There are times in which the various content contributor primary resources are not synchronized or updated on the same time interval. if(pathArray[4]){document.getElementById("usprov").href="/web/"+pathArray[4]+"/help/us-government-rights";} either the Remittance Advice Remark Code or NCPDP Reject Reason Code). Payment adjusted because charges have been paid by another payer. Payment denied. Procedure/service was partially or fully furnished by another provider. The responsibility for the content of this file/product is with Noridian Healthcare Solutions or the CMS and no endorsement by the AMA is intended or implied. See the payer's claim submission instructions. Basically, it's a code that signifies a denial and it falls within the grouping of the same that's based on the contract and as per the fee schedule amount. Claim adjusted by the monthly Medicaid patient liability amount. CO/96/N216. IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THESE AGREEMENTS CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. Remark New Group / Reason / Remark Invalid place of service for this Service Facility Location NPI. Claim lacks indication that service was supervised or evaluated by a physician. CO/185. Amitabh Bachchan launches the trailer of Anand Pandit's Underworld Ka Kabzaa on social media; Nawazuddin Siddiqui is planning a careful legal strategy to regain his rights and reputation Claim/service denied. Missing/incomplete/invalid ordering provider name. Do not use this code for claims attachment(s)/other . 1) Get the Denial date and check why the rendering provider is not eligible to perform the service billed. Insurance company denies the claim with denial code 27 when patient policy wasn't active on Date of Service. PR 2, 127 Exceeded Reasonable & Customary Amount - Provider's charge for the rendered service(s) exceeds the Reasonable & Customary amount. Denial Code - 140 defined as "Patient/Insured health identification number and name do not match". The CO16 denial code alerts you that there is information that is missing in order for Medicare to process the claim. The diagnosis is inconsistent with the provider type. Missing patient medical record for this service. Payment adjusted because this care may be covered by another payer per coordination of benefits. Some of the Provider information contained on the Noridian Medicare web site is copyrighted by the American Medical Association, the American Dental Association, and/or the American Hospital Association. A CO16 denial does not necessarily mean that information was missing. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. At any time, and for any lawful Government purpose, the government may monitor, record, and audit your system usage and/or intercept, search and seize any communication or data transiting or stored on this system. Insured has no dependent coverage. 16 Claim/service lacks information or has submission/billing error(s). PR 96 DENIAL CODE: PATIENT RELATED CONCERNS When a patient meets and undergoes treatment from an Out-of-Network provider. Missing/Invalid Molecular Diagnostic Services (MolDX) DEX Z-Code Identifier. Successful exploitation of these vulnerabilities may allow an attacker to cause a denial-of-service condition or remotely exploit arbitrary code. Payment adjusted because rent/purchase guidelines were not met. LICENSE FOR NATIONAL UNIFORM BILLING COMMITTEE ("NUBC"), Point and Click American Hospital Association Copyright Notice, Copyright 2021, the American Hospital Association, Chicago, Illinois. If there is no adjustment to a claim/line, then there is no adjustment reason code. Siemens has produced a new version to mitigate this vulnerability. M127, 596, 287, 95. Unauthorized or illegal use of the computer system is prohibited and subject to criminal and civil penalties. If you choose not to accept the agreement, you will return to the Noridian Medicare home page. At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code.) Claim lacks indicator that x-ray is available for review. Patient Responsibility (PR): Denials with the code PR assign financial responsibility to patients or their secondary insurance provider. PR Deductible: MI 2; Coinsurance Amount. if, the patient has a secondary bill the secondary . Therefore, you have no reasonable expectation of privacy. PR 42 - Use adjustment reason code 45, effective 06/01/07. The Washington Publishing Company publishes the CMS-approved Reason Codes and Remark Codes. Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Therapeutic Behavioral Service valid only with a Full Scope Aid Code and an EPSDT Aid Code. What does that sentence mean? BY CLICKING ABOVE ON THE LINK LABELED "I Accept", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THESE AGREEMENTS. CPT is a trademark of the AMA. Denial Code - 146 described as "Diagnosis was invalid for the DOS reported". Level of subluxation is missing or inadequate. Payment denied. Last Updated Mon, 30 Aug 2021 18:01:22 +0000. Remark New Group / Reason / Remark CO/171/M143. This (these) procedure(s) is (are) not covered. 