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# Denial Journal

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- [CPT Code 01214 for Anes open px tot hip arthrp](https://denialjournal.com/cpt-code-01214-for-anes-open-px-tot-hip-arthrp/) - Understanding CPT Code 01214 for Anesthesia in Total Hip Arthroplasty In the complex world of medical billing and coding, Current Procedural Terminology (CPT) codes play a critical role. These codes are essential for accurately documenting and billing medical procedures. One such code, CPT Code 01214, is specifically used for anesthesia services during an open procedure
- [CPT Code 01212 for Anes open px hip jt disrtcj](https://denialjournal.com/cpt-code-01212-for-anes-open-px-hip-jt-disrtcj/) - CPT Code 01212 is a specific billing code used in the medical field to denote anesthesia services for an open procedure involving the hip joint disarticulation. Understanding this code is crucial for healthcare providers, coders, and billing teams to ensure accurate billing and reimbursement processes. This article will provide a comprehensive guide to CPT Code
- [CPT Code 01210 for Anes open px hip joint nos](https://denialjournal.com/cpt-code-01210-for-anes-open-px-hip-joint-nos/) - Understanding CPT Code 01210 for Anes Open Px Hip Joint NOS In the realm of medical billing and coding, precision and accuracy are paramount, especially when dealing with anesthesia services. One such specific code that demands attention is CPT Code 01210. This code pertains to anesthesia services for open procedures on the hip joint not
- [CPT Code 01202 for Anes arthroscopic px hip jt](https://denialjournal.com/cpt-code-01202-for-anes-arthroscopic-px-hip-jt/) - CPT Code 01202 for Anes Arthroscopic Px Hip Jt: A Comprehensive Guide When it comes to medical billing and coding, precision is critical. One of the codes frequently referenced in anesthesia billing for orthopedic procedures is CPT Code 01202, which specifically applies to anesthesia for arthroscopic procedures on the hip joint. This code is pivotal
- [CPT Code 01200 for Anes all closed px hip joint](https://denialjournal.com/cpt-code-01200-for-anes-all-closed-px-hip-joint/) - Understanding CPT Code 01200: Anesthesia for All Closed Procedures on the Hip Joint In the complex world of medical billing and coding, the importance of accurate coding cannot be overstated. CPT Code 01200 stands out as a specific code utilized for anesthesia services related to all closed procedures on the hip joint. For healthcare providers,
- [CPT Code 01173 for Anes opn rpr fx disrpj plvs](https://denialjournal.com/cpt-code-01173-for-anes-opn-rpr-fx-disrpj-plvs/) - CPT Code 01173 for Anes opn rpr fx disrpj plvs: A Comprehensive Guide Understanding CPT Code 01173 The Current Procedural Terminology (CPT) code 01173 is used to denote anesthesia services for open repair of fractures and dislocations involving the pelvis. This specific code is vital for healthcare providers, coders, and billing teams to understand due
- [CPT Code 01170 for Anes opn px symph pub/si jt](https://denialjournal.com/cpt-code-01170-for-anes-opn-px-symph-pub-si-jt/) - CPT Code 01170 for Anesthesia in Open Procedures of Symphysis Pubis or Sacroiliac Joint As healthcare providers, coders, and billing teams often encounter the complexity of coding procedures accurately for reimbursement and documentation, understanding the specifics of CPT Code 01170 becomes essential. This code is used specifically for anesthesia services provided during open procedures involving
- [CPT Code 01160 for Anes clsd px symph pub/si jt](https://denialjournal.com/cpt-code-01160-for-anes-clsd-px-symph-pub-si-jt/) - CPT Code 01160 for Anesthesia: Closed Procedure Symphysis Pubis or Sacroiliac Joint Medical billing and coding can often resemble a complex puzzle, especially when it comes to anesthesia services. One particular area of interest is the use of CPT Code 01160, which pertains to anesthesia for closed procedures involving the symphysis pubis or sacroiliac joints.
- [CPT Code 01150 for Anes rad px tumor of pelvis](https://denialjournal.com/cpt-code-01150-for-anes-rad-px-tumor-of-pelvis/) - The world of medical billing and coding can often seem like a labyrinth, especially when it comes to anesthesia services. One such code that garners attention is CPT Code 01150, designated for anesthesia during procedures involving the radical surgery of tumors in the pelvis. This article aims to provide a comprehensive understanding of CPT Code
- [CPT Code 01140 for Anes ntrplvabdmnl amputation](https://denialjournal.com/cpt-code-01140-for-anes-ntrplvabdmnl-amputation/) - CPT Code 01140 for Anes Ntrplvabdmnl Amputation: A Comprehensive Guide Accurate coding is essential for the efficient operation of healthcare systems, especially in complex procedures such as anesthesia for interpelvic abdominal amputation. The CPT Code 01140 is pivotal in this context, ensuring proper documentation and facilitating accurate billing processes. This article delves into the clinical,
- [CPT Code 01130 for Anes body cast appl/revj](https://denialjournal.com/cpt-code-01130-for-anes-body-cast-appl-revj/) - CPT Code 01130 for Anes Body Cast Appl/Revj: A Comprehensive Guide Understanding CPT codes is crucial for healthcare providers, coders, and billing teams. One such code, CPT Code 01130, pertains to anesthesia for body cast application and revision. This article aims to clarify its usage, importance, and implications for accurate medical billing and compliance. What
- [CPT Code 01120 for Anes px on bony pelvis](https://denialjournal.com/cpt-code-01120-for-anes-px-on-bony-pelvis/) - CPT Code 01120: Navigating Anesthesia for Procedures on the Bony Pelvis In the complex world of medical billing and coding, precision is pivotal. Among the myriad of codes in the Current Procedural Terminology (CPT), CPT Code 01120 holds a specific place, denoting anesthesia services for procedures on the bony pelvis. This code is crucial for
- [CPT Code 01112 for Anes bone marrow aspir & /bx](https://denialjournal.com/cpt-code-01112-for-anes-bone-marrow-aspir-bx/) - CPT Code 01112 is a critical identifier in the medical billing and coding landscape, specifically used for anesthesia services related to bone marrow aspiration and biopsy procedures. As healthcare providers, coders, and billing teams navigate the complexities of medical coding, understanding the nuances of this particular code can significantly impact revenue cycle management and compliance.
- [CPT Code 00952 for Anes vag px hystsc & /hsg](https://denialjournal.com/cpt-code-00952-for-anes-vag-px-hystsc-hsg/) - CPT Code 00952 for Anesthesia: Understanding Its Use in Vaginal Procedures CPT Code 00952 is often a point of discussion among healthcare providers, coders, and billing teams. This code is specific to anesthesia services provided during vaginal procedures, such as hysteroscopy and hysterosalpingography. In this article, we'll explore what CPT Code 00952 entails, potential pitfalls
- [CPT Code 00950 for Anes vag px culdoscopy](https://denialjournal.com/cpt-code-00950-for-anes-vag-px-culdoscopy/) - CPT code 00950 is a specific coding designation used in medical billing and documentation, particularly for anesthesia related to vaginal procedures such as culdoscopy. Understanding this code—and its application—can be vital for healthcare providers, coders, and billing teams to ensure accurate billing and compliance with healthcare regulations. This article explores the intricacies of CPT code
- [CPT Code 00948 for Anes vag px crv cerclage](https://denialjournal.com/cpt-code-00948-for-anes-vag-px-crv-cerclage/) - CPT Code 00948 is a specific procedural code used in the medical billing and coding sector to describe anesthesia services for vaginal procedures such as cervical cerclage. Navigating the complexities of this code is crucial for healthcare providers, coders, and billing teams to ensure accurate billing, reimbursement, and compliance. This article delves into the intricacies
- [CPT Code 00944 for Anes vag px vag hysterectomy](https://denialjournal.com/cpt-code-00944-for-anes-vag-px-vag-hysterectomy/) - Understanding CPT Code 00944 for Anesthesia in Vaginal Procedures Including Vaginal Hysterectomy The correct use of procedural codes is crucial for effective billing and reimbursement in healthcare settings. One such code, CPT Code 00944, is used for anesthesia services related to vaginal procedures, including vaginal hysterectomy. This code is significant for healthcare providers, medical coders,
- [CPT Code 00942 for Anes vag px clptmy vgnc clpr](https://denialjournal.com/cpt-code-00942-for-anes-vag-px-clptmy-vgnc-clpr/) - CPT Code 00942 for Anes vag px clptmy vgnc clpr: A Comprehensive Guide The healthcare industry is rife with complex coding systems that ensure procedures are accurately billed. One such code, CPT Code 00942, is dedicated to anesthesia services provided during vaginal procedures, specifically for colpotomy and vaginal clamping repair. Understanding this code is crucial
- [CPT Code 00940 for Anes vaginal px nos](https://denialjournal.com/cpt-code-00940-for-anes-vaginal-px-nos/) - Coding and billing for anesthesia services require a meticulous approach due to their complexity and the critical nature of accurately representing the medical services provided. Among the numerous Current Procedural Terminology (CPT) codes utilized in anesthesia billing, CPT Code 00940 is specifically designated for anesthesia services related to vaginal procedures not otherwise specified (NOS). Understanding
- [CPT Code 00938 for Anes insj penile prosthesis](https://denialjournal.com/cpt-code-00938-for-anes-insj-penile-prosthesis/) - CPT Code 00938 is an anesthesia code specifically used for the insertion of a penile prosthesis. As a healthcare provider, coder, or billing team member, understanding the nuances of this code is crucial for accurate medical billing and compliance. This article will guide you through the complexities of CPT Code 00938, providing evidence, comparisons, and
- [CPT Code 00936 for Anes rad amp pns ingun & ilac](https://denialjournal.com/cpt-code-00936-for-anes-rad-amp-pns-ingun-ilac/) - CPT Code 00936 for Anes Rad Amp Pns Ingun & Ilac: Understanding Its Application When navigating the complex world of medical billing and coding, understanding specific CPT codes can make a significant difference in ensuring accurate claims and proper reimbursement. One such code is CPT Code 00936, which is used for anesthesia services in the
- [CPT Code 00934 for Anes rad amp penis ingun lym](https://denialjournal.com/cpt-code-00934-for-anes-rad-amp-penis-ingun-lym/) - CPT Code 00934: Anesthesia for Radical Amputation of the Penis with Inguinal Lymphadenectomy CPT Code 00934 is an anesthesia code specifically designated for procedures involving the radical amputation of the penis, which may include an inguinal lymphadenectomy. Understanding the nuances of this code is essential for healthcare providers, coders, and billing teams to ensure accurate
- [CPT Code 00932 for Anes male gent compl amp pns](https://denialjournal.com/cpt-code-00932-for-anes-male-gent-compl-amp-pns/) - When it comes to medical billing and coding, understanding the nuances of each CPT code is essential for healthcare providers, billing teams, and coders. One such code that often requires attention is CPT Code 00932, which pertains to anesthesia for surgical procedures involving complex amputation of the penis, specifically on male genitalia. This article provides
- [CPT Code 00930 for Anes px male gent orchiopexy](https://denialjournal.com/cpt-code-00930-for-anes-px-male-gent-orchiopexy/) - Introduction CPT Code 00930 is a crucial component in the realm of medical billing and coding, particularly for procedures involving anesthesia during male genital surgeries such as orchiopexy. Understanding this code is essential for healthcare providers, coders, and billing teams to ensure accurate documentation and efficient reimbursement. This article will delve into the specifics of
- [CPT Code 00928 for Anes male gent rad orch abd](https://denialjournal.com/cpt-code-00928-for-anes-male-gent-rad-orch-abd/) - CPT Code 00928 for Anes male gent rad orch abd The CPT Code 00928 plays a critical role in medical billing, specifically related to anesthesia services for male genital procedures. This code is pertinent for anesthesia provided during radical orchiectomy and abdominal procedures. Understanding its nuances is essential for healthcare providers, coders, and billing teams
- [CPT Code 00926 for Anes male gent rad orch ing](https://denialjournal.com/cpt-code-00926-for-anes-male-gent-rad-orch-ing/) - CPT Code 00926: Understanding Its Role in Anesthesia for Male Genital Procedures In the ever-evolving world of medical billing, precision in coding is crucial. CPT Code 00926 is particularly significant for healthcare providers involved in anesthesiology and urology. It specifies anesthesia services for procedures on the male genital system, especially those involving radical orchiectomy and
- [CPT Code 00924 for Anes male gent undscnd tstis](https://denialjournal.com/cpt-code-00924-for-anes-male-gent-undscnd-tstis/) - CPT Code 00924 for Anesthesia in Male Genital Procedures: Understanding Undescended Testes When it comes to anesthesia coding for specific procedures, having an accurate understanding of CPT codes is crucial for healthcare providers, coders, and billing teams. CPT Code 00924, which covers anesthesia for procedures on male genitalia, particularly for undescended testes (cryptorchidism), is one
- [CPT Code 00922 for Anes px male gent sem ves](https://denialjournal.com/cpt-code-00922-for-anes-px-male-gent-sem-ves/) - CPT Code 00922 for Anesthesia in Procedures on Male Genitalia and Seminal Vesicles: A Comprehensive Guide In the complex world of medical coding, understanding specific codes such as CPT Code 00922 is crucial for accurate billing and compliance. This guide aims to clarify common questions and concerns about this code, focusing on its application in
- [CPT Code 00921 for Anes px male genitalia vasec](https://denialjournal.com/cpt-code-00921-for-anes-px-male-genitalia-vasec/) - CPT Code 00921 for Anesthesia in Male Genitalia Vasectomy: Essential Insights Understanding the nuances of CPT codes is crucial for healthcare providers, coders, and billing teams. One such code, CPT Code 00921, is specifically used for anesthesia services during male genitalia procedures, such as vasectomies. This article aims to provide a comprehensive overview of CPT
- [CPT Code 00920 for Anes px male genitalia nos](https://denialjournal.com/cpt-code-00920-for-anes-px-male-genitalia-nos/) - CPT Code 00920 is a critical element in the billing and reimbursement process for anesthesia services related to procedures involving the male genitalia not otherwise specified (NOS). Understanding this code, its application, and implications is essential for healthcare providers, coders, and billing teams aiming to ensure compliance and optimize revenue cycle management. This article provides
- [CPT Code 00918 for Anes trurl px urtrl cal rmvl](https://denialjournal.com/cpt-code-00918-for-anes-trurl-px-urtrl-cal-rmvl/) - The medical billing and coding landscape is intricate, requiring precise attention to detail and understanding of various codes. One such code, CPT Code 00918, plays a critical role in anesthesia services during certain urological procedures. This article delves into the specifics of CPT Code 00918, focusing on its application for anesthesia during transurethral removal of
- [CPT Code 00916 for Anes trurl px rescj bleeding](https://denialjournal.com/cpt-code-00916-for-anes-trurl-px-rescj-bleeding/) - CPT Code 00916 for Anes trurl px rescj bleeding: A Comprehensive Guide CPT Code 00916 plays a crucial role in the medical billing and coding landscape, especially for procedures involving anesthesia during transurethral procedures aimed at controlling bleeding. For healthcare providers, coders, and billing teams, understanding the nuances of this code is essential to ensure
- [CPT Code 00914 for Anes trurl px rescj prst8](https://denialjournal.com/cpt-code-00914-for-anes-trurl-px-rescj-prst8/) - Understanding CPT Code 00914: Anesthesia for Transurethral Procedures Involving the Prostate Anesthesia coding is a nuanced aspect of medical billing, especially when it comes to specific procedures like those involving the prostate. Among the myriad of CPT codes used for anesthesia services, CPT Code 00914 is particularly significant for healthcare providers and billing professionals involved
- [CPT Code 00912 for Anes trurl px rescj bldr tum](https://denialjournal.com/cpt-code-00912-for-anes-trurl-px-rescj-bldr-tum/) - CPT Code 00912 for Anes Trurl Px Rescj Bldr Tum: Understanding Its Use and Implications Introduction Understanding healthcare codes is crucial for healthcare providers, billing teams, and medical coders to ensure accurate billing and reimbursement. In this article, we focus on CPT Code 00912, which is used for anesthesia services during transurethral resection of bladder
- [CPT Code 00910 for Anes transurethral px nos](https://denialjournal.com/cpt-code-00910-for-anes-transurethral-px-nos/) - CPT Code 00910 for Anesthesia in Transurethral Procedures: A Practical Guide Understanding the nuances of medical coding can be daunting, especially when it comes to anesthesia codes for specific procedures like transurethral surgeries. One such code is CPT 00910, which is used for anesthesia services related to transurethral procedures not otherwise specified (NOS). In this
- [CPT Code 00908 for Anes perineal prostatectomy](https://denialjournal.com/cpt-code-00908-for-anes-perineal-prostatectomy/) - In the intricate world of medical billing and coding, accurately understanding and applying Current Procedural Terminology (CPT) codes is crucial. Among these, CPT Code 00908 is specifically designated for anesthesia services related to perineal prostatectomy. Given its specificity, it presents both opportunities and challenges for healthcare providers, coders, and billing teams. This article aims to
- [CPT Code 00906 for Anes vulvectomy](https://denialjournal.com/cpt-code-00906-for-anes-vulvectomy/) - CPT Code 00906 is a specific code used in medical billing and coding to represent anesthesia services for vulvectomy procedures. Understanding the nuances of this CPT code is crucial for healthcare providers, billing teams, and coders to ensure accurate billing and reimbursement. This article explores the operational implications, common mistakes, documentation requirements, and recommended workflows
- [CPT Code 00904 for Anes radical perineal px](https://denialjournal.com/cpt-code-00904-for-anes-radical-perineal-px/) - CPT Code 00904 for Anes Radical Perineal Px: A Comprehensive Guide CPT Code 00904, used for anesthesia during radical perineal procedures, holds significant importance in medical coding and billing. Accurate coding ensures appropriate reimbursement and compliance with healthcare regulations, making it crucial for healthcare providers, coders, and billing teams to understand its application and implications.
- [CPT Code 00902 for Anes anorectal px](https://denialjournal.com/cpt-code-00902-for-anes-anorectal-px/) - CPT Code 00902 for Anes Anorectal Px: A Comprehensive Guide The medical industry frequently relies on the precise application of Current Procedural Terminology (CPT) codes to ensure accurate billing and documentation. One such code, CPT Code 00902 for Anes anorectal px, is used specifically for anesthesia services related to procedures on the anorectal region. This
- [CPT Code 00882 for Anes maj lwr adb vsl ivc lig](https://denialjournal.com/cpt-code-00882-for-anes-maj-lwr-adb-vsl-ivc-lig/) - In the complex world of medical billing and coding, Current Procedural Terminology (CPT) codes play a pivotal role. They ensure that healthcare providers are accurately reimbursed for the services they render. Among the myriad of codes, CPT Code 00882 stands out as it pertains to anesthesia for major lower abdominal vascular procedures, specifically the inferior
- [CPT Code 00880 for Anes maj lwr abd vessel nos](https://denialjournal.com/cpt-code-00880-for-anes-maj-lwr-abd-vessel-nos/) - CPT Code 00880 for Anesthesia of Major Lower Abdominal Vessels: A Comprehensive Guide CPT Code 00880, often used for anesthesia in procedures involving major lower abdominal vessels, is a critical component of medical billing and coding. Understanding its correct application ensures compliance, accurate reimbursement, and efficient healthcare operations. This article aims to demystify the complexities
- [CPT Code 00873 for Anes lithotrp esw wo wtr bth](https://denialjournal.com/cpt-code-00873-for-anes-lithotrp-esw-wo-wtr-bth/) - CPT Code 00873 for Anes lithotrp esw wo wtr bth: A Comprehensive Guide for Healthcare Professionals Understanding the nuances of CPT Code 00873 can be challenging, especially when it involves procedures like anesthesia for extracorporeal shock wave lithotripsy (ESWL) without water bath. In this article, we'll address the most common questions and concerns related to
- [CPT Code 00872 for Anes lithotrp esw water bath](https://denialjournal.com/cpt-code-00872-for-anes-lithotrp-esw-water-bath/) - CPT Code 00872 for Anesthesia in Lithotripsy with ESW and Water Bath is a specific yet essential concept for healthcare providers, medical coders, billing teams, and even patients seeking clarity. Navigating the complexities of Current Procedural Terminology (CPT) codes can significantly impact billing accuracy and reimbursement rates. This article delves into the nuances of using
- [CPT Code 00870 for Anes xtrprtl cystolithotomy](https://denialjournal.com/cpt-code-00870-for-anes-xtrprtl-cystolithotomy/) - The CPT Code 00870 is specific to anesthesia services provided during an extra-peritoneal cystolithotomy, a surgical procedure to remove bladder stones without opening the peritoneal cavity. This article aims to provide healthcare providers, coders, and billing teams with a comprehensive understanding of this CPT code, including its operational significance, common pitfalls, documentation requirements, and best
- [CPT Code 00868 for Anes xtrprtl px rnl transpl](https://denialjournal.com/cpt-code-00868-for-anes-xtrprtl-px-rnl-transpl/) - Mastering CPT Code 00868 for Anesthesia in Renal Transplants Understanding and appropriately applying CPT Code 00868 is essential for healthcare providers and billing teams involved in renal transplants. This guide provides a comprehensive breakdown of this code, ensuring compliance and optimizing reimbursement. Decoding CPT Code 00868 CPT Code 00868 is designated for anesthesia services during
- [CPT Code 00866 for Anes xtrprt lw abd adrnlctmy](https://denialjournal.com/cpt-code-00866-for-anes-xtrprt-lw-abd-adrnlctmy/) - CPT Code 00866 for Anes xtrprt lw abd adrnlctmy: An In-Depth Guide CPT Code 00866 is a crucial medical code utilized in the billing and documentation processes for anesthesia services during extra-peritoneal lower abdominal adrenalectomy procedures. Understanding its application, related guidelines, and billing implications is vital for healthcare providers, coders, and billing teams. This article
- [CPT Code 00865 for Anes xtrprt lwr abd prst8ect](https://denialjournal.com/cpt-code-00865-for-anes-xtrprt-lwr-abd-prst8ect/) - An In-Depth Examination of CPT Code 00865 for Anesthesia: Extraperitoneal Lower Abdominal Prostatectomy In the complex world of medical billing and coding, accuracy and specificity are paramount. One of the critical components for anesthesia services in surgical procedures is the proper use of Current Procedural Terminology (CPT) codes. Today, we delve into CPT Code 00865,
- [CPT Code 00864 for Anes xtrprt lwr abd tot cstc](https://denialjournal.com/cpt-code-00864-for-anes-xtrprt-lwr-abd-tot-cstc/) - CPT Code 00864 for Anes xtrprt lwr abd tot cstc: A Comprehensive Guide Introduction CPT Code 00864 is a specific medical billing code used to denote anesthesia services for "extra peritoneal lower abdominal surgery total cystectomy." Understanding this code is crucial for healthcare providers, billing teams, and coders to ensure accurate billing and reimbursement processes.
