MA47
What This Code Means
Our records show the provider have opted out of Medicare; the patient is responsible for payment.
Common Causes
- Requested documentation not submitted with the original claim
- Documentation sent but not received by the payer
- Wrong document type sent
How to Resolve or Appeal
- Confirm exactly what documentation the payer needs
- Submit it through the payer's preferred channel and confirm receipt
- Resubmit or request reprocessing once documentation is on file
More Denial Codes to Check
Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.