107 or in any way to diminish . Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government use. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. There should be other codes on the remit, especially if it was Medicare, like a CO or PR or OA code as well that should give the actual claim denial reason. CO/177. Select the Reason or Remark code link below to review supplier solutions to the denial and/or how to avoid the same denial in the future. Procedure code billed is not correct/valid for the services billed or the date of service billed. Claim Denial Codes List as of 03/01/2021 Claim Adjustment Reason Code (CARC) Remittance Advice Remark Code (RARC) Medicaid Denial Reason CORE Business . U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements. There are several reasons you may find it valuable, notably pulling them into your reports and dashboards, giving management and developers visibility into their vulnerability status within the portals and workflows they're already using. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. Claim lacks individual lab codes included in the test. For example, a provider cannot bill an office visit procedure code for inpatient hospital setting (21). Applications are available at the American Dental Association web site, http://www.ADA.org. This warning banner provides privacy and security notices consistent with applicable federal laws, directives, and other federal guidance for accessing this Government system, which includes all devices/storage media attached to this system. The sole responsibility for the software, including any CDT and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. The AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. If this is a U.S. Government information system, CMS maintains ownership and responsibility for its computer systems. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Same denial code can be adjustment as well as patient responsibility. Payment adjusted because the payer deems the information submitted does not support this many/frequency of services. Charges adjusted as penalty for failure to obtain second surgical opinion. Services by an immediate relative or a member of the same household are not covered. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. CO/177 : PR/177 CO/177 : Revised 1/28/2014 : Only SED services are valid for Healthy Families aid code. Oxygen equipment has exceeded the number of approved paid rentals. Balance $16.00 with denial code CO 23. Check to see the procedure code billed on the DOS is valid or not? Benefit maximum for this time period has been reached. Reproduced with permission. Denial Code - 182 defined as "Procedure modifier was invalid on the DOS. The AMA is a third-party beneficiary to this license. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. Balance does not exceed co-payment amount. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials. Non-covered charge(s). Prior hospitalization or 30 day transfer requirement not met. HCPCS code is inconsistent with modifier used or a required modifier is missing, HCPCScode is inconsistent with modifier used or required modifier is missing. . At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice . Enter the email address you signed up with and we'll email you a reset link. This decision was based on a Local Coverage Determination (LCD). The advance indemnification notice signed by the patient did not comply with requirements. Item(s) billed did not have a valid ordering physician National Provider Identifier (NPI) registered in Medicare Provider Enrollment, Chain and Ownership System (PECOS), Please follow the steps under claim submission for this error on the. LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT"). Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. 1) Get the denial date and the procedure code its denied? else{document.getElementById("usprov").href="/web/"+"jeb"+"/help/us-government-rights";}, Advance Beneficiary Notice of Noncoverage (ABN), Oral Anticancer Drugs and Oral Antiemetic Drugs, Transcutaneous Electrical Nerve Stimulators (TENS), Supplemental Medical Review Contractor (SMRC), Unified Program Integrity Contractor (UPIC), Provider Outreach and Education Advisory Group (POE AG), Healthcare Integrated General Ledger Accounting System (HIGLAS), Reason Code 16 | Remark Codes MA13 N265 N276, click here to see all U.S. Government Rights Provisions, American Hospital Association Online Store. The Home Health Claim has more than one Claim line with a HIPPS code and revenue code 0023. 