- [CPT Code 00862 for Anes xtrprtl lwr abd rnl px](https://denialjournal.com/cpt-code-00862-for-anes-xtrprtl-lwr-abd-rnl-px/) - CPT Code 00862 for Anesthesia in Extraperitoneal Lower Abdominal Renal Procedures: A Comprehensive Guide Understanding the nuances of medical coding, particularly when it comes to anesthesia, can be a daunting task. CPT Code 00862 is specifically used for anesthesia services provided during extraperitoneal lower abdominal renal procedures. This article aims to clarify the complexities surrounding
- [CPT Code 00860 for Anes xtrprtl px lwr abd nos](https://denialjournal.com/cpt-code-00860-for-anes-xtrprtl-px-lwr-abd-nos/) - CPT Code 00860 refers to anesthesia services for procedures that are extraperitoneal on the lower abdomen, not otherwise specified (NOS). This billing code is part of the Current Procedural Terminology (CPT) system, which provides a uniform language for reporting medical services and procedures across healthcare settings. Understanding the nuances of this code is essential for
- [CPT Code 00851 for Anes iper px tubal ligation](https://denialjournal.com/cpt-code-00851-for-anes-iper-px-tubal-ligation/) - The use of CPT Code 00851 is critical when it comes to billing for anesthesia services related to percutaneous tubal ligation procedures. This code is specifically designated for anesthesia administration during this type of surgical sterilization for women. Understanding the nuances of CPT Code 00851 helps healthcare providers, coders, and billing teams ensure accurate billing
- [CPT Code 00848 for Anes iper px pel exentration](https://denialjournal.com/cpt-code-00848-for-anes-iper-px-pel-exentration/) - CPT Code 00848 for Anesthesia in Pelvic Exenteration: A Strategic Guide Understanding the complexities of CPT Code 00848 for anesthesia services during pelvic exenteration procedures is crucial for healthcare providers and billing teams. This guide offers insights into optimizing operational efficiency, avoiding common denial pitfalls, and ensuring compliance with billing regulations. Understanding CPT Code 00848
- [CPT Code 00846 for Anes iper px rad hystrectomy](https://denialjournal.com/cpt-code-00846-for-anes-iper-px-rad-hystrectomy/) - CPT Code 00846 for Anes iper px rad hystrectomy: A Comprehensive Guide Understanding CPT Code 00846, specifically for anesthesia during radical hysterectomy procedures, is crucial for healthcare providers, coders, and billing teams. This code is integral for ensuring accurate billing and reimbursement, which affects the financial health of medical practices. In this guide, we will
- [CPT Code 00844 for Anes iper px abdmnprnl rescj](https://denialjournal.com/cpt-code-00844-for-anes-iper-px-abdmnprnl-rescj/) - The intricate world of medical billing and coding is ever-evolving, demanding precision and up-to-date knowledge from healthcare providers, coders, and billing teams. The CPT (Current Procedural Terminology) code 00844, specifically for anesthesia during an abdominoperineal resection, exemplifies this complexity. This article delves into the nuances of CPT Code 00844, offering insights into its application, implications
- [CPT Code 00842 for Anes iper px amniocentesis](https://denialjournal.com/cpt-code-00842-for-anes-iper-px-amniocentesis/) - CPT Code 00842 for Anes iper px amniocentesis: A Comprehensive Guide Understanding the intricacies of medical billing, particularly when it comes to anesthesia during procedures like amniocentesis, is crucial for healthcare providers, coders, and billing teams. This article delves into the specifics of CPT Code 00842, its application, and factors that should be considered for
- [CPT Code 00834 for Anes hernia repair < 1 yr age](https://denialjournal.com/cpt-code-00834-for-anes-hernia-repair-1-yr-age/) - In the realm of medical billing and coding, accurately assigning CPT codes is crucial for ensuring proper reimbursement and compliance with regulatory standards. One such code, CPT Code 00834, is specifically designated for anesthesia services related to hernia repair in patients less than one year of age. Understanding the nuances of this code is essential
- [CPT Code 00836 for Anes hrna rpr < 37wk brth < 50](https://denialjournal.com/cpt-code-00836-for-anes-hrna-rpr-37wk-brth-50/) - CPT Code 00836 for Anesthesia in Hernia Repair: Understanding Its Use in Preterm Neonates In the complex world of medical billing and coding, precise understanding and application of CPT codes are paramount. One such code that often raises questions is CPT Code 00836. This particular code is used for anesthesia during hernia repair procedures in
- [CPT Code 00840 for Anes iper px lower abd nos](https://denialjournal.com/cpt-code-00840-for-anes-iper-px-lower-abd-nos/) - CPT Code 00840 for Anesthesia in Peritoneal Procedures: What You Need to Know As a healthcare provider, coder, or billing specialist, understanding the nuances of anesthesia codes is crucial for accurate billing and compliance. CPT Code 00840 specifically concerns anesthesia for peritoneal procedures in the lower abdomen. Let's dive into the specifics of this code
- [Liver Ultrasound CPT Codes Explained for Healthcare Providers](https://denialjournal.com/liver-ultrasound-cpt-codes-explained-for-healthcare-providers/) - Medical billing isn't simple. If your clinical documentation lacks precision, your practice loses legitimate revenue or faces severe compliance audits. In five years of consulting with radiology groups and health systems, I have seen numerous billing teams struggle with diagnostic imaging codes because there is no standalone, specific cpt code for liver ultrasound procedures. Instead,
- [CPT Code 00797 for Anes iper upr abd gstr px mo](https://denialjournal.com/cpt-code-00797-for-anes-iper-upr-abd-gstr-px-mo/) - The healthcare billing landscape can be intricate, especially when dealing with anesthesia codes. For professionals navigating the billing process, understanding the specifics of each code is crucial. This article focuses on CPT Code 00797 for Anes iper upr abd gstr px mo, a code that plays a vital role in the billing for anesthesia services
- [CPT Code 00796 for Anes iper upr abd lvr trnspl](https://denialjournal.com/cpt-code-00796-for-anes-iper-upr-abd-lvr-trnspl/) - Understanding CPT Code 00796 for Anesthesia in Upper Abdominal Liver Transplant Procedures In the complex realm of medical billing and coding, Current Procedural Terminology (CPT) codes play a crucial role in standardizing medical procedures. One such code, CPT Code 00796, is specifically used for anesthesia services during upper abdominal procedures, particularly liver transplants. This article
- [CPT Code 00794 for Anes iper upr abd pncrtect](https://denialjournal.com/cpt-code-00794-for-anes-iper-upr-abd-pncrtect/) - CPT Code 00794: Anesthesia for Upper Abdominal Procedures Including Pancreatectomy Understanding the intricacies of medical billing and coding is crucial for healthcare providers to ensure accurate reimbursement for services rendered. One specific area of interest is the use of Current Procedural Terminology (CPT) codes, which are used to describe medical, surgical, and diagnostic services. Among
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- [CPT Code 00300 for Anes all px integ h/n/ptrunk](https://denialjournal.com/cpt-code-00300-for-anes-all-px-integ-h-n-ptrunk/) - Understanding CPT Code 00300: Anesthesia for Procedures on Integumentary System of Head, Neck, and Posterior Trunk CPT Code 00350 is another important code that also pertains to anesthesia services for procedures involving major vessels of the neck. This code is specifically used for anesthesia administered during procedures on the integumentary system of the head, neck,
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- [99204 CPT Code Explained: Requirements, Time, MDM & Billing Rules](https://denialjournal.com/99204-cpt-code-explained-requirements-time-mdm-billing-rules/) - Mastering evaluation and management (E/M) coding requires looking past theoretical manuals and focusing directly on compliance realities. As an industry consultant who has spent the last 10 years auditing physician charts and resolving payer disputes, I know how frequently the 99204 CPT code becomes a primary target for recovery auditors. The 2021 E/M guidelines completely
- [CPT Code 00100 for Anes px salivary gland w/bx](https://denialjournal.com/cpt-code-00100-for-anes-px-salivary-gland-w-bx/) - Understanding CPT Code 00100: Anesthesia for Salivary Gland Procedures with Biopsy The healthcare industry relies heavily on standardized coding systems to ensure consistent communication and billing practices. One such system is the Current Procedural Terminology (CPT) codes, maintained by the American Medical Association (AMA). These codes are essential for documenting medical services and procedures. In
- [CPT Code 00102 for Anes px plstc rpr cleft lip](https://denialjournal.com/cpt-code-00102-for-anes-px-plstc-rpr-cleft-lip/) - Understanding CPT Code 00102 for Anesthesia in Plastic Repair of Cleft Lip In the medical billing and coding world, Current Procedural Terminology (CPT) codes are crucial for accurately documenting and billing medical procedures. Among these codes, CPT Code 00102 holds specific significance for industry professionals dealing with anesthesia services during the plastic repair of cleft
- [CPT Code 00164 for Anes px nose&sins bx sft tis](https://denialjournal.com/cpt-code-00164-for-anes-px-nosesins-bx-sft-tis/) - CPT Code 00164 for Anesthesia Procedures: Nose and Sinus Biopsy of Soft Tissue In the realm of medical billing and coding, understanding the nuances of Current Procedural Terminology (CPT) codes is crucial for both industry professionals and general searchers. One such code that often comes under scrutiny is CPT Code 00164, which pertains to anesthesia
- [CPT Code 00170 for Anes intraoral px nos](https://denialjournal.com/cpt-code-00170-for-anes-intraoral-px-nos/) - Understanding CPT Code 00170 for Anesthesia in Intraoral Procedures CPT Code 00170 is a specific code used in the medical billing and coding industry to categorize anesthesia services provided during intraoral procedures. This code is crucial for healthcare providers, medical billing professionals, and insurance companies to ensure accurate billing and reimbursement. In this article, we
- [CPT Code 00172 for Anes ntroral px rpr clft pal](https://denialjournal.com/cpt-code-00172-for-anes-ntroral-px-rpr-clft-pal/) - CPT Code 00172: Anesthesia for Intraoral Procedures Involving Repair of Cleft Palate CPT Code 00172 is a specific code used in the field of medical billing and coding, particularly for anesthesia services. It pertains to anesthesia provided during intraoral procedures for the repair of cleft palates. Understanding the nuances of this code is crucial for
- [CPT Code 00174 for Anes ntrorl exc rtrphrng tum](https://denialjournal.com/cpt-code-00174-for-anes-ntrorl-exc-rtrphrng-tum/) - CPT Code 00174: Anesthesia for Control of Excision of Retropharyngeal Tumor CPT Code 00174 is a specific billing code used in the medical field to represent anesthesia services provided during the excision of a retropharyngeal tumor. This code is integral for healthcare providers as it ensures the accurate billing and documentation of anesthesia services during
- [CPT Code 00192 for Anes px fcl b1/skl rad surg](https://denialjournal.com/cpt-code-00192-for-anes-px-fcl-b1-skl-rad-surg/) - CPT Code 00192 is a specific designation used in medical billing and coding to describe anesthesia services provided during procedures involving facial bone or skull base surgery, specifically those that require radiological surgery. Understanding this code is crucial for industry professionals involved in medical billing and coding, as well as for healthcare providers who need
- [Texas Medical Billing Companies: Top Picks for 2026](https://denialjournal.com/texas-medical-billing-companies-top-picks-for-2026/) - Explore top Texas medical billing companies for 2026. Compare services, expertise, compliance, and quality to choose the right billing partner.
- [The Ultimate Guide to Medical Billing Software: Features, Pricing, and Implementation for Modern Practices](https://denialjournal.com/the-ultimate-guide-to-medical-billing-software-features-pricing-and-implementation-for-modern-practices/) - Introduction Reimbursement is the lifeline of a practice’s financial health. Any small inefficiency, such as incorrect patient data or failure to collect correct policy data, may lead to a delay in the reimbursement process from many days to weeks. To minimize these errors, many medical practices are turning towards Medical Billing Software (MBS). This software
- [Understanding the Medical Billing Cycle in RCM](https://denialjournal.com/understanding-the-medical-billing-cycle-in-rcm/) - What Is the Medical Billing Cycle? Without an efficient revenue cycle management (RCM), a health care organization may face financial loss. The medical billing cycle plays a major role in the collection of payments and maintaining financial health for medical practices, which is further explained in the medical billing process. The medical billing process cycle
- [Top Physician Billing Service Companies in the USA](https://denialjournal.com/top-physician-billing-service-companies-in-the-usa/) - Compare the top physician billing service companies in the USA. Discover features, pricing, and best providers to improve your practice revenue cycle.
- [5 Medical Billing Systems with Integrated EHR: A Seamless Workflow Review](https://denialjournal.com/5-medical-billing-systems-with-integrated-ehr-a-seamless-workflow-review/) - The Power of a Unified Platform Running a medical practice today often means juggling multiple systems at once. Like you have to jump from one login to another just to keep the workflow smooth. One software for clinical notes, another for billing, and sometimes a third tool for scheduling or patient communication. While each system
- [Optimizing Reimbursement Through Mastery of All CPT Codes](https://denialjournal.com/optimizing-reimbursement-through-mastery-of-all-cpt-codes/) - Master 2026 CPT codes to optimize reimbursement. Explore Category I-III, PLA codes, and AI-driven diagnostic updates.
- [20561 CPT Code: A Guide to Medical Billing and Clinical Best Practices](https://denialjournal.com/20561-cpt-code-a-guide-to-medical-billing-and-clinical-best-practices/) - 20561 CPT code is a standardized medical billing code used by healthcare providers to report the insertion of a needle electrode into three or more muscles during a needle electromyography (EMG) procedure, distinct from cranial nerve-supplied muscles, to evaluate neuromuscular function. American Medical Association (AMA): "CPT code 20561 describes the insertion of needle electrode(s); 3
- [Navigating Behavioral Health: The Intersection of Counseling and RCM](https://denialjournal.com/navigating-behavioral-health-the-intersection-of-counseling-and-rcm/) - What is Counseling? Counseling are a collaborative clinical process where licensed professional help individuals navigate emotional, psychological, and behavioral challenges. It empowers patients to process trauma, build coping strategys, and ultimately improve their overall mental well-being. Types of Counseling Specialized Approaches: Treatments are specifically tailored to meet clinical benchmarks and patient goals. Cognitive Behavioral Therapy
- [CPT Code for Mona Lisa Laser Treatment](https://denialjournal.com/cpt-code-for-mona-lisa-laser-treatment/) - Medical billing teams frequently encounter friction when managing claims for energy-based gynecological procedures. Specifically, providers want to know the exact cpt code for mona lisa laser treatment to secure consistent insurance coverage. Unfortunately, the path to reimbursement is rarely straightforward. Reality Behind the CPT Code for Mona Lisa Laser Treatment A standardized, distinct insurance code
- [CPT Code 72192 for CT scan of the pelvis without contrast](https://denialjournal.com/cpt-code-72192-for-ct-scan-of-the-pelvis-without-contrast/) - CPT Code 72192: Understanding CT Scan of the Pelvis Without Contrast When discussing diagnostic imaging, the use of CPT codes becomes essential for accurate billing and documentation. One such code, CPT Code 72192, is specifically used for a computed tomography (CT) scan of the pelvis without the use of contrast material. This article aims to
- [CPT Code 00103 for Anes rcnstv px eyelid](https://denialjournal.com/cpt-code-00103-for-anes-rcnstv-px-eyelid/) - Understanding CPT Code 00103 for Anesthesia in Reconstructive Eyelid Procedures CPT Code 00103 is a critical component in the realm of medical billing and coding, particularly for anesthesia services related to reconstructive eyelid procedures. This code is used by healthcare providers to accurately document and bill for the anesthesia administered during surgeries that aim to
- [CPT Code 00124 for Anes px ear otoscopy](https://denialjournal.com/cpt-code-00124-for-anes-px-ear-otoscopy/) - Understanding CPT Code 00124: Anesthesia for Ear Procedures In the medical billing and coding landscape, Current Procedural Terminology (CPT) codes are essential for accurately documenting and billing medical procedures. One such code, CPT 00124, is specifically used for anesthesia services related to procedures on the external, middle, and inner ear, such as otoscopy. This article
- [CPT Code 00126 for Anes px ear tympanotomy](https://denialjournal.com/cpt-code-00126-for-anes-px-ear-tympanotomy/) - Understanding CPT Code 00126 for Anesthesia During Ear Tympanotomy CPT Code 00126 is a procedural code used by healthcare professionals to document anesthesia services provided during an ear tympanotomy. This code is pertinent for both industry professionals managing billing and coding processes and general searchers seeking to understand specific medical billing practices. Understanding this code
- [CPT Code 00142 for Anes px on eye lens surgery](https://denialjournal.com/cpt-code-00142-for-anes-px-on-eye-lens-surgery/) - Understanding CPT Code 00142 for Anesthesia during Eye Lens Surgery CPT Code 00142 is a procedural code used to describe the administration of anesthesia during surgical procedures involving the eye lens, such as cataract surgery. This code is a part of the Current Procedural Terminology (CPT) system, which is maintained by the American Medical Association
- [CPT Code 00145 for Anes px eye vitreortnl surg](https://denialjournal.com/cpt-code-00145-for-anes-px-eye-vitreortnl-surg/) - Understanding CPT Code 00145 for Anesthesia in Eye Vitreoretinal Surgery CPT Code 00145 is a procedural code used to describe anesthesia services provided during eye vitreoretinal surgery. This code is vital for healthcare professionals, particularly those involved in medical billing and coding, as it ensures the correct documentation and reimbursement for anesthesia services in these
- [CPT Code 00147 for Anes px on eye iridectomy](https://denialjournal.com/cpt-code-00147-for-anes-px-on-eye-iridectomy/) - Understanding CPT Code 00147: Anesthesia for Eye Iridectomy In the realm of medical billing and coding, the accurate use of Current Procedural Terminology (CPT) codes is crucial for ensuring proper reimbursement and documentation. One such code, CPT 00147, is specifically used for anesthesia services provided during an eye iridectomy procedure. This article serves as a
- [CPT Code 00148 for Anes px eye ophthalmoscopy](https://denialjournal.com/cpt-code-00148-for-anes-px-eye-ophthalmoscopy/) - Understanding CPT Code 00148 for Anesthesia in Eye Ophthalmoscopy Current Procedural Terminology (CPT) codes are essential tools used by healthcare professionals to uniformly document medical procedures and services. Among these, CPT Code 00148 is specific to anesthesia services for procedures on the eye, particularly ophthalmoscopy. This article aims to provide a comprehensive overview of CPT
- [CPT Code 00160 for Anes px nose&sinus nos](https://denialjournal.com/cpt-code-00160-for-anes-px-nosesinus-nos/) - Understanding CPT Code 00160 for Anesthesia in Nose and Sinus Procedures CPT code 00160 is an integral part of medical billing, particularly in the field of anesthesia for procedures involving the nose and sinus. This article will delve into the specifics of this code, its appropriate usage, and its importance in both clinical practice and
- [CPT Code 00162 for Anes px nose&sinus rad surg](https://denialjournal.com/cpt-code-00162-for-anes-px-nosesinus-rad-surg/) - Understanding CPT Code 00162 for Anesthesia in Nose and Sinus Radical Surgery In the world of medical billing and coding, precision is key. One such precise detail is the use of Current Procedural Terminology (CPT) codes, which are essential for documenting medical procedures. Among these codes, CPT Code 00162 is specifically used for anesthesia in
- [CPT Code 00176 for Anes intraoral px rad surg](https://denialjournal.com/cpt-code-00176-for-anes-intraoral-px-rad-surg/) - Understanding CPT Code 00176 for Anesthesia in Intraoral Procedures CPT Code 00176 is a billing code used by medical professionals to describe anesthesia services provided during intraoral procedures, particularly those involving radical surgeries. This code is part of the Current Procedural Terminology (CPT) system, which standardizes the reporting of medical services and procedures to ensure
- [CPT Code 00190 for Anes px facial b1/skull nos](https://denialjournal.com/cpt-code-00190-for-anes-px-facial-b1-skull-nos/) - Understanding CPT Code 00190: Anesthesia for Procedures on the Facial Bones or Skull CPT Code 00190 is a crucial billing code used by healthcare professionals to designate anesthesia services associated with surgical procedures on the facial bones or the skull. This code plays a significant role in the medical billing and coding process, including the
- [CPT Code 00211 for Anes icr px crnec/crnot hmtm](https://denialjournal.com/cpt-code-00211-for-anes-icr-px-crnec-crnot-hmtm/) - Understanding CPT Code 00211: Anesthesia for Intracranial Procedures CPT Code 00211 is a medical billing code used to describe anesthesia services provided for intracranial procedures. This code is specifically applied in cases involving craniotomies or craniectomies that do not include hematoma evacuation. Industry professionals and general searchers alike can benefit from a comprehensive understanding of
- [CPT Code 00144 for Anes px eye corneal trnspl](https://denialjournal.com/cpt-code-00144-for-anes-px-eye-corneal-trnspl/) - CPT Code 00144 is an important billing code in the realm of medical procedures, specifically for anesthesia services associated with corneal transplant surgeries. Understanding the intricacies of this code is essential for industry professionals, including medical billers, coders, and healthcare providers, as well as for individuals seeking information about billing for corneal transplant procedures. This
- [Guidelines for Utilizing CPT Code 99213](https://denialjournal.com/guidelines-for-utilizing-cpt-code-99213/) - Master the guidelines for CPT Code 99213. Learn documentation requirements, time-based billing, and MDM levels for 2026.
