FAMILY PLANNING INDICATOR INVALID. 067 A1 Claim denied charges. M49068M58AM/PM PICK-UP INDICATOR MISSING ORINVALID. 068 A1 Claim denied charges. M49069 TIME OF CALL IN MISSING/INVALID. 069 A1 Claim denied charges. M125070 TIME OF PICK UP IS MISSING OR INVALID. 070 A1 Claim denied charges.071MORE THAN 10 ERRORS AT THE HEADERLEVEL 071 A1 Claim denied charges.072PICK-UP LOCATION CODE MISSING ORINVALID. 072 A1 Claim denied charges. N53073 REFERRED TO "OTHER" CODE INVALID. 073 A1 Claim denied charges. M49M58M58M58Transportation to and from thisdestination is not covered.Missing/incomplete/ invalid valuecode(s) or amount(s).Missing/incomplete/ invalid claiminformation. Resubmit claim aftercorrections.Missing/incomplete/ invalid valuecode(s) or amount(s).Missing/incomplete/ invalid claiminformation. Resubmit claim aftercorrections.Missing/incomplete/ invalid valuecode(s) or amount(s).Missing/incomplete/ invalid claiminformation. Resubmit claim aftercorrections.Missing/incomplete/ invalidinformation on the period of time forwhich the service/supply/ equipmentwill be needed.Missing/incomplete/invalid point ofpick-up address.Missing/incomplete/ invalid valuecode(s) or amount(s).Missing/incomplete/ invalid claiminformation. Resubmit claim aftercorrections.074076077078ANCILLARY CHARGES NOT PAYABLE INCONJUNCTION WITH VENTILATOR ORBRAIN INJURY PROGRAM REIMBURSEMENT. 074 B597Payment adjusted becauseoverage/ program guidelines werenot met or were exceeded.Payment is included in theallowance for anotherservice/procedure.OTHER MEANS OF TRANSPORTATION CODEMISSING OR INVALID. 076 A1 Claim denied charges. M58CLAIM DETAIL/DENIED. TIME OF CALL-INAM/PM INDICATOR MISSING 077 A1 Claim denied charges. M58CLAIM/DETAIL DENIED. BASE RATE OR RATEPER MILE MISSING OR INVALID. 078 A1 Claim denied charges. M51M2Not paid separately when the patientis an inpatientMissing/incomplete/invalid claiminformation. Resubmit claim aftercorrections.Missing/incomplete/invalid claiminformation. Resubmit claim aftercorrections.Missing/incomplete/ invalidprocedure code(s) and/or rates.Page 4 of 46 Date: 3/30/2005