EOB Codes and Descriptions - Kymmis.com

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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
KYEOB079080081082083084KENTUCKY EOB/ESC CROSSWALK TO HIPAAHIPAAADJ RSNCODESMEDICAID DESCRIPTIONMMIS EXCEPTIONCODE(S)HIPAA ADJ RSN CODEDESCRIPTIONHIPAAREMARKCLAIM/DETAIL DENIED. DETAIL TOTAL BILLNOT=(RATE PER MILE X EXTRA MILES). 079 A1 Claim denied charges. M54PROVIDER TYPE INVALID FOR CATEGORYOF SERVICE. 080 A1 Claim denied charges. N95CLAIM DENIED. NUMBER OF PERSONSSHARING RIDE INVALID. 081 A1 Claim denied charges. N76CLAIM DENIED. TYPE OF TRIP MISSING ORINVALID. 082 A1 Claim denied charges.CLAIM DENIED. SECONDARY SURGERYDATE MISSING/INVALID 083 A1 Claim denied charges. MA06CLAIM DENIED. PRIMARY SURGERY DATEMISSING/INVALID. 084 A1 Claim denied charges. MA06CLAIM DENIED. EPSDT DISPOSITION CODEMISSING OR INVALID. 090 A1 Claim denied charges. M58CLAIM DENIED. YOU MUST INDICATE INBLOCK 15 IF THIS WAS A PARTIAL,COMPLETE, OR COMPLETION OF A PARTIALEXAM FOR PROCESSING. 091 A1 Claim denied charges.THIS SERVICE DENIED. PLEASE RESUBMITCLAIM WITH COPY OF PATHOLOGYREPORT. 182 A1 Claim denied charges. M30HIPAA REMARK CODEDESCRIPTIONMissing/incomplete/ invalid totalcharges.This provider type/ provider specialtymay not bill this service.Missing/incomplete/invalid number ofriders.Missing/incomplete/ invalid beginningand/or ending date(s).Missing/incomplete/ invalid beginningand/or ending date(s).Missing/incomplete/invalidprescribing/referring/attendingprovider license number.085CLAIM DENIED/INVALID LINE ITEM PROVIDERLICENSE NUMBER 085 A1 Claim denied charges. N31PROVIDER INELIGIBLE FOR DATE OFSERVICE. PLEASE CONTACT PROVIDERENROLLMENT AT (877) 838-5085 FOR NF ORMissing/incomplete/ invalid086 ICF/MR. 086 A1 Claim denied charges. N77 designated provider number.Missing/incomplete/ invalid providerM57 identifier.CLAIM DENIED. TO DATE OF SERVICEMissing/incomplete/ invalid “to”087 EQUAL TO DATE OF RECEIPT. 087 110 Billing date predates service date. M59 date(s) of service.CLAIM DENIED. CLAIM INVOICE DATE088 MISSING/INVALID. 088 A1 Claim denied charges. MA52 Missing/incomplete/ invalid date.089 DETAIL CHARGE MISSING OR INVALID. 089 A1 Claim denied charges. M79 Missing/incomplete/invalid charge.Missing/incomplete/invalid claiminformation. Resubmit claim after090corrections.091092Missing/incomplete/ invalid pathologyreport.093094095096097098099100101Claim/service lacks informationwhich is needed for adjudication.Additional information is suppliedTHIS SERVICE DENIED. PLEASE RESUBMITWITH HISTORY AND PHYSICAL NOTES. 182, 183 16using remittance advice remarkscodes whenever appropriate. N29PHYSICIAN SIGNATURE AND DATE ONCONSENT FORM MUST BE ON OR AFTERDATE OF SERVICE 181 A1 Claim denied charges. N3CONSENT FORM IS ILLEGIBLE. RESUBMITLEGIBLE COPY WITH CLAIM 181, 183 16Claim/service lacks informationwhich is needed for adjudication.Additional information is suppliedusing remittance advice remarkscodes whenever appropriate.N28RECIPIENT'S SIGNATURE ON CONSENTFORM MUST BE ON OR BEFORE DATE OFSERVICE. 183 A1 Claim denied charges. N3MA52DATES OF SERVICE ON CLAIM ANDCONSENT FORM DISAGREE. 181 A1 Claim denied charges. N3RECIPIENT MUST BE 21 TO LEGALLY SIGNTHE FEDERAL STERILIZATION CONSENTFORM. 181 6The procedure/revenue code isinconsistent with the patient's age.N28PERSON OBTAINING CONSENT MUST SIGNON OR AFTER DATE OF RECIPIENTSIGNATURE BUT PRIOR TO THESTERILIZATION PROCEDURE. CLAIM NOTPAYABLE BY MEDICAID. 181 A1 Claim denied charges. N3N28DETAIL FROM DATE OF SERVICE MISSINGOR INVALID. 100 A1 Claim denied charges. M52DETAIL TO DATE OF SERVICE MISSING ORINVALID. 101 A1 Claim denied charges. M59N28N3N28N3Missingdocumentation/orders/notes/summary/report/invoice.Missing/incomplete/ invalid consentform.Consent form requirements notfulfilled.Missing/incomplete/invalid consentform.Consent form requirements notfulfilled.Missing/incomplete/invalid consentform.Missing/incomplete/invalid date.Missing/incomplete/invalid consentform.Consent form requirements notfulfilled.Missing/incomplete/invalid consentform.Consent form requirements notfulfilled.Missing/incomplete/invalid consentform.Consent form requirements notfulfilled.Missing/incomplete/invalid “from”date(s) of service.Missing/incomplete/invalid “to”date(s) of service.Page 5 of 46 Date: 3/30/2005
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