- [Medical Billing for Mental Health Practices: Key Strategies for Success](https://denialjournal.com/medical-billing-for-mental-health-practices-key-strategies-for-success/) - Master mental health billing with our guide on CPT codes, HIPAA compliance, and RCM strategies to boost revenue and ensure practice success.
- [How AI and Automation are Revolutionizing Medical Billing Denial Management](https://denialjournal.com/how-ai-and-automation-are-revolutionizing-medical-billing-denial-management/) - AI and automation are transforming medical billing denial management by improving claim accuracy, reducing errors, speeding reimbursements, and increasing healthcare revenue efficiency.
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## Denial Codes

- [N69](https://denialjournal.com/denial-codes/n69/) - Informational remark: PPS (Prospective Payment System) code changed by claims processing system.
- [N70](https://denialjournal.com/denial-codes/n70/) - Consolidated billing and payment applies.
- [N71](https://denialjournal.com/denial-codes/n71/) - Your unassigned claim for a drug, biological, clinical diagnostic laboratory services or ambulance service was processed as an assigned claim.
- [N72](https://denialjournal.com/denial-codes/n72/) - PPS (Prospective Payment System) code changed by medical reviewers; not supported by clinical records.
- [N73](https://denialjournal.com/denial-codes/n73/) - A Skilled Nursing Facility is responsible for payment of outside providers who furnish services/supplies under arrangement to its residents. This code was deactivated by X12 (as of 01/31/2004). See: MA101, N200.
- [N74](https://denialjournal.com/denial-codes/n74/) - Resubmit with multiple claims, each claim covering services provided in only one calendar month.
- [N75](https://denialjournal.com/denial-codes/n75/) - The claim is missing, incomplete, or has an invalid tooth surface information.
- [N76](https://denialjournal.com/denial-codes/n76/) - The claim is missing, incomplete, or has an invalid number of riders.
- [N77](https://denialjournal.com/denial-codes/n77/) - The claim is missing, incomplete, or has an invalid designated provider number.
- [N78](https://denialjournal.com/denial-codes/n78/) - The necessary components of the child and teen checkup (EPSDT) were not completed.
- [N79](https://denialjournal.com/denial-codes/n79/) - Service billed is not compatible with patient location information.
- [N80](https://denialjournal.com/denial-codes/n80/) - The claim is missing, incomplete, or has an invalid prenatal screening information.
- [N81](https://denialjournal.com/denial-codes/n81/) - Procedure billed is not compatible with tooth surface code.
- [N82](https://denialjournal.com/denial-codes/n82/) - Provider must accept insurance payment as payment in full when a third party payer contract specifies full reimbursement.
- [N83](https://denialjournal.com/denial-codes/n83/) - No appeal rights. Adjudicative decision based on the provisions of a demonstration project.
- [N84](https://denialjournal.com/denial-codes/n84/) - Informational remark: Further installment payments are forthcoming.
- [N85](https://denialjournal.com/denial-codes/n85/) - Informational remark: This is the final installment payment.
- [N86](https://denialjournal.com/denial-codes/n86/) - A failed trial of pelvic muscle exercise training is required for biofeedback training for urinary incontinence to be covered.
- [N87](https://denialjournal.com/denial-codes/n87/) - Home use of biofeedback therapy is not covered.
- [N88](https://denialjournal.com/denial-codes/n88/) - Informational remark: This payment is being made conditionally; an HHA episode of care notice has been filed for this patient.
- [N89](https://denialjournal.com/denial-codes/n89/) - Informational remark: Payment information for this claim has been forwarded to more than one other payer.
- [N90](https://denialjournal.com/denial-codes/n90/) - Covered only when performed by the attending physician.
- [N91](https://denialjournal.com/denial-codes/n91/) - Services not included in the appeal review.
- [N92](https://denialjournal.com/denial-codes/n92/) - This facility is not certified for digital mammography.
- [N93](https://denialjournal.com/denial-codes/n93/) - A separate claim must be submitted for each place of service.
- [N96](https://denialjournal.com/denial-codes/n96/) - Patient must be refractory to conventional therapy and be an appropriate surgical candidate for implantation with anesthesia to occur.
- [N97](https://denialjournal.com/denial-codes/n97/) - Patients with stress incontinence, urinary obstruction, and specific neurologic diseases are excluded.
- [N98](https://denialjournal.com/denial-codes/n98/) - Patient must have had a successful test stimulation to support subsequent implantation.
- [N99](https://denialjournal.com/denial-codes/n99/) - Patient must be able to demonstrate adequate ability to record voiding diary data.
- [N100](https://denialjournal.com/denial-codes/n100/) - PPS (Prospective Payment System) code corrected during adjudication. This code was deactivated by X12 (as of 11/01/2016).
- [N101](https://denialjournal.com/denial-codes/n101/) - Additional information is needed; resubmit the claim with the identification number of the provider where this service took place. This code was deactivated by X12 (as of 01/31/2004). See: MA105.
- [N102](https://denialjournal.com/denial-codes/n102/) - This claim has been denied without reviewing the medical/dental record because the requested records were not received timely. This code was deactivated by X12 (as of 07/01/2016).
- [N103](https://denialjournal.com/denial-codes/n103/) - Records indicate this patient was a prisoner or in custody of a Federal, State, or local authority when the service was rendered.
- [N104](https://denialjournal.com/denial-codes/n104/) - This claim/service is not payable under our claims jurisdiction area.
- [MA133](https://denialjournal.com/denial-codes/ma133/) - Claim overlaps inpatient stay. Rebill only those services rendered outside the inpatient stay.
- [MA134](https://denialjournal.com/denial-codes/ma134/) - The claim is missing, incomplete, or has an invalid provider number of the facility where the patient resides.
- [N1](https://denialjournal.com/denial-codes/n1/) - Informational remark: You may appeal this decision in writing within the required time limits following receipt of this notice.
- [N2](https://denialjournal.com/denial-codes/n2/) - This allowance has been made in accordance with the most appropriate course of treatment provision of the plan.
- [N3](https://denialjournal.com/denial-codes/n3/) - Missing consent form.
- [N4](https://denialjournal.com/denial-codes/n4/) - The claim is missing, incomplete, or has an invalid prior Insurance Carrier(s) EOB.
- [N5](https://denialjournal.com/denial-codes/n5/) - EOB received from previous payer. Claim not on file.
- [N6](https://denialjournal.com/denial-codes/n6/) - Under FEHB law we cannot pay more for covered care than the amount Medicare would have allowed.
- [N7](https://denialjournal.com/denial-codes/n7/) - Informational remark: Processing of this claim/service has included consideration under Major Medical provisions.
- [N8](https://denialjournal.com/denial-codes/n8/) - Crossover claim denied by previous payer and complete claim data not forwarded.
- [N9](https://denialjournal.com/denial-codes/n9/) - Adjustment represents the estimated amount a previous payer may pay.
- [N10](https://denialjournal.com/denial-codes/n10/) - Adjustment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review.
- [N11](https://denialjournal.com/denial-codes/n11/) - Denial reversed because of medical review.
- [N12](https://denialjournal.com/denial-codes/n12/) - Policy provides coverage supplemental to Medicare; the member is responsible for the portion Medicare would have covered.
- [N13](https://denialjournal.com/denial-codes/n13/) - Payment based on professional/technical component modifier(s).
- [N14](https://denialjournal.com/denial-codes/n14/) - Payment based on a contractual amount or agreement, fee schedule, or maximum allowable amount. This code was deactivated by X12 (as of 10/01/2007).
- [N15](https://denialjournal.com/denial-codes/n15/) - Services for a newborn must be billed separately.
- [N16](https://denialjournal.com/denial-codes/n16/) - Family/member Out-of-Pocket maximum has been met. Payment based on a higher percentage.
- [N17](https://denialjournal.com/denial-codes/n17/) - Per admission deductible. This code was deactivated by X12 (as of 08/01/2004).
- [N18](https://denialjournal.com/denial-codes/n18/) - Payment based on the Medicare allowed amount. This code was deactivated by X12 (as of 01/31/2004). See: N14.
- [N20](https://denialjournal.com/denial-codes/n20/) - Service not payable with other service rendered on the same date.
- [N21](https://denialjournal.com/denial-codes/n21/) - Informational remark: Your line item has been separated into multiple lines to expedite handling.
- [N22](https://denialjournal.com/denial-codes/n22/) - Informational remark: This procedure code was added/changed because it more accurately describes the services rendered.
- [N23](https://denialjournal.com/denial-codes/n23/) - Informational remark: Patient liability may be affected due to coordination of benefits with other carriers and/or maximum benefit provisions.
- [N24](https://denialjournal.com/denial-codes/n24/) - The claim is missing, incomplete, or has an invalid Electronic Funds Transfer (EFT) banking information.
- [N25](https://denialjournal.com/denial-codes/n25/) - This company has been contracted by your benefit plan to provide administrative claims payment services only.
- [N26](https://denialjournal.com/denial-codes/n26/) - Missing itemized bill/statement.
- [N27](https://denialjournal.com/denial-codes/n27/) - The claim is missing, incomplete, or has an invalid treatment number.
- [N28](https://denialjournal.com/denial-codes/n28/) - Consent form requirements not fulfilled.
- [N29](https://denialjournal.com/denial-codes/n29/) - Missing documentation/orders/notes/summary/report/chart. This code was deactivated by X12 (as of 03/01/2016).
- [N31](https://denialjournal.com/denial-codes/n31/) - The claim is missing, incomplete, or has an invalid prescribing provider identifier.
- [N32](https://denialjournal.com/denial-codes/n32/) - Claim must be submitted by the provider who rendered the service.
- [N33](https://denialjournal.com/denial-codes/n33/) - No record of health check prior to initiation of treatment.
- [N34](https://denialjournal.com/denial-codes/n34/) - Incorrect claim form/format for this service.
- [N35](https://denialjournal.com/denial-codes/n35/) - Program integrity/utilization review decision.
- [N36](https://denialjournal.com/denial-codes/n36/) - Claim must meet primary payer's processing requirements before we can consider payment.
- [N37](https://denialjournal.com/denial-codes/n37/) - The claim is missing, incomplete, or has an invalid tooth number/letter.
- [N38](https://denialjournal.com/denial-codes/n38/) - The claim is missing, incomplete, or has an invalid place of service. This code was deactivated by X12 (as of 02/05/2005). See: M77.
- [N39](https://denialjournal.com/denial-codes/n39/) - Procedure code is not compatible with tooth number/letter.
- [N40](https://denialjournal.com/denial-codes/n40/) - Missing radiology film(s)/image(s).
- [N41](https://denialjournal.com/denial-codes/n41/) - Authorization request denied. This code was deactivated by X12 (as of 10/16/2003).
- [N42](https://denialjournal.com/denial-codes/n42/) - Missing mental health assessment.
- [N43](https://denialjournal.com/denial-codes/n43/) - Bed hold or leave days exceeded.
- [N44](https://denialjournal.com/denial-codes/n44/) - Payer's share of regulatory surcharges, assessments, allowances or health care-related taxes paid directly to the regulatory authority. This code was deactivated by X12 (as of 10/16/2003).
- [N45](https://denialjournal.com/denial-codes/n45/) - Payment based on authorized amount.
- [N46](https://denialjournal.com/denial-codes/n46/) - The claim is missing, incomplete, or has an invalid admission hour.
- [N47](https://denialjournal.com/denial-codes/n47/) - Claim conflicts with another inpatient stay.
- [N48](https://denialjournal.com/denial-codes/n48/) - Claim information does not agree with information received from other insurance carrier.
- [N49](https://denialjournal.com/denial-codes/n49/) - Court ordered coverage information needs validation.
- [N51](https://denialjournal.com/denial-codes/n51/) - Electronic interchange agreement not on file for provider/submitter.
- [N52](https://denialjournal.com/denial-codes/n52/) - Patient not enrolled in the billing provider's managed care plan on the date of service.
- [N53](https://denialjournal.com/denial-codes/n53/) - The claim is missing, incomplete, or has an invalid point of pick-up address.
- [N55](https://denialjournal.com/denial-codes/n55/) - Procedures for billing with group/referring/performing providers were not followed.
- [N57](https://denialjournal.com/denial-codes/n57/) - The claim is missing, incomplete, or has an invalid prescribing date.
- [N58](https://denialjournal.com/denial-codes/n58/) - The claim is missing, incomplete, or has an invalid patient liability amount.
- [N59](https://denialjournal.com/denial-codes/n59/) - Informational remark: Please refer to your provider manual for additional program and provider information.
- [N60](https://denialjournal.com/denial-codes/n60/) - A valid NDC is required for payment of drug claims. This code was deactivated by X12 (as of 01/31/2004). See: M119.
- [N61](https://denialjournal.com/denial-codes/n61/) - Rebill services on separate claims.
- [N62](https://denialjournal.com/denial-codes/n62/) - Dates of service span multiple rate periods. Resubmit separate claims.
- [N63](https://denialjournal.com/denial-codes/n63/) - Rebill services on separate claim lines.
- [N64](https://denialjournal.com/denial-codes/n64/) - The 'from' and 'to' dates must be different.
- [N66](https://denialjournal.com/denial-codes/n66/) - The claim is missing, incomplete, or has an invalid documentation. This code was deactivated by X12 (as of 02/05/2005). See: N29, N225.
- [N67](https://denialjournal.com/denial-codes/n67/) - Professional provider services not paid separately when included in facility payment under a demonstration project.
- [N68](https://denialjournal.com/denial-codes/n68/) - Prior payment being cancelled as we were subsequently notified this patient was covered by a demonstration project at this site of service.
- [MA66](https://denialjournal.com/denial-codes/ma66/) - The claim is missing, incomplete, or has an invalid principal procedure code.
- [MA67](https://denialjournal.com/denial-codes/ma67/) - Informational remark: Correction to a prior claim.
- [MA68](https://denialjournal.com/denial-codes/ma68/) - Informational remark: We did not crossover this claim because the secondary insurance information on the claim was incomplete.
- [MA69](https://denialjournal.com/denial-codes/ma69/) - The claim is missing, incomplete, or has an invalid remarks.
- [MA70](https://denialjournal.com/denial-codes/ma70/) - The claim is missing, incomplete, or has an invalid provider representative signature.
- [MA71](https://denialjournal.com/denial-codes/ma71/) - The claim is missing, incomplete, or has an invalid provider representative signature date.
- [MA72](https://denialjournal.com/denial-codes/ma72/) - Informational remark: The patient overpaid you for these assigned services. You must issue a refund within 30 days.
- [MA73](https://denialjournal.com/denial-codes/ma73/) - Informational remittance associated with a Medicare demonstration; patient has elected managed care.
- [MA74](https://denialjournal.com/denial-codes/ma74/) - Informational remark: This payment replaces an earlier payment for this claim that was either lost, damaged or returned.
- [MA75](https://denialjournal.com/denial-codes/ma75/) - The claim is missing, incomplete, or has an invalid patient or authorized representative signature.
- [MA76](https://denialjournal.com/denial-codes/ma76/) - The claim is missing, incomplete, or has an invalid provider identifier for home health agency or hospice when physician is performing care plan oversight services.
- [MA77](https://denialjournal.com/denial-codes/ma77/) - Informational remark: The patient overpaid you. You must issue a refund within 30 days.
- [MA78](https://denialjournal.com/denial-codes/ma78/) - The patient overpaid you. The provider must issue a refund within 30 days for the difference. This code was deactivated by X12 (as of 01/31/2004). See: MA59.
- [MA79](https://denialjournal.com/denial-codes/ma79/) - Billed in excess of interim rate.
- [MA80](https://denialjournal.com/denial-codes/ma80/) - Informational notice. No payment issued for this claim; payment issued to the hospital by its intermediary under a demonstration project.
- [MA81](https://denialjournal.com/denial-codes/ma81/) - The claim is missing, incomplete, or has an invalid provider/supplier signature.
- [MA82](https://denialjournal.com/denial-codes/ma82/) - The claim is missing, incomplete, or has an invalid provider/supplier billing number/identifier or billing name, address, city, state, zip code, or phone number. This code was deactivated by X12 (as of 06/02/2005).
- [MA83](https://denialjournal.com/denial-codes/ma83/) - Did not indicate whether we are the primary or secondary payer.
- [MA84](https://denialjournal.com/denial-codes/ma84/) - Patient identified as participating in the National Emphysema Treatment Trial but records indicate discrepancy.
- [MA85](https://denialjournal.com/denial-codes/ma85/) - Our records indicate a primary payer exists; the provider did not complete or enter accurately the insurance plan/group/program name or ID number. This code was deactivated by X12 (as of 08/01/2004). See: MA92.
- [MA86](https://denialjournal.com/denial-codes/ma86/) - The claim is missing, incomplete, or has an invalid group or policy number of the insured for the primary coverage. This code was deactivated by X12 (as of 08/01/2004). See: MA92.
- [MA87](https://denialjournal.com/denial-codes/ma87/) - The claim is missing, incomplete, or has an invalid insured's name for the primary payer. This code was deactivated by X12 (as of 08/01/2004). See: MA92.
- [MA88](https://denialjournal.com/denial-codes/ma88/) - The claim is missing, incomplete, or has an invalid insured's address and/or telephone number for the primary payer.
- [MA89](https://denialjournal.com/denial-codes/ma89/) - The claim is missing, incomplete, or has an invalid patient's relationship to the insured for the primary payer.
- [MA90](https://denialjournal.com/denial-codes/ma90/) - The claim is missing, incomplete, or has an invalid employment status code for the primary insured.
- [MA91](https://denialjournal.com/denial-codes/ma91/) - Informational remark: This determination is the result of the appeal you filed.
- [MA92](https://denialjournal.com/denial-codes/ma92/) - Missing plan information for other insurance.
- [MA93](https://denialjournal.com/denial-codes/ma93/) - Non-PIP (Periodic Interim Payment) claim.
- [MA94](https://denialjournal.com/denial-codes/ma94/) - Did not enter the statement 'Attending physician not hospice employee' on the claim form.
- [MA95](https://denialjournal.com/denial-codes/ma95/) - A not otherwise classified or unlisted procedure code(s) was billed but a narrative description was not entered. This code was deactivated by X12 (as of 01/01/2004). See: M51.
- [MA96](https://denialjournal.com/denial-codes/ma96/) - Claim rejected. Coded as a Medicare Managed Care Demonstration but patient is not enrolled.
- [MA97](https://denialjournal.com/denial-codes/ma97/) - The claim is missing, incomplete, or has an invalid Medicare Managed Care Demonstration contract number or clinical trial registry number.
- [MA98](https://denialjournal.com/denial-codes/ma98/) - Claim Rejected. Does not contain the correct Medicare Managed Care Demonstration contract number. This code was deactivated by X12 (as of 10/16/2003). See: MA97.
- [MA99](https://denialjournal.com/denial-codes/ma99/) - The claim is missing, incomplete, or has an invalid Medigap information.
- [MA100](https://denialjournal.com/denial-codes/ma100/) - The claim is missing, incomplete, or has an invalid date of current illness or symptoms.
- [MA101](https://denialjournal.com/denial-codes/ma101/) - A Skilled Nursing Facility (SNF) is responsible for payment of outside providers who furnish services/supplies to residents. This code was deactivated by X12 (as of 01/01/2011). See: N538.
- [MA102](https://denialjournal.com/denial-codes/ma102/) - The claim is missing, incomplete, or has an invalid name or provider identifier for the rendering/referring/ordering/supervising provider. This code was deactivated by X12 (as of 08/01/2004). See: M68.
- [MA103](https://denialjournal.com/denial-codes/ma103/) - Hemophilia Add On.
- [MA104](https://denialjournal.com/denial-codes/ma104/) - The claim is missing, incomplete, or has an invalid date the patient was last seen or the provider identifier of the attending physician. This code was deactivated by X12 (as of 01/31/2004). See: M128, M57.
- [MA105](https://denialjournal.com/denial-codes/ma105/) - The claim is missing, incomplete, or has an invalid provider number for this place of service. This code was deactivated by X12 (as of 06/02/2005).
- [MA106](https://denialjournal.com/denial-codes/ma106/) - PIP (Periodic Interim Payment) claim.
- [MA107](https://denialjournal.com/denial-codes/ma107/) - Paper claim contains more than three separate data items in field 19.
- [MA108](https://denialjournal.com/denial-codes/ma108/) - Paper claim contains more than one data item in field 23.
- [MA109](https://denialjournal.com/denial-codes/ma109/) - Claim processed in accordance with ambulatory surgical guidelines.
- [MA110](https://denialjournal.com/denial-codes/ma110/) - The claim is missing, incomplete, or has an invalid information on whether the diagnostic test(s) were performed by an outside entity or if no purchased tests are included on the claim.
- [MA111](https://denialjournal.com/denial-codes/ma111/) - The claim is missing, incomplete, or has an invalid purchase price of the test(s) and/or the performing laboratory's name and address.
- [MA112](https://denialjournal.com/denial-codes/ma112/) - The claim is missing, incomplete, or has an invalid group practice information.
- [MA113](https://denialjournal.com/denial-codes/ma113/) - Incomplete/invalid taxpayer identification number (TIN) submitted.
- [MA114](https://denialjournal.com/denial-codes/ma114/) - The claim is missing, incomplete, or has an invalid information on where the services were furnished.
- [MA115](https://denialjournal.com/denial-codes/ma115/) - The claim is missing, incomplete, or has an invalid physical location (name and address, or PIN) where the service(s) were rendered in a Health Professional Shortage Area (HPSA).
- [MA116](https://denialjournal.com/denial-codes/ma116/) - Did not complete the statement 'Homebound' on the claim to validate whether laboratory services were performed at home or in an institution.
- [MA117](https://denialjournal.com/denial-codes/ma117/) - This claim has been assessed a $1.00 user fee.
- [MA118](https://denialjournal.com/denial-codes/ma118/) - Informational remark: No Medicare payment issued for this claim for services or supplies furnished to a Medicare-eligible veteran through a VA facility.
- [MA119](https://denialjournal.com/denial-codes/ma119/) - Provider level adjustment for late claim filing applies to this claim. This code was deactivated by X12 (as of 05/01/2008).
- [MA120](https://denialjournal.com/denial-codes/ma120/) - The claim is missing, incomplete, or has an invalid CLIA certification number.
- [MA121](https://denialjournal.com/denial-codes/ma121/) - The claim is missing, incomplete, or has an invalid x-ray date.
- [MA122](https://denialjournal.com/denial-codes/ma122/) - The claim is missing, incomplete, or has an invalid initial treatment date.
- [MA123](https://denialjournal.com/denial-codes/ma123/) - Your center was not selected to participate in this study, therefore, we cannot pay for these services.
- [MA124](https://denialjournal.com/denial-codes/ma124/) - Processed for IME only. This code was deactivated by X12 (as of 01/31/2004).
- [MA125](https://denialjournal.com/denial-codes/ma125/) - Per legislation governing this program, payment constitutes payment in full.
- [MA126](https://denialjournal.com/denial-codes/ma126/) - Pancreas transplant not covered unless kidney transplant performed.
- [MA127](https://denialjournal.com/denial-codes/ma127/) - Reserved for future use. This code was deactivated by X12 (as of 06/02/2005).
- [MA128](https://denialjournal.com/denial-codes/ma128/) - The claim is missing, incomplete, or has an invalid FDA approval number.
- [MA129](https://denialjournal.com/denial-codes/ma129/) - This provider was not certified for this procedure on this date of service. This code was deactivated by X12 (as of 01/31/2004).
- [MA131](https://denialjournal.com/denial-codes/ma131/) - Physician already paid for services in conjunction with this demonstration claim.
- [MA132](https://denialjournal.com/denial-codes/ma132/) - Adjustment to the pre-demonstration rate.
- [M136](https://denialjournal.com/denial-codes/m136/) - The claim is missing, incomplete, or has an invalid indication that the service was supervised or evaluated by a physician.
- [M137](https://denialjournal.com/denial-codes/m137/) - Part B coinsurance under a demonstration project or pilot program.
- [M138](https://denialjournal.com/denial-codes/m138/) - Patient identified as a demonstration participant but not enrolled at the time services were rendered.
- [M139](https://denialjournal.com/denial-codes/m139/) - Denied services exceed the coverage limit for the demonstration.
- [M140](https://denialjournal.com/denial-codes/m140/) - Service not covered until after the patient's 50th birthday. This code was deactivated by X12 (as of 01/30/2004). See: M82.
- [M141](https://denialjournal.com/denial-codes/m141/) - Missing physician certified plan of care.
- [M142](https://denialjournal.com/denial-codes/m142/) - Missing American Diabetes Association Certificate of Recognition.
- [M143](https://denialjournal.com/denial-codes/m143/) - The provider must update license information with the payer.
- [M144](https://denialjournal.com/denial-codes/m144/) - Pre-/post-operative care payment is included in the allowance for the surgery/procedure.
- [MA01](https://denialjournal.com/denial-codes/ma01/) - Informational remark: If you do not agree with what we approved for these services, you may appeal our decision.
- [MA02](https://denialjournal.com/denial-codes/ma02/) - Informational remark: If you do not agree with this determination, you have the right to appeal. You must file a written request within 180 days.
- [MA03](https://denialjournal.com/denial-codes/ma03/) - If the provider do not agree with the approved amounts and $100 or more is in dispute, the provider may ask for a hearing within six months. This code was deactivated by X12 (as of 10/01/2006). See: MA02.
- [MA05](https://denialjournal.com/denial-codes/ma05/) - Incorrect admission date patient status or type of bill entry on claim. This code was deactivated by X12 (as of 10/16/2003). See: MA30, MA40, MA43.
- [MA06](https://denialjournal.com/denial-codes/ma06/) - The claim is missing, incomplete, or has an invalid beginning and/or ending date(s). This code was deactivated by X12 (as of 08/01/2004). See: MA31.
- [MA07](https://denialjournal.com/denial-codes/ma07/) - Informational remark: The claim information has also been forwarded to Medicaid for review.
- [MA08](https://denialjournal.com/denial-codes/ma08/) - Informational remark: Claim information was not forwarded because the supplemental coverage is not with a Medigap plan, or you do not participate in Medicare.
- [MA09](https://denialjournal.com/denial-codes/ma09/) - Informational remark: Claim submitted as unassigned but processed as assigned in accordance with our current assignment/participation agreement.
- [MA10](https://denialjournal.com/denial-codes/ma10/) - Informational remark: The patient's payment was in excess of the amount owed. You must refund the overpayment to the patient.
- [MA11](https://denialjournal.com/denial-codes/ma11/) - Payment is being issued on a conditional basis. This code was deactivated by X12 (as of 01/31/2004). See: M32.
- [MA12](https://denialjournal.com/denial-codes/ma12/) - The provider have not established that the provider have the right under the law to bill for services furnished by the person(s) that furnished this (these) service(s).
- [MA14](https://denialjournal.com/denial-codes/ma14/) - Informational remark: The patient is a member of an employer-sponsored prepaid health plan; services from outside that health plan are not covered, but we are paying this time.
- [MA15](https://denialjournal.com/denial-codes/ma15/) - Informational remark: Your claim has been separated to expedite handling. You will receive a separate notice for the other services reported.
- [MA16](https://denialjournal.com/denial-codes/ma16/) - The patient is covered by the Black Lung Program. Send this claim to the Department of Labor.
- [MA17](https://denialjournal.com/denial-codes/ma17/) - We are the primary payer and have paid at the primary rate.
- [MA18](https://denialjournal.com/denial-codes/ma18/) - Informational remark: The claim information is also being forwarded to the patient's supplemental insurer.
- [MA19](https://denialjournal.com/denial-codes/ma19/) - Informational remark: Information was not sent to the Medigap insurer due to incorrect/invalid information you submitted concerning that insurer.
- [MA20](https://denialjournal.com/denial-codes/ma20/) - Skilled Nursing Facility (SNF) stay not covered when care is primarily related to the use of an urethral catheter for convenience or the control of incontinence.
- [MA21](https://denialjournal.com/denial-codes/ma21/) - SSA records indicate mismatch with name and sex.
- [MA22](https://denialjournal.com/denial-codes/ma22/) - Payment of less than $1.00 suppressed.
- [MA23](https://denialjournal.com/denial-codes/ma23/) - Demand bill approved as result of medical review.
- [MA24](https://denialjournal.com/denial-codes/ma24/) - Christian Science Sanitarium/Skilled Nursing Facility (SNF) bill in the same benefit period.
- [MA25](https://denialjournal.com/denial-codes/ma25/) - A patient may not elect to change a hospice provider more than once in a benefit period.
- [MA26](https://denialjournal.com/denial-codes/ma26/) - Informational remark: Our records indicate that you were previously informed of this rule.
- [MA27](https://denialjournal.com/denial-codes/ma27/) - The claim is missing, incomplete, or has an invalid entitlement number or name shown on the claim.
- [MA28](https://denialjournal.com/denial-codes/ma28/) - Informational remark: Receipt of this notice by a physician or supplier who did not accept assignment is for information only.
- [MA29](https://denialjournal.com/denial-codes/ma29/) - The claim is missing, incomplete, or has an invalid provider name, city, state, or zip code. This code was deactivated by X12 (as of 06/02/2005).
- [MA30](https://denialjournal.com/denial-codes/ma30/) - The claim is missing, incomplete, or has an invalid type of bill.
- [MA31](https://denialjournal.com/denial-codes/ma31/) - The claim is missing, incomplete, or has an invalid beginning and ending dates of the period billed.
- [MA32](https://denialjournal.com/denial-codes/ma32/) - The claim is missing, incomplete, or has an invalid number of covered days during the billing period.
- [MA33](https://denialjournal.com/denial-codes/ma33/) - The claim is missing, incomplete, or has an invalid non-covered days during the billing period.
- [MA34](https://denialjournal.com/denial-codes/ma34/) - The claim is missing, incomplete, or has an invalid number of coinsurance days during the billing period.
- [MA35](https://denialjournal.com/denial-codes/ma35/) - The claim is missing, incomplete, or has an invalid number of lifetime reserve days.
- [MA36](https://denialjournal.com/denial-codes/ma36/) - The claim is missing, incomplete, or has an invalid patient name.
- [MA37](https://denialjournal.com/denial-codes/ma37/) - The claim is missing, incomplete, or has an invalid patient's address.
- [MA38](https://denialjournal.com/denial-codes/ma38/) - The claim is missing, incomplete, or has an invalid birth date. This code was deactivated by X12 (as of 06/02/2005).
- [MA39](https://denialjournal.com/denial-codes/ma39/) - The claim is missing, incomplete, or has an invalid gender.
- [MA40](https://denialjournal.com/denial-codes/ma40/) - The claim is missing, incomplete, or has an invalid admission date.
- [MA41](https://denialjournal.com/denial-codes/ma41/) - The claim is missing, incomplete, or has an invalid admission type.
- [MA42](https://denialjournal.com/denial-codes/ma42/) - The claim is missing, incomplete, or has an invalid admission source.
- [MA43](https://denialjournal.com/denial-codes/ma43/) - The claim is missing, incomplete, or has an invalid patient status.
- [MA44](https://denialjournal.com/denial-codes/ma44/) - Informational remark: No appeal rights. Adjudicative decision based on law.
- [MA45](https://denialjournal.com/denial-codes/ma45/) - Informational remark: As previously advised, a portion or all of your payment is being held in a special account.
- [MA46](https://denialjournal.com/denial-codes/ma46/) - Informational remark: The new information was considered but additional payment will not be issued.
- [MA47](https://denialjournal.com/denial-codes/ma47/) - Our records show the provider have opted out of Medicare; the patient is responsible for payment.
- [MA48](https://denialjournal.com/denial-codes/ma48/) - The claim is missing, incomplete, or has an invalid name or address of responsible party or primary payer.
- [MA49](https://denialjournal.com/denial-codes/ma49/) - The claim is missing, incomplete, or has an invalid six-digit provider identifier for home health agency or hospice for physician(s) performing care plan oversight services. This code was deactivated by X12 (as of 08/01/2004). See: MA76.
- [MA50](https://denialjournal.com/denial-codes/ma50/) - The claim is missing, incomplete, or has an invalid Investigational Device Exemption number or Clinical Trial number.
- [MA51](https://denialjournal.com/denial-codes/ma51/) - The claim is missing, incomplete, or has an invalid CLIA certification number for laboratory services billed by physician office laboratory. This code was deactivated by X12 (as of 02/05/2005). See: MA120.
- [MA52](https://denialjournal.com/denial-codes/ma52/) - The claim is missing, incomplete, or has an invalid date. This code was deactivated by X12 (as of 06/02/2005).
- [MA53](https://denialjournal.com/denial-codes/ma53/) - The claim is missing, incomplete, or has an invalid Competitive Bidding Demonstration Project identification.
- [MA54](https://denialjournal.com/denial-codes/ma54/) - Physician certification or election consent for hospice care not received timely.
- [MA55](https://denialjournal.com/denial-codes/ma55/) - Not covered as patient received medical health care services, automatically revoking his/her election to receive religious non-medical health care services.
- [MA56](https://denialjournal.com/denial-codes/ma56/) - Our records show the provider have opted out of Medicare; patient responsible, but the provider cannot charge more than the limiting charge amount.
- [MA57](https://denialjournal.com/denial-codes/ma57/) - Patient submitted written request to revoke his/her election for religious non-medical health care services.
- [MA58](https://denialjournal.com/denial-codes/ma58/) - The claim is missing, incomplete, or has an invalid release of information indicator.
- [MA59](https://denialjournal.com/denial-codes/ma59/) - Informational remark: The patient overpaid you for these services. You must issue the patient a refund within 30 days.
- [MA60](https://denialjournal.com/denial-codes/ma60/) - The claim is missing, incomplete, or has an invalid patient relationship to insured.
- [MA61](https://denialjournal.com/denial-codes/ma61/) - The claim is missing, incomplete, or has an invalid social security number.
- [MA62](https://denialjournal.com/denial-codes/ma62/) - Informational remark: This is a telephone review decision.
- [MA63](https://denialjournal.com/denial-codes/ma63/) - The claim is missing, incomplete, or has an invalid principal diagnosis.
- [MA64](https://denialjournal.com/denial-codes/ma64/) - Our records indicate that we should be the third payer for this claim.
- [MA65](https://denialjournal.com/denial-codes/ma65/) - The claim is missing, incomplete, or has an invalid admitting diagnosis.
- [M58](https://denialjournal.com/denial-codes/m58/) - The claim is missing, incomplete, or has an invalid claim information. Resubmit claim after corrections. This code was deactivated by X12 (as of 02/05/2005).
- [M59](https://denialjournal.com/denial-codes/m59/) - The claim is missing, incomplete, or has an invalid 'to' date(s) of service.
- [M60](https://denialjournal.com/denial-codes/m60/) - Missing Certificate of Medical Necessity.
- [M61](https://denialjournal.com/denial-codes/m61/) - This payer cannot pay for this as the approval period for the FDA clinical trial has expired.
- [M62](https://denialjournal.com/denial-codes/m62/) - The claim is missing, incomplete, or has an invalid treatment authorization code.
- [M63](https://denialjournal.com/denial-codes/m63/) - This payer does not pay for more than one of these on the same day. This code was deactivated by X12 (as of 01/31/2004). See: M86.
- [M64](https://denialjournal.com/denial-codes/m64/) - The claim is missing, incomplete, or has an invalid other diagnosis.
- [M65](https://denialjournal.com/denial-codes/m65/) - One interpreting physician charge can be submitted per claim when a purchased diagnostic test is indicated.
- [M66](https://denialjournal.com/denial-codes/m66/) - Diagnostic tests subject to price limitations must have technical and professional components submitted as separate line items.
- [M67](https://denialjournal.com/denial-codes/m67/) - The claim is missing, incomplete, or has an invalid other procedure code(s).
- [M68](https://denialjournal.com/denial-codes/m68/) - The claim is missing, incomplete, or has an invalid attending, ordering, rendering, supervising or referring physician identification. This code was deactivated by X12 (as of 06/02/2005).
- [M69](https://denialjournal.com/denial-codes/m69/) - Paid at the regular rate as the provider did not submit documentation to justify the modified procedure code.
- [M70](https://denialjournal.com/denial-codes/m70/) - Informational remark: The NDC code submitted for this service was translated to a HCPCS code for processing, but please continue to submit the NDC on future claims for this item.
- [M71](https://denialjournal.com/denial-codes/m71/) - Total payment reduced due to overlap of tests billed.
- [M72](https://denialjournal.com/denial-codes/m72/) - Did not enter full 8-digit date (MM/DD/CCYY). This code was deactivated by X12 (as of 10/16/2003). See: MA52.
- [M73](https://denialjournal.com/denial-codes/m73/) - The HPSA/Physician Scarcity bonus can only be paid on the professional component of this service.
- [M74](https://denialjournal.com/denial-codes/m74/) - This service does not qualify for a HPSA/Physician Scarcity bonus payment.
- [M75](https://denialjournal.com/denial-codes/m75/) - Multiple automated multichannel tests performed on the same day combined for payment.
- [M77](https://denialjournal.com/denial-codes/m77/) - The claim is missing, incomplete, or has an invalid inappropriate place of service.
- [M78](https://denialjournal.com/denial-codes/m78/) - The claim is missing, incomplete, or has an invalid HCPCS modifier. This code was deactivated by X12 (as of 05/18/2006).
- [M79](https://denialjournal.com/denial-codes/m79/) - The claim is missing, incomplete, or has an invalid charge.
- [M80](https://denialjournal.com/denial-codes/m80/) - Not covered when performed during the same session/date as a previously processed service for the patient.
- [M81](https://denialjournal.com/denial-codes/m81/) - The provider are required to code to the highest level of specificity.
- [M82](https://denialjournal.com/denial-codes/m82/) - Service is not covered when patient is under age 50.
- [M83](https://denialjournal.com/denial-codes/m83/) - Service is not covered unless the patient is classified as at high risk.
- [M84](https://denialjournal.com/denial-codes/m84/) - Medical code sets used must be the codes in effect at the time of service.
- [M85](https://denialjournal.com/denial-codes/m85/) - Subjected to review of physician evaluation and management services.
- [M87](https://denialjournal.com/denial-codes/m87/) - Claim/service(s) subjected to CFO-CAP prepayment review.
- [M88](https://denialjournal.com/denial-codes/m88/) - This payer cannot pay for laboratory tests unless billed by the laboratory that did the work. This code was deactivated by X12 (as of 08/01/2004).
- [M89](https://denialjournal.com/denial-codes/m89/) - Not covered more than once under age 40.
- [M90](https://denialjournal.com/denial-codes/m90/) - Not covered more than once in a 12 month period.
- [M91](https://denialjournal.com/denial-codes/m91/) - Lab procedures with different CLIA certification numbers must be billed on separate claims.
- [M92](https://denialjournal.com/denial-codes/m92/) - Services subjected to review under the Home Health Medical Review Initiative. This code was deactivated by X12 (as of 08/01/2004).
- [M93](https://denialjournal.com/denial-codes/m93/) - Information supplied supports a break in therapy. A new capped rental period began with delivery of this equipment.
- [M94](https://denialjournal.com/denial-codes/m94/) - Information supplied does not support a break in therapy. A new capped rental period will not begin.
- [M95](https://denialjournal.com/denial-codes/m95/) - Services subjected to Home Health Initiative medical review/cost report audit.
- [M96](https://denialjournal.com/denial-codes/m96/) - The technical component of a service furnished to an inpatient may only be billed by that inpatient facility.
- [M97](https://denialjournal.com/denial-codes/m97/) - Not paid to practitioner when provided to patient in this place of service. Payment included in the reimbursement issued the facility.
- [M98](https://denialjournal.com/denial-codes/m98/) - Begin to report the Universal Product Number on claims for items of this type. This code was deactivated by X12 (as of 01/31/2004). See: M99.
- [M99](https://denialjournal.com/denial-codes/m99/) - The claim is missing, incomplete, or has an invalid Universal Product Number/Serial Number.
- [M100](https://denialjournal.com/denial-codes/m100/) - This payer does not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug.
- [M101](https://denialjournal.com/denial-codes/m101/) - Begin to report a G1-G5 modifier with this HCPCS. This code was deactivated by X12 (as of 01/31/2004). See: M78.
- [M102](https://denialjournal.com/denial-codes/m102/) - Service not performed on equipment approved by the FDA for this purpose.
- [M103](https://denialjournal.com/denial-codes/m103/) - Information supplied supports a break in therapy, but the medical information does not support the need for this item as billed; payment approved at a reduced level.
- [M104](https://denialjournal.com/denial-codes/m104/) - Information supplied supports a break in therapy. A new capped rental period will begin with delivery of the equipment.
- [M105](https://denialjournal.com/denial-codes/m105/) - Information supplied does not support a break in therapy, and does not support the need for this item as billed; payment approved at a reduced level.
- [M106](https://denialjournal.com/denial-codes/m106/) - Information supplied does not support a break in therapy. A new capped rental period will not begin. This code was deactivated by X12 (as of 01/31/2004). See: MA31.
- [M107](https://denialjournal.com/denial-codes/m107/) - Payment reduced as 90-day rolling average hematocrit for ESRD patient exceeded 36.5%.
- [M108](https://denialjournal.com/denial-codes/m108/) - The claim is missing, incomplete, or has an invalid provider identifier for the provider who interpreted the diagnostic test. This code was deactivated by X12 (as of 06/02/2005).
- [M109](https://denialjournal.com/denial-codes/m109/) - We have provided the provider with a bundled payment for a teleconsultation. The provider must send 25 percent of the teleconsultation payment to the referring practitioner.
- [M110](https://denialjournal.com/denial-codes/m110/) - The claim is missing, incomplete, or has an invalid provider identifier for the provider from whom you purchased interpretation services. This code was deactivated by X12 (as of 06/02/2005).
- [M111](https://denialjournal.com/denial-codes/m111/) - This payer does not pay for chiropractic manipulative treatment when the patient refuses to have an x-ray taken.
- [M112](https://denialjournal.com/denial-codes/m112/) - Reimbursement for this item is based on the single payment amount required under the DMEPOS Competitive Bidding Program for the area where the patient resides.
- [M113](https://denialjournal.com/denial-codes/m113/) - Our records indicate that this patient began using this item/service prior to the current contract period for the DMEPOS Competitive Bidding Program.
- [M114](https://denialjournal.com/denial-codes/m114/) - This service was processed in accordance with rules and guidelines under the DMEPOS Competitive Bidding Program or a Demonstration Project.
- [M115](https://denialjournal.com/denial-codes/m115/) - This item is denied when provided to this patient by a non-contract or non-demonstration supplier.
- [M116](https://denialjournal.com/denial-codes/m116/) - Processed under a demonstration project or program; the project is ending and additional services may not be paid.
- [M117](https://denialjournal.com/denial-codes/m117/) - Not covered unless submitted via electronic claim.
- [M118](https://denialjournal.com/denial-codes/m118/) - Letter to follow containing further information. This code was deactivated by X12 (as of 01/01/2011). See: N202.
- [M119](https://denialjournal.com/denial-codes/m119/) - The claim is missing, incomplete, or has an invalid deactivated/withdrawn National Drug Code (NDC).
- [M120](https://denialjournal.com/denial-codes/m120/) - The claim is missing, incomplete, or has an invalid provider identifier for the substituting physician under a reciprocal billing or locum tenens arrangement. This code was deactivated by X12 (as of 06/02/2005).
- [M121](https://denialjournal.com/denial-codes/m121/) - We pay for this service only when performed with a covered cryosurgical ablation.
- [M122](https://denialjournal.com/denial-codes/m122/) - The claim is missing, incomplete, or has an invalid level of subluxation.
- [M123](https://denialjournal.com/denial-codes/m123/) - The claim is missing, incomplete, or has an invalid name, strength, or dosage of the drug furnished.
- [M124](https://denialjournal.com/denial-codes/m124/) - Missing indication of whether the patient owns the equipment that requires the part or supply.
- [M125](https://denialjournal.com/denial-codes/m125/) - The claim is missing, incomplete, or has an invalid information on the period of time for which the service/supply/equipment will be needed.
- [M126](https://denialjournal.com/denial-codes/m126/) - The claim is missing, incomplete, or has an invalid individual lab codes included in the test.
- [M127](https://denialjournal.com/denial-codes/m127/) - Missing patient medical record for this service.
- [M128](https://denialjournal.com/denial-codes/m128/) - The claim is missing, incomplete, or has an invalid date of the patient's last physician visit. This code was deactivated by X12 (as of 06/02/2005).
- [M129](https://denialjournal.com/denial-codes/m129/) - The claim is missing, incomplete, or has an invalid indicator of x-ray availability for review.
- [M130](https://denialjournal.com/denial-codes/m130/) - Missing invoice or statement certifying the actual cost of the lens, less discounts, and/or the type of intraocular lens used.
- [M131](https://denialjournal.com/denial-codes/m131/) - Missing physician financial relationship form.
- [M132](https://denialjournal.com/denial-codes/m132/) - Missing pacemaker registration form.
- [M133](https://denialjournal.com/denial-codes/m133/) - Claim did not identify who performed the purchased diagnostic test or the amount the provider were charged for the test.
- [M134](https://denialjournal.com/denial-codes/m134/) - Performed by a facility/supplier in which the provider has a financial interest.
- [M135](https://denialjournal.com/denial-codes/m135/) - The claim is missing, incomplete, or has an invalid plan of treatment.
- [CO-D20](https://denialjournal.com/denial-codes/co-d20/) - Claim/Service missing service/product information. This code was deactivated by X12 (as of 06/30/2007). See: 16.
- [CO-D21](https://denialjournal.com/denial-codes/co-d21/) - This (these) diagnosis(es) is (are) missing or are invalid. This code was deactivated by X12 (as of 06/30/2007).
- [CO-D22](https://denialjournal.com/denial-codes/co-d22/) - Reimbursement was adjusted for the reasons to be provided in separate correspondence. This code was deactivated by X12 (as of 01/01/2009).
- [CO-D23](https://denialjournal.com/denial-codes/co-d23/) - This dual eligible patient is covered by Medicare Part D per Medicare Retro-Eligibility. This code was deactivated by X12 (as of 01/01/2012).
- [CO-P1](https://denialjournal.com/denial-codes/co-p1/) - State-mandated Requirement for Property and Casualty, see Claim Payment Remarks Code for specific explanation. To be used for Property and Casualty only.
- [CO-P2](https://denialjournal.com/denial-codes/co-p2/) - Not a work related injury/illness and thus not the liability of the workers' compensation carrier. To be used for Workers' Compensation only.
- [PR-P3](https://denialjournal.com/denial-codes/pr-p3/) - Workers' Compensation case settled. Patient is responsible for amount of this claim/service through WC 'Medicare set aside arrangement' or other agreement. To be used for Workers' Compensation only.
- [CO-P4](https://denialjournal.com/denial-codes/co-p4/) - Workers' Compensation claim adjudicated as non-compensable. This Payer not liable for claim or service/treatment. To be used for Workers' Compensation only
- [CO-P5](https://denialjournal.com/denial-codes/co-p5/) - Based on payer reasonable and customary fees. No maximum allowable defined by legislated fee arrangement. To be used for Property and Casualty only.
- [CO-P6](https://denialjournal.com/denial-codes/co-p6/) - Based on entitlement to benefits. To be used for Property and Casualty only.
- [CO-P7](https://denialjournal.com/denial-codes/co-p7/) - The applicable fee schedule/fee database does not contain the billed code. To be used for Property and Casualty only.
- [CO-P8](https://denialjournal.com/denial-codes/co-p8/) - Claim is under investigation. To be used for Property and Casualty only.
- [CO-P9](https://denialjournal.com/denial-codes/co-p9/) - No available or correlating CPT/HCPCS code to describe this service. To be used for Property and Casualty only.
- [CO-P10](https://denialjournal.com/denial-codes/co-p10/) - Payment reduced to zero due to litigation. To be used for Property and Casualty only.
- [OA-P11](https://denialjournal.com/denial-codes/oa-p11/) - The disposition of the related Property & Casualty claim (injury or illness) is pending due to litigation. To be used for Property and Casualty only.
- [CO-P12](https://denialjournal.com/denial-codes/co-p12/) - Workers' compensation jurisdictional fee schedule adjustment. To be used for Workers' Compensation only.
- [CO-P13](https://denialjournal.com/denial-codes/co-p13/) - Payment reduced or denied based on workers' compensation jurisdictional regulations or payment policies, use only if no other code is applicable. To be used for Workers' Compensation only.
- [CO-P14](https://denialjournal.com/denial-codes/co-p14/) - The Benefit for this Service is included in the payment/allowance for another service/procedure that has been performed on the same day. To be used for Property and Casualty only.
- [CO-P15](https://denialjournal.com/denial-codes/co-p15/) - Workers' Compensation Medical Treatment Guideline Adjustment. To be used for Workers' Compensation only.
- [CO-P16](https://denialjournal.com/denial-codes/co-p16/) - Medical provider not authorized/certified to provide treatment to injured workers in this jurisdiction. To be used for Workers' Compensation only. (Use with Group Code CO or OA)
- [CO-P17](https://denialjournal.com/denial-codes/co-p17/) - Referral not authorized by attending physician per regulatory requirement. To be used for Property and Casualty only.
- [CO-P18](https://denialjournal.com/denial-codes/co-p18/) - Procedure is not listed in the jurisdiction fee schedule. An allowance has been made for a comparable service. To be used for Property and Casualty only.
- [CO-P19](https://denialjournal.com/denial-codes/co-p19/) - Procedure has a relative value of zero in the jurisdiction fee schedule, therefore no payment is due. To be used for Property and Casualty only.
- [M1](https://denialjournal.com/denial-codes/m1/) - X-ray not taken within the past 12 months or near enough to the start of treatment.
- [M2](https://denialjournal.com/denial-codes/m2/) - Not paid separately when the patient is an inpatient.
- [M3](https://denialjournal.com/denial-codes/m3/) - Equipment is the same or similar to equipment already being used.
- [M4](https://denialjournal.com/denial-codes/m4/) - Informational remark: This is the last monthly installment payment for this durable medical equipment.
- [M5](https://denialjournal.com/denial-codes/m5/) - Monthly rental payments can continue until the earlier of the 15th month from the first rental month, or the month when the equipment is no longer needed.
- [M6](https://denialjournal.com/denial-codes/m6/) - Informational remark: You must furnish and service this item for any period of medical need for the remainder of the reasonable useful lifetime of the equipment.
- [M7](https://denialjournal.com/denial-codes/m7/) - No rental payments after the item is purchased, returned or after the total of issued rental payments equals the purchase price.
- [M8](https://denialjournal.com/denial-codes/m8/) - We do not accept blood gas tests results when the test was conducted by a medical supplier or taken while the patient is on oxygen.
- [M9](https://denialjournal.com/denial-codes/m9/) - Informational remark: This is the tenth rental month. You must offer the patient the choice of changing the rental to a purchase agreement.
- [M10](https://denialjournal.com/denial-codes/m10/) - Equipment purchases are limited to the first or the tenth month of medical necessity.
- [M11](https://denialjournal.com/denial-codes/m11/) - DME, orthotics and prosthetics must be billed to the DME carrier who services the patient's zip code.
- [M12](https://denialjournal.com/denial-codes/m12/) - Diagnostic tests performed by a physician must indicate whether purchased services are included on the claim.
- [M13](https://denialjournal.com/denial-codes/m13/) - Only one initial visit is covered per specialty per medical group.
- [M14](https://denialjournal.com/denial-codes/m14/) - No separate payment for an injection administered during an office visit, and no payment for a full office visit if the patient only received an injection.
- [M16](https://denialjournal.com/denial-codes/m16/) - Informational remark: Please see our web site, mailings, or bulletins for more details concerning this policy/procedure/decision.
- [M17](https://denialjournal.com/denial-codes/m17/) - Informational remark: Payment approved as you did not know, and could not reasonably have been expected to know, that this would not normally have been covered for this patient.
- [M18](https://denialjournal.com/denial-codes/m18/) - Certain services may be approved for home use. Neither a hospital nor a Skilled Nursing Facility (SNF) is considered to be a patient's home.
- [M19](https://denialjournal.com/denial-codes/m19/) - Missing oxygen certification/re-certification.
- [M21](https://denialjournal.com/denial-codes/m21/) - The claim is missing, incomplete, or has an invalid place of residence for this service/item provided in a home.
- [M22](https://denialjournal.com/denial-codes/m22/) - The claim is missing, incomplete, or has an invalid number of miles traveled.
- [M23](https://denialjournal.com/denial-codes/m23/) - Missing invoice.
- [M24](https://denialjournal.com/denial-codes/m24/) - The claim is missing, incomplete, or has an invalid number of doses per vial.
- [M26](https://denialjournal.com/denial-codes/m26/) - The information furnished does not substantiate the need for this level of service (refund provisions apply).
- [M27](https://denialjournal.com/denial-codes/m27/) - Informational remark: The patient has been relieved of liability of payment of these items and services under the limitation of liability provision of the law.
- [M28](https://denialjournal.com/denial-codes/m28/) - This does not qualify for payment under Part B when Part A coverage is exhausted or not otherwise available.
- [M29](https://denialjournal.com/denial-codes/m29/) - Missing operative note/report.
- [M30](https://denialjournal.com/denial-codes/m30/) - Missing pathology report.
- [M31](https://denialjournal.com/denial-codes/m31/) - Missing radiology report.
- [M32](https://denialjournal.com/denial-codes/m32/) - Informational remark: This is a conditional payment made pending a decision on this service by the patient's primary payer.
- [M33](https://denialjournal.com/denial-codes/m33/) - The claim is missing, incomplete, or has an invalid UPIN for the ordering/referring/performing provider. This code was deactivated by X12 (as of 08/01/2004). See: M68.
- [M34](https://denialjournal.com/denial-codes/m34/) - Claim lacks the CLIA certification number. This code was deactivated by X12 (as of 08/01/2004). See: MA120.
- [M35](https://denialjournal.com/denial-codes/m35/) - The claim is missing, incomplete, or has an invalid pre-operative photos or visual field results. This code was deactivated by X12 (as of 02/05/2005). See: N178.
- [M36](https://denialjournal.com/denial-codes/m36/) - This is the 11th rental month. We cannot pay for this until the provider indicate that the patient has been given the option of changing the rental to a purchase.
- [M37](https://denialjournal.com/denial-codes/m37/) - Not covered when the patient is under age 35.
- [M38](https://denialjournal.com/denial-codes/m38/) - Informational remark: The patient is liable for the charges for this service as they were informed in writing before the service was furnished that we would not pay for it and the patient agreed to be responsible for the charges.
- [M39](https://denialjournal.com/denial-codes/m39/) - Informational remark: The patient is not liable for payment of this service as the advance notice of non-coverage you provided the patient did not comply with program requirements.
- [M40](https://denialjournal.com/denial-codes/m40/) - Claim must be assigned and must be filed by the practitioner's employer.
- [M41](https://denialjournal.com/denial-codes/m41/) - This payer does not pay for this as the patient has no legal obligation to pay for this.
- [M42](https://denialjournal.com/denial-codes/m42/) - The medical necessity form must be personally signed by the attending physician.
- [M43](https://denialjournal.com/denial-codes/m43/) - Payment for this service previously issued to the provider or another provider by another carrier/intermediary. This code was deactivated by X12 (as of 01/31/2004).
- [M44](https://denialjournal.com/denial-codes/m44/) - The claim is missing, incomplete, or has an invalid condition code.
- [M45](https://denialjournal.com/denial-codes/m45/) - The claim is missing, incomplete, or has an invalid occurrence code(s).
- [M46](https://denialjournal.com/denial-codes/m46/) - The claim is missing, incomplete, or has an invalid occurrence span code(s).
- [M47](https://denialjournal.com/denial-codes/m47/) - The claim is missing, incomplete, or has an invalid Payer Claim Control Number.
- [M48](https://denialjournal.com/denial-codes/m48/) - Payment for services furnished to hospital inpatients can only be made to the hospital. This code was deactivated by X12 (as of 01/31/2004). See: M97.
- [M49](https://denialjournal.com/denial-codes/m49/) - The claim is missing, incomplete, or has an invalid value code(s) or amount(s).
- [M50](https://denialjournal.com/denial-codes/m50/) - The claim is missing, incomplete, or has an invalid revenue code(s).
- [M52](https://denialjournal.com/denial-codes/m52/) - The claim is missing, incomplete, or has an invalid 'from' date(s) of service.
- [M53](https://denialjournal.com/denial-codes/m53/) - The claim is missing, incomplete, or has an invalid days or units of service.
- [M54](https://denialjournal.com/denial-codes/m54/) - The claim is missing, incomplete, or has an invalid total charges.
- [M55](https://denialjournal.com/denial-codes/m55/) - This payer does not pay for self-administered anti-emetic drugs that are not administered with a covered oral anti-cancer drug.
- [M56](https://denialjournal.com/denial-codes/m56/) - The claim is missing, incomplete, or has an invalid payer identifier.
- [M57](https://denialjournal.com/denial-codes/m57/) - The claim is missing, incomplete, or has an invalid provider identifier. This code was deactivated by X12 (as of 06/02/2005).
- [CO-290](https://denialjournal.com/denial-codes/co-290/) - Claim received by the dental plan, but benefits not available under this plan. Claim has been forwarded to the patient's medical plan for further consideration.
- [CO-291](https://denialjournal.com/denial-codes/co-291/) - Claim received by the medical plan, but benefits not available under this plan. Claim has been forwarded to the patient's dental plan for further consideration.
- [CO-292](https://denialjournal.com/denial-codes/co-292/) - Claim received by the medical plan, but benefits not available under this plan. Claim has been forwarded to the patient's pharmacy plan for further consideration.
- [CO-293](https://denialjournal.com/denial-codes/co-293/) - Payment made to employer.
- [CO-294](https://denialjournal.com/denial-codes/co-294/) - Payment made to attorney.
- [CO-295](https://denialjournal.com/denial-codes/co-295/) - Pharmacy Direct/Indirect Remuneration (DIR)
- [CO-296](https://denialjournal.com/denial-codes/co-296/) - Precertification/authorization/notification/pre-treatment number may be valid but does not apply to the provider.
- [CO-297](https://denialjournal.com/denial-codes/co-297/) - Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's vision plan for further consideration.
- [CO-298](https://denialjournal.com/denial-codes/co-298/) - Claim received by the medical plan, but benefits not available under this plan. Claim has been forwarded to the patient's vision plan for further consideration.
- [CO-300](https://denialjournal.com/denial-codes/co-300/) - Claim received by the Medical Plan, but benefits not available under this plan. Claim has been forwarded to the patient's Behavioral Health Plan for further consideration.
- [CO-301](https://denialjournal.com/denial-codes/co-301/) - Claim received by the Medical Plan, but benefits not available under this plan. Submit these services to the patient's Behavioral Health Plan for further consideration.
- [CO-302](https://denialjournal.com/denial-codes/co-302/) - Precertification/notification/authorization/pre-treatment time limit has expired.
- [CO-303](https://denialjournal.com/denial-codes/co-303/) - Prior payer's (or payers') patient responsibility (deductible, coinsurance, co-payment) not covered for Qualified Medicare and Medicaid Beneficiaries.
- [CO-304](https://denialjournal.com/denial-codes/co-304/) - Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's hearing plan for further consideration.
- [CO-305](https://denialjournal.com/denial-codes/co-305/) - Claim received by the medical plan, but benefits not available under this plan. Claim has been forwarded to the patient's hearing plan for further consideration.
- [CO-306](https://denialjournal.com/denial-codes/co-306/) - Type of bill is inconsistent with the patient status.
- [CO-307](https://denialjournal.com/denial-codes/co-307/) - Medicare Maximum Fair Price Standard Default Refund Amount Adjustment.
- [CO-308](https://denialjournal.com/denial-codes/co-308/) - Payment is adjusted due to contracted funding agreement between the payer and provider.
- [CO-A0](https://denialjournal.com/denial-codes/co-a0/) - Patient refund amount.
- [CO-A2](https://denialjournal.com/denial-codes/co-a2/) - Contractual adjustment. This code was deactivated by X12 (as of 01/01/2008).
- [CO-A3](https://denialjournal.com/denial-codes/co-a3/) - Medicare Secondary Payer liability met. This code was deactivated by X12 (as of 10/16/2003).
- [CO-A4](https://denialjournal.com/denial-codes/co-a4/) - Medicare Claim PPS Capital Day Outlier Amount. This code was deactivated by X12 (as of 04/01/2008).
- [CO-A5](https://denialjournal.com/denial-codes/co-a5/) - Medicare Claim PPS Capital Cost Outlier Amount.
- [CO-A6](https://denialjournal.com/denial-codes/co-a6/) - Prior hospitalization or 30 day transfer requirement not met.
- [CO-A7](https://denialjournal.com/denial-codes/co-a7/) - Presumptive Payment Adjustment. This code was deactivated by X12 (as of 07/01/2015).
- [CO-A8](https://denialjournal.com/denial-codes/co-a8/) - Ungroupable DRG.
- [CO-B1](https://denialjournal.com/denial-codes/co-b1/) - Non-covered visits.
- [CO-B2](https://denialjournal.com/denial-codes/co-b2/) - Covered visits. This code was deactivated by X12 (as of 10/16/2003).
- [CO-B3](https://denialjournal.com/denial-codes/co-b3/) - Covered charges. This code was deactivated by X12 (as of 10/16/2003).
- [CO-B4](https://denialjournal.com/denial-codes/co-b4/) - Late filing penalty.
- [CO-B5](https://denialjournal.com/denial-codes/co-b5/) - Coverage/program guidelines were not met or were exceeded. This code was deactivated by X12 (as of 05/01/2016).
- [CO-B6](https://denialjournal.com/denial-codes/co-b6/) - This payment is adjusted when performed/billed by this type of provider, by this type of provider in this type of facility, or by a provider of this specialty. This code was deactivated by X12 (as of 02/01/2006).
- [CO-B8](https://denialjournal.com/denial-codes/co-b8/) - Alternative services were available, and should have been utilized.
- [CO-B10](https://denialjournal.com/denial-codes/co-b10/) - Allowed amount has been reduced because a component of the basic procedure/test was paid.
- [CO-B11](https://denialjournal.com/denial-codes/co-b11/) - The claim/service has been transferred to the proper payer/processor for processing.
- [CO-B12](https://denialjournal.com/denial-codes/co-b12/) - Services not documented in patient's medical records.
- [CO-B13](https://denialjournal.com/denial-codes/co-b13/) - Previously paid. Payment for this claim/service may have been provided in a previous payment.
- [CO-B14](https://denialjournal.com/denial-codes/co-b14/) - Only one visit or consultation per physician per day is covered.
- [CO-B17](https://denialjournal.com/denial-codes/co-b17/) - Payment adjusted because this service was not prescribed by a physician, not prescribed prior to delivery, the prescription is incomplete, or the prescription is not current. This code was deactivated by X12 (as of 02/01/2006).
- [CO-B18](https://denialjournal.com/denial-codes/co-b18/) - This procedure code and modifier were invalid on the date of service. This code was deactivated by X12 (as of 03/01/2009).
- [CO-B19](https://denialjournal.com/denial-codes/co-b19/) - Claim/service adjusted because of the finding of a Review Organization. This code was deactivated by X12 (as of 10/16/2003).
- [CO-B20](https://denialjournal.com/denial-codes/co-b20/) - Procedure/service was partially or fully furnished by another provider.
- [CO-B21](https://denialjournal.com/denial-codes/co-b21/) - The charges were reduced because the service/care was partially furnished by another physician. This code was deactivated by X12 (as of 10/16/2003).
- [CO-B22](https://denialjournal.com/denial-codes/co-b22/) - This payment is adjusted based on the diagnosis.
- [CO-B23](https://denialjournal.com/denial-codes/co-b23/) - Procedure billed is not authorized per your Clinical Laboratory Improvement Amendment (CLIA) proficiency test.
- [CO-D1](https://denialjournal.com/denial-codes/co-d1/) - Claim/service denied. Level of subluxation is missing or inadequate. This code was deactivated by X12 (as of 10/16/2003). See: 16.
- [CO-D2](https://denialjournal.com/denial-codes/co-d2/) - Claim lacks the name, strength, or dosage of the drug furnished. This code was deactivated by X12 (as of 10/16/2003). See: 16.
- [CO-D3](https://denialjournal.com/denial-codes/co-d3/) - Claim/service denied because information to indicate if the patient owns the equipment that requires the part or supply was missing. This code was deactivated by X12 (as of 10/16/2003). See: 16.
- [CO-D4](https://denialjournal.com/denial-codes/co-d4/) - Claim/service does not indicate the period of time for which this will be needed. This code was deactivated by X12 (as of 10/16/2003). See: 16.
- [CO-D5](https://denialjournal.com/denial-codes/co-d5/) - Claim/service denied. Claim lacks individual lab codes included in the test. This code was deactivated by X12 (as of 10/16/2003). See: 16.
- [CO-D6](https://denialjournal.com/denial-codes/co-d6/) - Claim/service denied. Claim did not include patient's medical record for the service. This code was deactivated by X12 (as of 10/16/2003). See: 16.
- [CO-D7](https://denialjournal.com/denial-codes/co-d7/) - Claim/service denied. Claim lacks date of patient's most recent physician visit. This code was deactivated by X12 (as of 10/16/2003). See: 16.
- [CO-D8](https://denialjournal.com/denial-codes/co-d8/) - Claim/service denied. Claim lacks indicator that 'x-ray is available for review.'. This code was deactivated by X12 (as of 10/16/2003). See: 16.
- [CO-D9](https://denialjournal.com/denial-codes/co-d9/) - Claim/service denied. Claim lacks invoice or statement certifying the actual cost of the lens, less discounts or the type of intraocular lens used. This code was deactivated by X12 (as of 10/16/2003). See: 16.
- [CO-D10](https://denialjournal.com/denial-codes/co-d10/) - Claim/service denied. Completed physician financial relationship form not on file. This code was deactivated by X12 (as of 10/16/2003). See: 17.
- [CO-D11](https://denialjournal.com/denial-codes/co-d11/) - Claim lacks completed pacemaker registration form. This code was deactivated by X12 (as of 10/16/2003). See: 17.
- [CO-D12](https://denialjournal.com/denial-codes/co-d12/) - Claim/service denied. Claim does not identify who performed the purchased diagnostic test or the amount the provider were charged for the test. This code was deactivated by X12 (as of 10/16/2003). See: 17.
- [CO-D13](https://denialjournal.com/denial-codes/co-d13/) - Claim/service denied. Performed by a facility/supplier in which the ordering/referring physician has a financial interest. This code was deactivated by X12 (as of 10/16/2003). See: 17.
- [CO-D14](https://denialjournal.com/denial-codes/co-d14/) - Claim lacks indication that plan of treatment is on file. This code was deactivated by X12 (as of 10/16/2003). See: 17.
- [CO-D15](https://denialjournal.com/denial-codes/co-d15/) - Claim lacks indication that service was supervised or evaluated by a physician. This code was deactivated by X12 (as of 10/16/2003). See: 17.
- [CO-D16](https://denialjournal.com/denial-codes/co-d16/) - Claim lacks prior payer payment information. This code was deactivated by X12 (as of 06/30/2007).
- [CO-D17](https://denialjournal.com/denial-codes/co-d17/) - Claim/Service has invalid non-covered days. This code was deactivated by X12 (as of 06/30/2007). See: 16.
- [CO-D18](https://denialjournal.com/denial-codes/co-d18/) - Claim/Service has missing diagnosis information. This code was deactivated by X12 (as of 06/30/2007). See: 16.
- [CO-D19](https://denialjournal.com/denial-codes/co-d19/) - Claim/Service lacks Physician/Operative or other supporting documentation. This code was deactivated by X12 (as of 06/30/2007). See: 16.
- [PR-201](https://denialjournal.com/denial-codes/pr-201/) - Patient is responsible for amount of this claim/service through 'set aside arrangement' or other agreement.
- [CO-202](https://denialjournal.com/denial-codes/co-202/) - Non-covered personal comfort or convenience services.
- [CO-203](https://denialjournal.com/denial-codes/co-203/) - Discontinued or reduced service.
- [CO-205](https://denialjournal.com/denial-codes/co-205/) - Pharmacy discount card processing fee
- [CO-209](https://denialjournal.com/denial-codes/co-209/) - Per regulatory or other agreement. The provider cannot collect this amount from the patient. However, this amount may be billed to subsequent payer. Refund to patient if collected. (Use only with Group code OA)
- [CO-210](https://denialjournal.com/denial-codes/co-210/) - Payment adjusted because pre-certification/authorization not received in a timely fashion
- [CO-211](https://denialjournal.com/denial-codes/co-211/) - National Drug Codes (NDC) not eligible for rebate, are not covered.
- [CO-212](https://denialjournal.com/denial-codes/co-212/) - Administrative surcharges are not covered
- [CO-213](https://denialjournal.com/denial-codes/co-213/) - Non-compliance with the physician self referral prohibition legislation or payer policy.
- [CO-214](https://denialjournal.com/denial-codes/co-214/) - Workers' Compensation claim adjudicated as non-compensable. This Payer not liable for claim or service/treatment. This code was deactivated by X12 (as of 07/01/2014). See: P4.
- [CO-215](https://denialjournal.com/denial-codes/co-215/) - Based on subrogation of a third party settlement
- [CO-216](https://denialjournal.com/denial-codes/co-216/) - Based on the findings of a review organization or the payer's findings.
- [CO-217](https://denialjournal.com/denial-codes/co-217/) - Based on payer reasonable and customary fees. No maximum allowable defined by legislated fee arrangement. This code was deactivated by X12 (as of 07/01/2014). See: P5.
- [CO-218](https://denialjournal.com/denial-codes/co-218/) - Based on entitlement to benefits. This code was deactivated by X12 (as of 07/01/2014). See: P6.
- [CO-219](https://denialjournal.com/denial-codes/co-219/) - Based on extent of injury.
- [CO-220](https://denialjournal.com/denial-codes/co-220/) - The applicable fee schedule/fee database does not contain the billed code. This code was deactivated by X12 (as of 07/01/2014). See: P7.
- [CO-221](https://denialjournal.com/denial-codes/co-221/) - Claim is under investigation. This code was deactivated by X12 (as of 07/01/2014). See: P8.
- [CO-222](https://denialjournal.com/denial-codes/co-222/) - Exceeds the contracted maximum number of hours/days/units by this provider for this period. This is not patient specific.
- [CO-223](https://denialjournal.com/denial-codes/co-223/) - Adjustment code for mandated federal, state or local law/regulation that is not already covered by another code and is mandated before a new code can be created.
- [CO-224](https://denialjournal.com/denial-codes/co-224/) - Patient identification compromised by identity theft. Identity verification required for processing this and future claims.
- [CO-225](https://denialjournal.com/denial-codes/co-225/) - Penalty or Interest Payment by Payer
- [CO-226](https://denialjournal.com/denial-codes/co-226/) - Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete.
- [CO-227](https://denialjournal.com/denial-codes/co-227/) - Information requested from the patient/insured/responsible party was not provided or was insufficient/incomplete.
- [CO-228](https://denialjournal.com/denial-codes/co-228/) - Denied for failure of this provider, another provider or the subscriber to supply requested information to a previous payer for their adjudication
- [CO-229](https://denialjournal.com/denial-codes/co-229/) - Partial charge amount not considered by Medicare due to the initial claim Type of Bill being 12X.
- [CO-230](https://denialjournal.com/denial-codes/co-230/) - No available or correlating CPT/HCPCS code to describe this service. This code was deactivated by X12 (as of 07/01/2014). See: P9.
- [CO-232](https://denialjournal.com/denial-codes/co-232/) - Institutional Transfer Amount.
- [CO-233](https://denialjournal.com/denial-codes/co-233/) - Services/charges related to the treatment of a hospital-acquired condition or preventable medical error.
- [CO-234](https://denialjournal.com/denial-codes/co-234/) - This procedure is not paid separately.
- [CO-235](https://denialjournal.com/denial-codes/co-235/) - Sales Tax
- [CO-237](https://denialjournal.com/denial-codes/co-237/) - Legislated/Regulatory Penalty.
- [PR-238](https://denialjournal.com/denial-codes/pr-238/) - Claim spans eligible and ineligible periods of coverage, this is the reduction for the ineligible period.
- [CO-239](https://denialjournal.com/denial-codes/co-239/) - Claim spans eligible and ineligible periods of coverage. Rebill separate claims.
- [CO-240](https://denialjournal.com/denial-codes/co-240/) - The diagnosis billed doesn't align with the patient's birth weight.
- [CO-241](https://denialjournal.com/denial-codes/co-241/) - Low Income Subsidy (LIS) Co-payment Amount
- [CO-242](https://denialjournal.com/denial-codes/co-242/) - Services not provided by network/primary care providers.
- [CO-243](https://denialjournal.com/denial-codes/co-243/) - Services not authorized by network/primary care providers.
- [CO-244](https://denialjournal.com/denial-codes/co-244/) - Payment reduced to zero due to litigation. This code was deactivated by X12 (as of 07/01/2014). See: P10.
- [CO-245](https://denialjournal.com/denial-codes/co-245/) - Provider performance program withhold.
- [CO-246](https://denialjournal.com/denial-codes/co-246/) - This non-payable code is for required reporting only.
- [CO-247](https://denialjournal.com/denial-codes/co-247/) - Deductible for Professional service rendered in an Institutional setting and billed on an Institutional claim.
- [CO-248](https://denialjournal.com/denial-codes/co-248/) - Coinsurance for Professional service rendered in an Institutional setting and billed on an Institutional claim.
- [CO-249](https://denialjournal.com/denial-codes/co-249/) - This claim has been identified as a readmission.
- [CO-250](https://denialjournal.com/denial-codes/co-250/) - The attachment/other documentation that was received was the incorrect attachment/document. The expected attachment/document is still missing.
- [CO-251](https://denialjournal.com/denial-codes/co-251/) - The attachment/other documentation that was received was incomplete or deficient. The necessary information is still needed to process the claim.
- [CO-253](https://denialjournal.com/denial-codes/co-253/) - Sequestration - reduction in federal payment
- [CO-254](https://denialjournal.com/denial-codes/co-254/) - Claim received by the dental plan, but benefits not available under this plan. Submit these services to the patient's medical plan for further consideration.
- [OA-255](https://denialjournal.com/denial-codes/oa-255/) - The disposition of the related Property & Casualty claim (injury or illness) is pending due to litigation. This code was deactivated by X12 (as of 07/01/2014). See: P11.
- [CO-256](https://denialjournal.com/denial-codes/co-256/) - Service not payable per managed care contract.
- [OA-257](https://denialjournal.com/denial-codes/oa-257/) - The disposition of the claim/service is undetermined during the premium payment grace period, per Health Insurance Exchange requirements.
- [CO-258](https://denialjournal.com/denial-codes/co-258/) - Claim/service not covered when patient is in custody/incarcerated.
- [CO-259](https://denialjournal.com/denial-codes/co-259/) - Additional payment for Dental/Vision service utilization.
- [CO-260](https://denialjournal.com/denial-codes/co-260/) - Processed under Medicaid ACA Enhanced Fee Schedule
- [CO-262](https://denialjournal.com/denial-codes/co-262/) - Adjustment for delivery cost.
- [CO-263](https://denialjournal.com/denial-codes/co-263/) - Adjustment for shipping cost.
- [CO-264](https://denialjournal.com/denial-codes/co-264/) - Adjustment for postage cost.
- [CO-265](https://denialjournal.com/denial-codes/co-265/) - Adjustment for administrative cost.
- [CO-266](https://denialjournal.com/denial-codes/co-266/) - Adjustment for compound preparation cost.
- [CO-267](https://denialjournal.com/denial-codes/co-267/) - Claim/service spans multiple months.
- [CO-268](https://denialjournal.com/denial-codes/co-268/) - The Claim spans two calendar years. Please resubmit one claim per calendar year.
- [CO-269](https://denialjournal.com/denial-codes/co-269/) - Anesthesia not covered for this service/procedure.
- [CO-270](https://denialjournal.com/denial-codes/co-270/) - Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's dental plan for further consideration.
- [OA-271](https://denialjournal.com/denial-codes/oa-271/) - Prior contractual reductions related to a current periodic payment as part of a contractual payment schedule when deferred amounts have been previously reported.
- [CO-272](https://denialjournal.com/denial-codes/co-272/) - Coverage/program guidelines were not met.
- [CO-273](https://denialjournal.com/denial-codes/co-273/) - Coverage/program guidelines were exceeded.
- [CO-274](https://denialjournal.com/denial-codes/co-274/) - Fee/Service not payable per patient Care Coordination arrangement.
- [PR-275](https://denialjournal.com/denial-codes/pr-275/) - Prior payer's (or payers') patient responsibility (deductible, coinsurance, co-payment) not covered.
- [CO-276](https://denialjournal.com/denial-codes/co-276/) - Services denied by the prior payer(s) are not covered by this payer.
- [OA-277](https://denialjournal.com/denial-codes/oa-277/) - The disposition of the claim/service is undetermined during the premium payment grace period, per Health Insurance SHOP Exchange requirements.
- [CO-278](https://denialjournal.com/denial-codes/co-278/) - Performance program proficiency requirements not met.
- [CO-279](https://denialjournal.com/denial-codes/co-279/) - Services not provided by Preferred network providers.
- [CO-280](https://denialjournal.com/denial-codes/co-280/) - Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's Pharmacy plan for further consideration.
- [CO-281](https://denialjournal.com/denial-codes/co-281/) - Deductible waived per contractual agreement.
- [CO-284](https://denialjournal.com/denial-codes/co-284/) - Precertification/authorization/notification/pre-treatment number may be valid but does not apply to the billed services.
- [CO-285](https://denialjournal.com/denial-codes/co-285/) - Appeal procedures not followed
- [CO-286](https://denialjournal.com/denial-codes/co-286/) - Appeal time limits not met
- [CO-287](https://denialjournal.com/denial-codes/co-287/) - Referral exceeded
- [CO-288](https://denialjournal.com/denial-codes/co-288/) - Referral absent
- [CO-289](https://denialjournal.com/denial-codes/co-289/) - Services considered under the dental and medical plans, benefits not available.
- [CO-101](https://denialjournal.com/denial-codes/co-101/) - Predetermination: anticipated payment upon completion of services or claim adjudication.
- [CO-102](https://denialjournal.com/denial-codes/co-102/) - Major Medical Adjustment.
- [CO-103](https://denialjournal.com/denial-codes/co-103/) - Provider promotional discount (e.g., Senior citizen discount).
- [CO-104](https://denialjournal.com/denial-codes/co-104/) - Managed care withholding.
- [CO-105](https://denialjournal.com/denial-codes/co-105/) - Tax withholding.
- [CO-106](https://denialjournal.com/denial-codes/co-106/) - Patient payment option/election not in effect.
- [CO-107](https://denialjournal.com/denial-codes/co-107/) - The related or qualifying claim/service was not identified on this claim.
- [CO-108](https://denialjournal.com/denial-codes/co-108/) - Rent/purchase guidelines were not met.
- [CO-110](https://denialjournal.com/denial-codes/co-110/) - Billing date predates service date.
- [CO-111](https://denialjournal.com/denial-codes/co-111/) - Not covered unless the provider accepts assignment.
- [CO-112](https://denialjournal.com/denial-codes/co-112/) - Service not furnished directly to the patient and/or not documented.
- [CO-113](https://denialjournal.com/denial-codes/co-113/) - Payment denied because service/procedure was provided outside the United States or as a result of war. This code was deactivated by X12 (as of 06/30/2007).
- [CO-114](https://denialjournal.com/denial-codes/co-114/) - Procedure/product not approved by the Food and Drug Administration.
- [CO-115](https://denialjournal.com/denial-codes/co-115/) - Procedure postponed, canceled, or delayed.
- [CO-116](https://denialjournal.com/denial-codes/co-116/) - The advance indemnification notice signed by the patient did not comply with requirements.
- [CO-117](https://denialjournal.com/denial-codes/co-117/) - Transportation is only covered to the closest facility that can provide the necessary care.
- [CO-118](https://denialjournal.com/denial-codes/co-118/) - ESRD network support adjustment.
- [CO-120](https://denialjournal.com/denial-codes/co-120/) - Patient is covered by a managed care plan. This code was deactivated by X12 (as of 06/30/2007). See: 24.
- [CO-121](https://denialjournal.com/denial-codes/co-121/) - Indemnification adjustment - compensation for outstanding member responsibility.
- [CO-122](https://denialjournal.com/denial-codes/co-122/) - Psychiatric reduction.
- [CO-123](https://denialjournal.com/denial-codes/co-123/) - Payer refund due to overpayment. This code was deactivated by X12 (as of 06/30/2007).
- [CO-124](https://denialjournal.com/denial-codes/co-124/) - Payer refund amount - not our patient. This code was deactivated by X12 (as of 06/30/2007).
- [CO-125](https://denialjournal.com/denial-codes/co-125/) - Submission/billing error(s). This code was deactivated by X12 (as of 11/01/2013).
- [CO-126](https://denialjournal.com/denial-codes/co-126/) - Deductible -- Major Medical. This code was deactivated by X12 (as of 04/01/2008).
- [CO-127](https://denialjournal.com/denial-codes/co-127/) - Coinsurance -- Major Medical. This code was deactivated by X12 (as of 04/01/2008).
- [CO-128](https://denialjournal.com/denial-codes/co-128/) - Newborn's services are covered in the mother's Allowance.
- [CO-129](https://denialjournal.com/denial-codes/co-129/) - Prior processing information appears incorrect.
- [CO-130](https://denialjournal.com/denial-codes/co-130/) - Claim submission fee.
- [CO-131](https://denialjournal.com/denial-codes/co-131/) - Claim specific negotiated discount.
- [CO-132](https://denialjournal.com/denial-codes/co-132/) - Prearranged demonstration project adjustment.
- [OA-133](https://denialjournal.com/denial-codes/oa-133/) - The disposition of this service line is pending further review.
- [CO-134](https://denialjournal.com/denial-codes/co-134/) - Technical fees removed from charges.
- [CO-135](https://denialjournal.com/denial-codes/co-135/) - Interim bills cannot be processed.
- [OA-136](https://denialjournal.com/denial-codes/oa-136/) - Failure to follow prior payer's coverage rules.
- [CO-137](https://denialjournal.com/denial-codes/co-137/) - Regulatory Surcharges, Assessments, Allowances or Health Related Taxes.
- [CO-138](https://denialjournal.com/denial-codes/co-138/) - Appeal procedures not followed or time limits not met. This code was deactivated by X12 (as of 05/01/2018).
- [CO-140](https://denialjournal.com/denial-codes/co-140/) - Patient/Insured health identification number and name do not match.
- [CO-141](https://denialjournal.com/denial-codes/co-141/) - Claim spans eligible and ineligible periods of coverage. This code was deactivated by X12 (as of 07/01/2012).
- [CO-142](https://denialjournal.com/denial-codes/co-142/) - Monthly Medicaid patient liability amount.
- [CO-143](https://denialjournal.com/denial-codes/co-143/) - Portion of payment deferred.
- [CO-144](https://denialjournal.com/denial-codes/co-144/) - Incentive adjustment, e.g. preferred product/service.
- [CO-145](https://denialjournal.com/denial-codes/co-145/) - Premium payment withholding. This code was deactivated by X12 (as of 04/01/2008).
- [CO-148](https://denialjournal.com/denial-codes/co-148/) - Information from another provider was not provided or was insufficient/incomplete.
- [CO-149](https://denialjournal.com/denial-codes/co-149/) - Lifetime benefit maximum has been reached for this service/benefit category.
- [CO-155](https://denialjournal.com/denial-codes/co-155/) - Patient refused the service/procedure.
- [CO-156](https://denialjournal.com/denial-codes/co-156/) - Flexible spending account payments. This code was deactivated by X12 (as of 10/01/2009). See: 187.
- [CO-157](https://denialjournal.com/denial-codes/co-157/) - Service/procedure was provided as a result of an act of war.
- [CO-158](https://denialjournal.com/denial-codes/co-158/) - Service/procedure was provided outside of the United States.
- [CO-159](https://denialjournal.com/denial-codes/co-159/) - Service/procedure was provided as a result of terrorism.
- [CO-160](https://denialjournal.com/denial-codes/co-160/) - Injury/illness was the result of an activity that is a benefit exclusion.
- [CO-161](https://denialjournal.com/denial-codes/co-161/) - Provider performance bonus
- [CO-162](https://denialjournal.com/denial-codes/co-162/) - State-mandated Requirement for Property and Casualty, see Claim Payment Remarks Code for specific explanation. This code was deactivated by X12 (as of 07/01/2014). See: P1.
- [CO-165](https://denialjournal.com/denial-codes/co-165/) - Referral absent or exceeded. This code was deactivated by X12 (as of 05/01/2018).
- [CO-166](https://denialjournal.com/denial-codes/co-166/) - These services were submitted after this payers responsibility for processing claims under this plan ended.
- [CO-168](https://denialjournal.com/denial-codes/co-168/) - Service(s) have been considered under the patient's medical plan. Benefits are not available under this dental plan. This code was deactivated by X12 (as of 05/01/2018).
- [CO-169](https://denialjournal.com/denial-codes/co-169/) - Alternate benefit has been provided.
- [CO-170](https://denialjournal.com/denial-codes/co-170/) - Payment is denied when performed/billed by this type of provider.
- [CO-171](https://denialjournal.com/denial-codes/co-171/) - Payment is denied when performed/billed by this type of provider in this type of facility.
- [CO-172](https://denialjournal.com/denial-codes/co-172/) - Payment is adjusted when performed/billed by a provider of this specialty.
- [CO-173](https://denialjournal.com/denial-codes/co-173/) - Service/equipment was not prescribed by a physician.
- [CO-174](https://denialjournal.com/denial-codes/co-174/) - Service was not prescribed prior to delivery.
- [CO-175](https://denialjournal.com/denial-codes/co-175/) - Prescription is incomplete.
- [CO-176](https://denialjournal.com/denial-codes/co-176/) - Prescription is not current.
- [CO-177](https://denialjournal.com/denial-codes/co-177/) - Patient has not met the required eligibility requirements.
- [CO-178](https://denialjournal.com/denial-codes/co-178/) - Patient has not met the required spend down requirements.
- [CO-179](https://denialjournal.com/denial-codes/co-179/) - Patient has not met the required waiting requirements.
- [CO-180](https://denialjournal.com/denial-codes/co-180/) - Patient has not met the required residency requirements.
- [CO-184](https://denialjournal.com/denial-codes/co-184/) - The prescribing/ordering provider is not eligible to prescribe/order the service billed.
- [CO-186](https://denialjournal.com/denial-codes/co-186/) - Level of care change adjustment.
- [CO-187](https://denialjournal.com/denial-codes/co-187/) - Consumer Spending Account payments (includes but is not limited to Flexible Spending Account, Health Savings Account, Health Reimbursement Account, etc.)
- [CO-188](https://denialjournal.com/denial-codes/co-188/) - This product/procedure is only covered when used according to FDA recommendations.
- [CO-190](https://denialjournal.com/denial-codes/co-190/) - Payment is included in the allowance for a Skilled Nursing Facility (SNF) qualified stay.
- [CO-191](https://denialjournal.com/denial-codes/co-191/) - Not a work related injury/illness and thus not the liability of the workers' compensation carrier. This code was deactivated by X12 (as of 07/01/2014). See: P2.
- [CO-192](https://denialjournal.com/denial-codes/co-192/) - Non standard adjustment code from paper remittance.
- [CO-193](https://denialjournal.com/denial-codes/co-193/) - Original payment decision is being maintained. Upon review, it was determined that this claim was processed properly.
- [CO-194](https://denialjournal.com/denial-codes/co-194/) - Anesthesia performed by the operating physician, the assistant surgeon or the attending physician.
- [CO-195](https://denialjournal.com/denial-codes/co-195/) - Refund issued to an erroneous priority payer for this claim/service.
- [CO-196](https://denialjournal.com/denial-codes/co-196/) - Claim/service denied based on prior payer's coverage determination. This code was deactivated by X12 (as of 02/01/2007). See: 136.
- [CO-199](https://denialjournal.com/denial-codes/co-199/) - Revenue code and Procedure code do not match.
- [CO-200](https://denialjournal.com/denial-codes/co-200/) - Expenses incurred during lapse in coverage
- [A1](https://denialjournal.com/denial-codes/a1/) - A general denial code meant to be used only when a more specific CARC isn't available; it should always be paired with a remark code explaining the actual reason.
- [B7](https://denialjournal.com/denial-codes/b7/) - The rendering provider wasn't certified or eligible to be paid for this specific procedure on the billed date of service.
- [B9](https://denialjournal.com/denial-codes/b9/) - The patient's hospice enrollment affects coverage for this claim; certain services are bundled into the hospice benefit.
- [B15](https://denialjournal.com/denial-codes/b15/) - This service requires a related, qualifying service to be billed and adjudicated first, and that hasn't happened yet.
- [B16](https://denialjournal.com/denial-codes/b16/) - A new-patient E/M code was billed, but the patient doesn't meet the payer's definition of a new patient (e.g. seen within the last 3 years).
- [M20](https://denialjournal.com/denial-codes/m20/) - The HCPCS code on the claim is missing, incomplete, or invalid.
- [M25](https://denialjournal.com/denial-codes/m25/) - The documentation submitted doesn't support the specific level of service that was billed.
- [M86](https://denialjournal.com/denial-codes/m86/) - The payer already paid for the same or a similar procedure within its allowed frequency window.
- [N19](https://denialjournal.com/denial-codes/n19/) - This procedure is considered a routine part of the primary procedure and isn't paid separately.
- [N50](https://denialjournal.com/denial-codes/n50/) - The claim is missing required discharge information, typically for an inpatient stay.
- [N54](https://denialjournal.com/denial-codes/n54/) - What was billed doesn't match what was actually pre-certified or authorized.
- [N56](https://denialjournal.com/denial-codes/n56/) - The specific procedure code doesn't match the documented services, or isn't valid for the billed date.
- [N65](https://denialjournal.com/denial-codes/n65/) - The payer's system has no rate on file for this code, provider, and date combination.
- [N94](https://denialjournal.com/denial-codes/n94/) - The payer needs a more specific provider taxonomy code than what was submitted.
- [MA13](https://denialjournal.com/denial-codes/ma13/) - An informational alert reminding the provider that only amounts reported under the PR (Patient Responsibility) group code may be billed to the patient.
- [CO-15](https://denialjournal.com/denial-codes/co-15/) - The authorization number is missing, invalid, or does not apply to the billed services or provider. This code was deactivated by X12 (as of 05/01/2018).
- [CO-17](https://denialjournal.com/denial-codes/co-17/) - Requested information was not provided or was insufficient/incomplete. This code was deactivated by X12 (as of 07/01/2009).
- [CO-25](https://denialjournal.com/denial-codes/co-25/) - Payment denied. Your Stop loss deductible has not been met. This code was deactivated by X12 (as of 04/01/2008).
- [CO-28](https://denialjournal.com/denial-codes/co-28/) - Coverage not in effect at the time the service was provided. This code was deactivated by X12 (as of 10/16/2003).
- [CO-30](https://denialjournal.com/denial-codes/co-30/) - Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements. This code was deactivated by X12 (as of 02/01/2006).
- [CO-34](https://denialjournal.com/denial-codes/co-34/) - Insured has no coverage for newborns.
- [CO-36](https://denialjournal.com/denial-codes/co-36/) - Balance does not exceed co-payment amount. This code was deactivated by X12 (as of 10/16/2003).
- [CO-37](https://denialjournal.com/denial-codes/co-37/) - Balance does not exceed deductible. This code was deactivated by X12 (as of 10/16/2003).
- [CO-38](https://denialjournal.com/denial-codes/co-38/) - Services not provided or authorized by designated (network/primary care) providers. This code was deactivated by X12 (as of 01/01/2013).
- [CO-40](https://denialjournal.com/denial-codes/co-40/) - Charges do not meet qualifications for emergent/urgent care.
- [CO-41](https://denialjournal.com/denial-codes/co-41/) - Discount agreed to in Preferred Provider contract. This code was deactivated by X12 (as of 10/16/2003).
- [CO-42](https://denialjournal.com/denial-codes/co-42/) - Charges exceed our fee schedule or maximum allowable amount. (Use CARC 45). This code was deactivated by X12 (as of 06/01/2007). See: 45.
- [CO-43](https://denialjournal.com/denial-codes/co-43/) - Gramm-Rudman reduction. This code was deactivated by X12 (as of 07/01/2006).
- [CO-44](https://denialjournal.com/denial-codes/co-44/) - Prompt-pay discount.
- [CO-46](https://denialjournal.com/denial-codes/co-46/) - This service(s) is not covered under the plan. This code was deactivated by X12 (as of 10/16/2003). See: 96.
- [CO-47](https://denialjournal.com/denial-codes/co-47/) - This diagnosis(es) is not covered under the plan. This code was deactivated by X12 (as of 02/01/2006).
- [CO-48](https://denialjournal.com/denial-codes/co-48/) - This procedure(s) is not covered under the plan. This code was deactivated by X12 (as of 10/16/2003). See: 96.
- [CO-51](https://denialjournal.com/denial-codes/co-51/) - These are non-covered services because this is a pre-existing condition.
- [CO-52](https://denialjournal.com/denial-codes/co-52/) - The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed. This code was deactivated by X12 (as of 02/01/2006).
- [CO-53](https://denialjournal.com/denial-codes/co-53/) - Services by an immediate relative or a member of the same household are not covered.
- [CO-57](https://denialjournal.com/denial-codes/co-57/) - Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's supply. This code was deactivated by X12 (as of 06/30/2007).
- [CO-62](https://denialjournal.com/denial-codes/co-62/) - Payment denied/reduced for absence of, or exceeded, pre-certification/authorization. This code was deactivated by X12 (as of 04/01/2007).
- [CO-63](https://denialjournal.com/denial-codes/co-63/) - Correction to a prior claim. This code was deactivated by X12 (as of 10/16/2003).
- [CO-64](https://denialjournal.com/denial-codes/co-64/) - Denial reversed per Medical Review. This code was deactivated by X12 (as of 10/16/2003).
- [CO-65](https://denialjournal.com/denial-codes/co-65/) - Procedure code was incorrect. This payment reflects the correct code. This code was deactivated by X12 (as of 10/16/2003).
- [CO-66](https://denialjournal.com/denial-codes/co-66/) - Blood Deductible.
- [CO-67](https://denialjournal.com/denial-codes/co-67/) - Lifetime reserve days. This code was deactivated by X12 (as of 10/16/2003).
- [CO-68](https://denialjournal.com/denial-codes/co-68/) - DRG weight. This code was deactivated by X12 (as of 10/16/2003).
- [CO-69](https://denialjournal.com/denial-codes/co-69/) - Day outlier amount.
- [CO-70](https://denialjournal.com/denial-codes/co-70/) - Cost outlier - Adjustment to compensate for additional costs.
- [CO-71](https://denialjournal.com/denial-codes/co-71/) - Primary Payer amount. This code was deactivated by X12 (as of 06/30/2000). See: 23.
- [CO-72](https://denialjournal.com/denial-codes/co-72/) - Coinsurance day. This code was deactivated by X12 (as of 10/16/2003).
- [CO-73](https://denialjournal.com/denial-codes/co-73/) - Administrative days. This code was deactivated by X12 (as of 10/16/2003).
- [CO-74](https://denialjournal.com/denial-codes/co-74/) - Indirect Medical Education Adjustment.
- [CO-75](https://denialjournal.com/denial-codes/co-75/) - Direct Medical Education Adjustment.
- [CO-76](https://denialjournal.com/denial-codes/co-76/) - Disproportionate Share Adjustment.
- [CO-77](https://denialjournal.com/denial-codes/co-77/) - Covered days. This code was deactivated by X12 (as of 10/16/2003).
- [CO-78](https://denialjournal.com/denial-codes/co-78/) - Non-Covered days/Room charge adjustment.
- [CO-79](https://denialjournal.com/denial-codes/co-79/) - Cost Report days. This code was deactivated by X12 (as of 10/16/2003).
- [CO-80](https://denialjournal.com/denial-codes/co-80/) - Outlier days. This code was deactivated by X12 (as of 10/16/2003).
- [CO-81](https://denialjournal.com/denial-codes/co-81/) - Discharges. This code was deactivated by X12 (as of 10/16/2003).
- [CO-82](https://denialjournal.com/denial-codes/co-82/) - PIP days. This code was deactivated by X12 (as of 10/16/2003).
- [CO-83](https://denialjournal.com/denial-codes/co-83/) - Total visits. This code was deactivated by X12 (as of 10/16/2003).
- [CO-84](https://denialjournal.com/denial-codes/co-84/) - Capital Adjustment. This code was deactivated by X12 (as of 10/16/2003).
- [PR-85](https://denialjournal.com/denial-codes/pr-85/) - Patient Interest Adjustment (Use Only Group code PR)
- [CO-86](https://denialjournal.com/denial-codes/co-86/) - Statutory Adjustment. This code was deactivated by X12 (as of 10/16/2003).
- [CO-87](https://denialjournal.com/denial-codes/co-87/) - Transfer amount. This code was deactivated by X12 (as of 01/01/2012).
- [CO-88](https://denialjournal.com/denial-codes/co-88/) - Adjustment amount represents collection against receivable created in prior overpayment. This code was deactivated by X12 (as of 06/30/2007).
- [CO-89](https://denialjournal.com/denial-codes/co-89/) - Professional fees removed from charges.
- [CO-90](https://denialjournal.com/denial-codes/co-90/) - Ingredient cost adjustment.
- [CO-91](https://denialjournal.com/denial-codes/co-91/) - Dispensing fee adjustment.
- [CO-92](https://denialjournal.com/denial-codes/co-92/) - Claim Paid in full. This code was deactivated by X12 (as of 10/16/2003).
- [CO-93](https://denialjournal.com/denial-codes/co-93/) - No Claim level Adjustments. This code was deactivated by X12 (as of 10/16/2003).
- [CO-94](https://denialjournal.com/denial-codes/co-94/) - Processed in Excess of charges.
- [CO-95](https://denialjournal.com/denial-codes/co-95/) - Plan procedures not followed.
- [CO-98](https://denialjournal.com/denial-codes/co-98/) - The hospital must file the Medicare claim for this inpatient non-physician service. This code was deactivated by X12 (as of 10/16/2003).
- [CO-99](https://denialjournal.com/denial-codes/co-99/) - Medicare Secondary Payer Adjustment Amount. This code was deactivated by X12 (as of 10/16/2003).
- [CO-100](https://denialjournal.com/denial-codes/co-100/) - Payment made to patient/insured/responsible party.
- [CO-16](https://denialjournal.com/denial-codes/co-16/) - The claim or service was denied because it is missing information, or has submission/billing errors that prevent the payer from processing it. This is one of the most common front-end denial codes and is almost always paired with a RARC that names the specific missing item.
- [CO-18](https://denialjournal.com/denial-codes/co-18/) - The payer's system identified this claim or service line as a duplicate of one already submitted and processed.
- [CO-22](https://denialjournal.com/denial-codes/co-22/) - The payer believes another insurance plan is primary and should be billed first before this payer considers the claim.
- [CO-26](https://denialjournal.com/denial-codes/co-26/) - The date of service falls before the patient's coverage effective date with this plan.
- [CO-27](https://denialjournal.com/denial-codes/co-27/) - The date of service falls after the patient's coverage with this plan had already ended.
- [CO-29](https://denialjournal.com/denial-codes/co-29/) - The claim was submitted after the payer's timely filing deadline.
- [CO-45](https://denialjournal.com/denial-codes/co-45/) - The billed amount is more than the contracted or fee-schedule allowed amount; the difference is a contractual write-off, not something that can be billed to the patient.
- [CO-50](https://denialjournal.com/denial-codes/co-50/) - The payer determined the service does not meet its medical necessity criteria for the diagnosis billed.
- [CO-96](https://denialjournal.com/denial-codes/co-96/) - The service is specifically excluded from the patient's benefit plan.
- [CO-97](https://denialjournal.com/denial-codes/co-97/) - The payer considers this service bundled into, or a component of, another procedure already paid on the same claim or date of service.
- [CO-109](https://denialjournal.com/denial-codes/co-109/) - This payer is not responsible for the claim; it should be directed to a different payer or contractor.
- [CO-119](https://denialjournal.com/denial-codes/co-119/) - The patient has exhausted the plan's benefit limit (visit count, dollar cap, or occurrence limit) for this service type.
- [CO-151](https://denialjournal.com/denial-codes/co-151/) - The payer's review found the quantity, frequency, or duration of services billed isn't supported by the documentation submitted.
- [CO-167](https://denialjournal.com/denial-codes/co-167/) - The diagnosis code submitted is not covered for the billed service, or is missing/invalid.
- [CO-197](https://denialjournal.com/denial-codes/co-197/) - The service required prior authorization, precertification, or notification that was not obtained or not on file.
- [CO-236](https://denialjournal.com/denial-codes/co-236/) - An NCCI edit flagged this procedure/modifier combination as incompatible with another service billed on the same date.
- [PR-1](https://denialjournal.com/denial-codes/pr-1/) - The amount applied is the patient's plan deductible — the portion of costs the patient must pay before the plan begins paying.
- [PR-2](https://denialjournal.com/denial-codes/pr-2/) - The amount applied is the patient's coinsurance — their percentage share of the allowed amount after the deductible is met.
- [PR-3](https://denialjournal.com/denial-codes/pr-3/) - The amount applied is the patient's fixed co-payment for this type of visit or service.
- [PR-204](https://denialjournal.com/denial-codes/pr-204/) - The specific service, item, or drug is excluded from the patient's benefit plan, and the balance is the patient's responsibility.
- [OA-23](https://denialjournal.com/denial-codes/oa-23/) - This adjustment reflects amounts already paid or adjusted by a prior payer in a coordination-of-benefits scenario; it is informational rather than a new denial.
- [PI-B7](https://denialjournal.com/denial-codes/pi-b7/) - The payer's records show the rendering provider wasn't certified, credentialed, or eligible to bill this specific service on the date billed.
- [M15](https://denialjournal.com/denial-codes/m15/) - Supplemental remark clarifying that the services billed separately are considered part of the same overall procedure and won't be paid individually.
- [M51](https://denialjournal.com/denial-codes/m51/) - The claim is missing a procedure code, or the code submitted is incomplete or invalid for the date of service.
- [M76](https://denialjournal.com/denial-codes/m76/) - The diagnosis code field is missing, incomplete, or invalid.
- [MA04](https://denialjournal.com/denial-codes/ma04/) - Informational remark used with COB denials — the secondary payer needs the primary payer's EOB/payment details before it can process the claim.
- [MA130](https://denialjournal.com/denial-codes/ma130/) - The claim could not be processed at all due to missing or invalid information; because it was never truly adjudicated, standard appeal rights don't apply — it must be corrected and resubmitted instead.
- [N30](https://denialjournal.com/denial-codes/n30/) - Remark indicating the patient wasn't eligible for the specific service billed, distinct from general coverage termination.
- [N95](https://denialjournal.com/denial-codes/n95/) - The payer's records indicate a provider of this type or specialty isn't permitted to bill the specific service or procedure code.
- [N286](https://denialjournal.com/denial-codes/n286/) - The referring provider's NPI or other identifier is missing, incomplete, or invalid on the claim.
- [N362](https://denialjournal.com/denial-codes/n362/) - The quantity or units billed exceeds the payer's maximum allowed for this code, often per Medically Unlikely Edits (MUEs).
- [N822](https://denialjournal.com/denial-codes/n822/) - The claim requires a procedure modifier that was not included.
- [CO-4](https://denialjournal.com/denial-codes/co-4/) - The modifier attached to this procedure code doesn't logically apply to that procedure per payer edits.
- [CO-5](https://denialjournal.com/denial-codes/co-5/) - The procedure or bill type billed doesn't match the place-of-service code submitted.
- [CO-6](https://denialjournal.com/denial-codes/co-6/) - The billed code is not appropriate given the patient's age on the date of service.
- [CO-7](https://denialjournal.com/denial-codes/co-7/) - The billed code is gender-specific and doesn't match the patient's gender on file.
- [CO-8](https://denialjournal.com/denial-codes/co-8/) - The payer's records show this provider's specialty/taxonomy doesn't typically perform or bill this procedure.
- [CO-9](https://denialjournal.com/denial-codes/co-9/) - The diagnosis code billed is not clinically consistent with the patient's age.
- [CO-10](https://denialjournal.com/denial-codes/co-10/) - The diagnosis code billed doesn't align with the patient's gender on file.
- [CO-11](https://denialjournal.com/denial-codes/co-11/) - The diagnosis code doesn't support medical necessity for the specific procedure billed.
- [CO-12](https://denialjournal.com/denial-codes/co-12/) - The diagnosis billed isn't one this type of provider typically treats or reports.
- [CO-13](https://denialjournal.com/denial-codes/co-13/) - Payer records show the patient's date of death is before the billed date of service.
- [CO-14](https://denialjournal.com/denial-codes/co-14/) - Payer records show the patient's date of birth is after the billed date of service, which is not possible.
- [CO-19](https://denialjournal.com/denial-codes/co-19/) - The payer determined this claim relates to a work injury and should be billed to workers' compensation instead.
- [CO-20](https://denialjournal.com/denial-codes/co-20/) - The payer believes a liability insurer (e.g. auto or general liability) is responsible for this claim.
- [CO-21](https://denialjournal.com/denial-codes/co-21/) - The payer believes a no-fault auto insurance carrier is responsible for this claim.
- [CO-24](https://denialjournal.com/denial-codes/co-24/) - The service is included in a capitated payment arrangement, so no additional fee-for-service payment applies.
- [CO-31](https://denialjournal.com/denial-codes/co-31/) - The payer's records don't show this patient as a covered member under the plan/ID submitted.
- [CO-32](https://denialjournal.com/denial-codes/co-32/) - The payer's records show this individual doesn't qualify as a covered dependent under the subscriber's plan.
- [CO-33](https://denialjournal.com/denial-codes/co-33/) - The subscriber's plan doesn't include dependent coverage at all.
- [CO-35](https://denialjournal.com/denial-codes/co-35/) - The patient has used up the plan's lifetime maximum benefit for this category of service.
- [CO-39](https://denialjournal.com/denial-codes/co-39/) - The payer had already denied authorization for this service before it was performed.
- [CO-49](https://denialjournal.com/denial-codes/co-49/) - The service is excluded because it's a routine/preventive exam, or a screening/diagnostic procedure bundled with one.
- [CO-54](https://denialjournal.com/denial-codes/co-54/) - The plan doesn't cover having more than one physician or assistant involved for this type of case.
- [CO-55](https://denialjournal.com/denial-codes/co-55/) - The payer classifies this treatment as experimental or investigational and therefore not covered.
- [CO-56](https://denialjournal.com/denial-codes/co-56/) - Similar to CO-55 — the payer doesn't consider this treatment to have established clinical effectiveness.
- [CO-58](https://denialjournal.com/denial-codes/co-58/) - The payer determined the setting where the service was performed isn't appropriate for that service.
- [CO-59](https://denialjournal.com/denial-codes/co-59/) - Payment was reduced because multiple procedures, multiple surgeries, or concurrent anesthesia rules applied.
- [CO-60](https://denialjournal.com/denial-codes/co-60/) - Charges for outpatient services aren't separately payable because they fall within the payer's inpatient bundling window.
- [CO-61](https://denialjournal.com/denial-codes/co-61/) - Payment was reduced because a required second surgical opinion wasn't obtained before the procedure.
- [CO-139](https://denialjournal.com/denial-codes/co-139/) - A specific contractual arrangement applies because the patient is employed by the billing provider.
- [CO-146](https://denialjournal.com/denial-codes/co-146/) - The ICD-10 code submitted wasn't a valid, billable code as of the date of service (codes update annually).
- [CO-147](https://denialjournal.com/denial-codes/co-147/) - The payer doesn't have a current contracted rate on file for this provider for the billed service.
- [CO-150](https://denialjournal.com/denial-codes/co-150/) - The documentation submitted doesn't justify the complexity/level of the E/M or service code billed.
- [CO-152](https://denialjournal.com/denial-codes/co-152/) - Documentation doesn't support the duration of the service billed.
- [CO-153](https://denialjournal.com/denial-codes/co-153/) - Documentation doesn't support the dosage of a drug or biologic billed.
- [CO-154](https://denialjournal.com/denial-codes/co-154/) - Documentation doesn't support the days-supply quantity billed for a prescription or DME item.
- [CO-163](https://denialjournal.com/denial-codes/co-163/) - The claim referenced supporting documentation (e.g. operative notes) that the payer never received.
- [CO-164](https://denialjournal.com/denial-codes/co-164/) - The supporting documentation was received, but after the payer's required deadline.
- [CO-181](https://denialjournal.com/denial-codes/co-181/) - The CPT/HCPCS code wasn't a valid, active code as of the billed date of service.
- [CO-182](https://denialjournal.com/denial-codes/co-182/) - The modifier attached to the procedure code wasn't valid as of the date of service.
- [CO-183](https://denialjournal.com/denial-codes/co-183/) - The payer's records show the referring provider isn't eligible/enrolled to make referrals for this type of service.
- [CO-185](https://denialjournal.com/denial-codes/co-185/) - The payer's records show the rendering provider isn't eligible/credentialed to perform this specific service.
- [CO-189](https://denialjournal.com/denial-codes/co-189/) - An unlisted/NOC procedure code was used even though a more specific code exists for the service performed.
- [CO-198](https://denialjournal.com/denial-codes/co-198/) - The service exceeded the scope, units, or date range of the authorization that was actually obtained.
- [CO-206](https://denialjournal.com/denial-codes/co-206/) - The claim is missing an NPI that the payer requires.
- [CO-207](https://denialjournal.com/denial-codes/co-207/) - The NPI submitted doesn't match the required 10-digit format.
- [CO-208](https://denialjournal.com/denial-codes/co-208/) - The NPI submitted doesn't match any provider in the payer's records.
- [CO-231](https://denialjournal.com/denial-codes/co-231/) - NCCI edits flagged two procedures billed together as clinically mutually exclusive.
- [CO-252](https://denialjournal.com/denial-codes/co-252/) - The payer needs supporting documentation before it can process this claim at all.
- [CO-261](https://denialjournal.com/denial-codes/co-261/) - The billed service doesn't align with the patient's documented medical history on file with the payer.
- [CO-282](https://denialjournal.com/denial-codes/co-282/) - The billed procedure or revenue code doesn't match the type of bill submitted (e.g. inpatient vs. outpatient).
- [CO-283](https://denialjournal.com/denial-codes/co-283/) - The payer's records show the attending provider isn't eligible to direct care in this context.
- [CO-299](https://denialjournal.com/denial-codes/co-299/) - The payer's records show the billing provider isn't eligible to be paid for this specific service.

## Categories

- [Blog](https://denialjournal.com/category/blog/) - Your blog category
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- [RCM Software Reviews](https://denialjournal.com/category/rcm-software-reviews/) - medical billing software reviews, features, pricing, and comparisons
- [Billing Tips For Doctors](https://denialjournal.com/category/billing-tips-for-doctors/) - AI, automation, HIPAA, coding integration, and tech-related guides

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- [CPT Code 00142](https://denialjournal.com/tag/cpt-code-00142/)
- [eye lens surgery](https://denialjournal.com/tag/eye-lens-surgery/)
- [CPT Code 00144](https://denialjournal.com/tag/cpt-code-00144/)
- [corneal transplant](https://denialjournal.com/tag/corneal-transplant/)
- [CPT Code 00145](https://denialjournal.com/tag/cpt-code-00145/)
- [vitreoretinal surgery](https://denialjournal.com/tag/vitreoretinal-surgery/)
- [CPT Code 00147](https://denialjournal.com/tag/cpt-code-00147/)
- [iridectomy](https://denialjournal.com/tag/iridectomy/)
- [CPT Code 00148](https://denialjournal.com/tag/cpt-code-00148/)
- [ophthalmoscopy](https://denialjournal.com/tag/ophthalmoscopy/)
- [CPT code](https://denialjournal.com/tag/cpt-code/)
- [CPT Code 00162](https://denialjournal.com/tag/cpt-code-00162/)
- [anesthesia coding](https://denialjournal.com/tag/anesthesia-coding/)
- [CPT Code 00164](https://denialjournal.com/tag/cpt-code-00164/)
- [nasal biopsy](https://denialjournal.com/tag/nasal-biopsy/)
- [CPT Code 00170](https://denialjournal.com/tag/cpt-code-00170/)
- [CPT Code 00172](https://denialjournal.com/tag/cpt-code-00172/)
- [cleft palate repair](https://denialjournal.com/tag/cleft-palate-repair/)
- [CPT Code 00174](https://denialjournal.com/tag/cpt-code-00174/)
- [retropharyngeal tumor](https://denialjournal.com/tag/retropharyngeal-tumor/)
- [CPT Code 00176](https://denialjournal.com/tag/cpt-code-00176/)
- [intraoral procedures](https://denialjournal.com/tag/intraoral-procedures/)
- [CPT Code 00190](https://denialjournal.com/tag/cpt-code-00190/)
- [CPT Code 00192](https://denialjournal.com/tag/cpt-code-00192/)
- [CPT Code 00210](https://denialjournal.com/tag/cpt-code-00210/)
- [intracranial procedures](https://denialjournal.com/tag/intracranial-procedures/)
- [CPT Code 00211](https://denialjournal.com/tag/cpt-code-00211/)
- [CPT Code 00212](https://denialjournal.com/tag/cpt-code-00212/)
- [CPT Code 00214](https://denialjournal.com/tag/cpt-code-00214/)
- [burr hole procedures](https://denialjournal.com/tag/burr-hole-procedures/)
- [CPT Code 00215](https://denialjournal.com/tag/cpt-code-00215/)
- [CPT Code 00216](https://denialjournal.com/tag/cpt-code-00216/)
- [vascular procedures](https://denialjournal.com/tag/vascular-procedures/)
- [CPT Code 00218](https://denialjournal.com/tag/cpt-code-00218/)
- [CPT Code 00220](https://denialjournal.com/tag/cpt-code-00220/)
- [CPT Code 00222](https://denialjournal.com/tag/cpt-code-00222/)
- [CPT Code 00300](https://denialjournal.com/tag/cpt-code-00300/)
- [CPT Code 00320](https://denialjournal.com/tag/cpt-code-00320/)
- [CPT Code 00322](https://denialjournal.com/tag/cpt-code-00322/)
- [thyroid biopsy](https://denialjournal.com/tag/thyroid-biopsy/)
- [CPT Code 00326](https://denialjournal.com/tag/cpt-code-00326/)
- [Anesthesia](https://denialjournal.com/tag/anesthesia/)
- [Pediatric Procedures](https://denialjournal.com/tag/pediatric-procedures/)
- [CPT Code 00350](https://denialjournal.com/tag/cpt-code-00350/)
- [CPT Code 00352](https://denialjournal.com/tag/cpt-code-00352/)
- [CPT Code 00400](https://denialjournal.com/tag/cpt-code-00400/)
- [integumentary system](https://denialjournal.com/tag/integumentary-system/)
- [CPT Code 00402](https://denialjournal.com/tag/cpt-code-00402/)
- [reconstructive breast surgery](https://denialjournal.com/tag/reconstructive-breast-surgery/)
- [CPT Code 00404](https://denialjournal.com/tag/cpt-code-00404/)
- [breast surgery coding](https://denialjournal.com/tag/breast-surgery-coding/)
- [CPT Code 00406](https://denialjournal.com/tag/cpt-code-00406/)
- [CPT Code 00410](https://denialjournal.com/tag/cpt-code-00410/)
- [CPT code 00450](https://denialjournal.com/tag/cpt-code-00450/)
- [CPT Code 00454](https://denialjournal.com/tag/cpt-code-00454/)
- [clavicle biopsy](https://denialjournal.com/tag/clavicle-biopsy/)
- [CPT Code 00470](https://denialjournal.com/tag/cpt-code-00470/)
- [partial rib resection](https://denialjournal.com/tag/partial-rib-resection/)
- [CPT Code 00472](https://denialjournal.com/tag/cpt-code-00472/)
- [CPT Code 00500](https://denialjournal.com/tag/cpt-code-00500/)
- [esophageal procedures](https://denialjournal.com/tag/esophageal-procedures/)
- [anesthesia services](https://denialjournal.com/tag/anesthesia-services/)
- [CPT Code 00620](https://denialjournal.com/tag/cpt-code-00620/)
- [thoracic spine surgery](https://denialjournal.com/tag/thoracic-spine-surgery/)
- [thoracic spine procedures](https://denialjournal.com/tag/thoracic-spine-procedures/)
- [CPT code 00625](https://denialjournal.com/tag/cpt-code-00625/)
- [CPT Code 00626](https://denialjournal.com/tag/cpt-code-00626/)
- [CPT Code 00630](https://denialjournal.com/tag/cpt-code-00630/)
- [lumbar procedures](https://denialjournal.com/tag/lumbar-procedures/)
- [CPT Code 00632](https://denialjournal.com/tag/cpt-code-00632/)
- [lumbar sympathectomy](https://denialjournal.com/tag/lumbar-sympathectomy/)
- [CPT Code 00635](https://denialjournal.com/tag/cpt-code-00635/)
- [CPT Code 00640](https://denialjournal.com/tag/cpt-code-00640/)
- [spine manipulation](https://denialjournal.com/tag/spine-manipulation/)
- [CPT Code 00670](https://denialjournal.com/tag/cpt-code-00670/)
- [spine surgery](https://denialjournal.com/tag/spine-surgery/)
- [CPT Code 00700](https://denialjournal.com/tag/cpt-code-00700/)
- [CPT Code 00702](https://denialjournal.com/tag/cpt-code-00702/)
- [liver biopsy](https://denialjournal.com/tag/liver-biopsy/)
- [CPT Code 00730](https://denialjournal.com/tag/cpt-code-00730/)
- [CPT Code 00731](https://denialjournal.com/tag/cpt-code-00731/)
- [CPT Code 00732](https://denialjournal.com/tag/cpt-code-00732/)
- [ERCP procedures](https://denialjournal.com/tag/ercp-procedures/)
- [CPT Code 00750](https://denialjournal.com/tag/cpt-code-00750/)
- [hernia repair](https://denialjournal.com/tag/hernia-repair/)
- [CPT Code 00752](https://denialjournal.com/tag/cpt-code-00752/)
- [CPT code 00754](https://denialjournal.com/tag/cpt-code-00754/)
- [CPT Code 00756](https://denialjournal.com/tag/cpt-code-00756/)
- [diaphragmatic hernia repair](https://denialjournal.com/tag/diaphragmatic-hernia-repair/)
- [CPT Code 00770](https://denialjournal.com/tag/cpt-code-00770/)
- [CPT Code 00790](https://denialjournal.com/tag/cpt-code-00790/)
- [CPT Code 00792](https://denialjournal.com/tag/cpt-code-00792/)
- [percutaneous hepatic perfusion](https://denialjournal.com/tag/percutaneous-hepatic-perfusion/)
- [CPT Code 00794](https://denialjournal.com/tag/cpt-code-00794/)
- [pancreatectomy](https://denialjournal.com/tag/pancreatectomy/)
- [CPT Code 00796](https://denialjournal.com/tag/cpt-code-00796/)
- [liver transplant anesthesia](https://denialjournal.com/tag/liver-transplant-anesthesia/)
- [CPT Code 00797](https://denialjournal.com/tag/cpt-code-00797/)
- [CPT Code 00834](https://denialjournal.com/tag/cpt-code-00834/)
- [Hernia Repair Infants](https://denialjournal.com/tag/hernia-repair-infants/)
- [CPT Code 00836](https://denialjournal.com/tag/cpt-code-00836/)
- [Preterm Neonates](https://denialjournal.com/tag/preterm-neonates/)
- [CPT Code 00840](https://denialjournal.com/tag/cpt-code-00840/)
- [CPT Code 00842](https://denialjournal.com/tag/cpt-code-00842/)
- [Amniocentesis](https://denialjournal.com/tag/amniocentesis/)
- [CPT Code 00844](https://denialjournal.com/tag/cpt-code-00844/)
- [abdominoperineal resection](https://denialjournal.com/tag/abdominoperineal-resection/)
- [CPT Code 00846](https://denialjournal.com/tag/cpt-code-00846/)
- [radical hysterectomy](https://denialjournal.com/tag/radical-hysterectomy/)
- [CPT Code 00848](https://denialjournal.com/tag/cpt-code-00848/)
- [pelvic exenteration](https://denialjournal.com/tag/pelvic-exenteration/)
- [CPT Code 00851](https://denialjournal.com/tag/cpt-code-00851/)
- [Tubal Ligation](https://denialjournal.com/tag/tubal-ligation/)
- [CPT Code 00860](https://denialjournal.com/tag/cpt-code-00860/)
- [CPT Code 00862](https://denialjournal.com/tag/cpt-code-00862/)
- [renal procedures](https://denialjournal.com/tag/renal-procedures/)
- [CPT Code 00864](https://denialjournal.com/tag/cpt-code-00864/)
- [total cystectomy](https://denialjournal.com/tag/total-cystectomy/)
- [CPT Code 00865](https://denialjournal.com/tag/cpt-code-00865/)
- [prostatectomy billing](https://denialjournal.com/tag/prostatectomy-billing/)
- [CPT Code 00866](https://denialjournal.com/tag/cpt-code-00866/)
- [CPT Code 00868](https://denialjournal.com/tag/cpt-code-00868/)
- [renal transplant anesthesia](https://denialjournal.com/tag/renal-transplant-anesthesia/)
- [CPT Code 00870](https://denialjournal.com/tag/cpt-code-00870/)
- [cystolithotomy](https://denialjournal.com/tag/cystolithotomy/)
- [CPT Code 00872](https://denialjournal.com/tag/cpt-code-00872/)
- [lithotripsy billing](https://denialjournal.com/tag/lithotripsy-billing/)
- [CPT Code 00873](https://denialjournal.com/tag/cpt-code-00873/)
- [ESWL billing](https://denialjournal.com/tag/eswl-billing/)
- [CPT Code 00880](https://denialjournal.com/tag/cpt-code-00880/)
- [CPT Code 00882](https://denialjournal.com/tag/cpt-code-00882/)
- [CPT Code 00902](https://denialjournal.com/tag/cpt-code-00902/)
- [CPT Code 00904](https://denialjournal.com/tag/cpt-code-00904/)
- [perineal procedures](https://denialjournal.com/tag/perineal-procedures/)
- [CPT Code 00906](https://denialjournal.com/tag/cpt-code-00906/)
- [Vulvectomy](https://denialjournal.com/tag/vulvectomy/)
- [CPT Code 00908](https://denialjournal.com/tag/cpt-code-00908/)
- [Perineal Prostatectomy](https://denialjournal.com/tag/perineal-prostatectomy/)
- [CPT Code 00910](https://denialjournal.com/tag/cpt-code-00910/)
- [transurethral procedures](https://denialjournal.com/tag/transurethral-procedures/)
- [CPT Code 00912](https://denialjournal.com/tag/cpt-code-00912/)
- [CPT Code 00914](https://denialjournal.com/tag/cpt-code-00914/)
- [prostate procedures](https://denialjournal.com/tag/prostate-procedures/)
- [CPT Code 00916](https://denialjournal.com/tag/cpt-code-00916/)
- [CPT Code 00920](https://denialjournal.com/tag/cpt-code-00920/)
- [Male Genitalia NOS](https://denialjournal.com/tag/male-genitalia-nos/)
- [CPT Code 00921](https://denialjournal.com/tag/cpt-code-00921/)
- [CPT Code 00922](https://denialjournal.com/tag/cpt-code-00922/)
- [CPT Code 00924](https://denialjournal.com/tag/cpt-code-00924/)
- [undescended testes](https://denialjournal.com/tag/undescended-testes/)
- [CPT Code 00926](https://denialjournal.com/tag/cpt-code-00926/)
- [male genital procedures](https://denialjournal.com/tag/male-genital-procedures/)
- [CPT Code 00928](https://denialjournal.com/tag/cpt-code-00928/)
- [CPT Code 00930](https://denialjournal.com/tag/cpt-code-00930/)
- [orchiopexy](https://denialjournal.com/tag/orchiopexy/)
- [CPT Code 00932](https://denialjournal.com/tag/cpt-code-00932/)
- [CPT Code 00934](https://denialjournal.com/tag/cpt-code-00934/)
- [CPT Code 00936](https://denialjournal.com/tag/cpt-code-00936/)
- [CPT Code 00938](https://denialjournal.com/tag/cpt-code-00938/)
- [Penile Prosthesis](https://denialjournal.com/tag/penile-prosthesis/)
- [CPT Code 00940](https://denialjournal.com/tag/cpt-code-00940/)
- [vaginal procedures](https://denialjournal.com/tag/vaginal-procedures/)
- [CPT 00942](https://denialjournal.com/tag/cpt-00942/)
- [CPT Code 00944](https://denialjournal.com/tag/cpt-code-00944/)
- [Vaginal Hysterectomy](https://denialjournal.com/tag/vaginal-hysterectomy/)
- [CPT Code 00948](https://denialjournal.com/tag/cpt-code-00948/)
- [cervical cerclage](https://denialjournal.com/tag/cervical-cerclage/)
- [CPT Code 00950](https://denialjournal.com/tag/cpt-code-00950/)
- [culdoscopy](https://denialjournal.com/tag/culdoscopy/)
- [CPT Code 00952](https://denialjournal.com/tag/cpt-code-00952/)
- [hysteroscopy coding](https://denialjournal.com/tag/hysteroscopy-coding/)
- [CPT Code 01112](https://denialjournal.com/tag/cpt-code-01112/)
- [bone marrow biopsy](https://denialjournal.com/tag/bone-marrow-biopsy/)
- [CPT Code 01120](https://denialjournal.com/tag/cpt-code-01120/)
- [bony pelvis procedures](https://denialjournal.com/tag/bony-pelvis-procedures/)
- [CPT Code 01130](https://denialjournal.com/tag/cpt-code-01130/)
- [CPT Code 01140](https://denialjournal.com/tag/cpt-code-01140/)
- [CPT Code 01150](https://denialjournal.com/tag/cpt-code-01150/)
- [pelvic tumor surgery](https://denialjournal.com/tag/pelvic-tumor-surgery/)
- [CPT Code 01160](https://denialjournal.com/tag/cpt-code-01160/)
- [CPT Code 01170](https://denialjournal.com/tag/cpt-code-01170/)
- [CPT Code 01173](https://denialjournal.com/tag/cpt-code-01173/)
- [Pelvic Surgery](https://denialjournal.com/tag/pelvic-surgery/)
- [CPT Code 01200](https://denialjournal.com/tag/cpt-code-01200/)
- [Hip Joint Procedures](https://denialjournal.com/tag/hip-joint-procedures/)
- [CPT Code 01202](https://denialjournal.com/tag/cpt-code-01202/)
- [hip arthroscopy](https://denialjournal.com/tag/hip-arthroscopy/)
- [CPT Code 01210](https://denialjournal.com/tag/cpt-code-01210/)
- [hip joint surgery](https://denialjournal.com/tag/hip-joint-surgery/)
- [CPT Code 01212](https://denialjournal.com/tag/cpt-code-01212/)
- [CPT Code 01214](https://denialjournal.com/tag/cpt-code-01214/)
- [hip arthroplasty](https://denialjournal.com/tag/hip-arthroplasty/)

## Denial Categories

- [Coding/Modifier](https://denialjournal.com/denial-codes/category/coding-modifier/)
- [Duplicate/Timely Filing](https://denialjournal.com/denial-codes/category/duplicate-timely-filing/)
- [Coordination of Benefits](https://denialjournal.com/denial-codes/category/coordination-of-benefits/)
- [Eligibility](https://denialjournal.com/denial-codes/category/eligibility/)
- [Non-Covered](https://denialjournal.com/denial-codes/category/non-covered/)
- [Medical Necessity](https://denialjournal.com/denial-codes/category/medical-necessity/)
- [Authorization](https://denialjournal.com/denial-codes/category/authorization/)
- [Documentation](https://denialjournal.com/denial-codes/category/documentation/)
- [General](https://denialjournal.com/denial-codes/category/general/)
- [Informational Alert](https://denialjournal.com/denial-codes/category/informational-alert/)