2023 Noridian Healthcare Solutions, LLC Terms & Privacy. All Rights Reserved. Medicare coverage for a screening colonoscopy is based on patient risk. Force a job applicant or an employee to resign because of denial of a reasonable 46 accommodation; 47 (4) Deny employment opportunities to a job applicant or an employee, if such denial is . Prior processing information appears incorrect. These are non-covered services because this is a pre-existing condition. MACs use appropriate group, claim adjustment reason, and remittance advice remark codes to communicate clearly why an amount is not covered by Medicare and who is financially responsible for that amount. . Check the . Payment/Reduction for Regulatory Surcharges, Assessments, Allowances or Health Related Taxes. (Use only with Group Code PR). Let us see some of the important denial codes in medical billing with solutions: Denials with solutions in Medical Billing, Denials Management Causes of denials and solution in medical billing, CO 4 Denial Code The procedure code is inconsistent with the modifier used or a required modifier is missing, CO 5 Denial Code The Procedure code/Bill Type is inconsistent with the Place of Service, CO 6 Denial Code The Procedure/revenue code is inconsistent with the patients age, CO 7 Denial Code The Procedure/revenue code is inconsistent with the patients gender, CO 15 Denial Code The authorization number is missing, invalid, or does not apply to the billed services or provider, CO 17 Denial Code Requested information was not provided or was insufficient/incomplete, CO 19 Denial Code This is a work-related injury/illness and thus the liability of the Workers Compensation Carrier, CO 23 Denial Code The impact of prior payer(s) adjudication including payments and/or adjustments, CO 31 Denial Code- Patient cannot be identified as our insured, CO 119 Denial Code Benefit maximum for this time period or occurrence has been reached or exhausted, Molina Healthcare Phone Number claims address of Medicare and Medicaid, Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit, Kaiser Permanente Phone Number Claims address and Timely Filing Limit, Amerihealth Caritas Phone Number, Payer ID and Claim address, ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples, Anthem Blue Cross Blue Shield Timely filing limit BCBS TFL List, Workers Compensation Insurances List of United States, Workers Compensation time limit for filing Claim and reporting in United States. THE LICENSES GRANTED HEREIN ARE EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THESE AGREEMENTS. This updated advisory is a follow-up to the original advisory titled ICSA-16-336-01 Siemens SICAM PAS Vulnerabilities that was published December 1, 2016, on the NCCIC/ICS-CERT web site. The sole responsibility for the software, including any CDT and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. By continuing beyond this notice, users consent to being monitored, recorded, and audited by company personnel. PR - Patient Responsibility denial code list MCR - 835 Denial Code List PR - Patient Responsibility - We could bill the patient for this denial however please make sure that any other rejection reason not specified in the EOB. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Services denied at the time authorization/pre-certification was requested. Applications are available at the AMA Web site, https://www.ama-assn.org. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. Reason codes, and the text messages that define those codes, are used to explain why a . This code always come with additional code hence look the additional code and find out what information missing. This provider was not certified/eligible to be paid for this procedure/service on this date of service. Payment adjusted as procedure postponed or cancelled. Predetermination. 16 As used in this chapter, the term: 17 (1) 'Applicant' means an individual who seeks employment with the employer. Denial Code 54 described as "Multiple Physicians/assistants are not covered in this case". An LCD provides a guide to assist in determining whether a particular item or service is covered. 64 Denial reversed per Medical Review. Records indicate this patient was a prisoner or in custody of a Federal, State, or local authority when the service was rendered. Denial Code 16 described as "Claim/service lacks information or has submission/billing error(s) which is required for adjudication". Payment adjusted because the submitted authorization number is missing, invalid, or does not apply to the billed services or provider. By continuing beyond this notice, users consent to being monitored, recorded, and audited by company personnel. 16 Claim/service lacks information which is needed for adjudication. Expenses incurred after coverage terminated. Not covered unless submitted via electronic claim. Previously paid. The Washington Publishing Company publishes the CMS-approved Reason Codes and Remark Codes. Denial code co -16 - Claim/service lacks information which is needed for adjudication. The procedure code is inconsistent with the provider type/specialty (taxonomy). CDT is a trademark of the ADA. Billing/Reimbursement Medicare denial code PR-177 coder.rosebrum@yahoo.com Jul 12, 2021 C coder.rosebrum@yahoo.com New Messages 2 Location Freeman, WV Best answers 0 Jul 12, 2021 #1 Patient's visit denied by MCR for "PR-177: Patient has not met the required eligibility requirements". To obtain comprehensive knowledge about the UB-04 codes, the Official UB-04 Data Specification Manual is available for purchase on the American Hospital Association Online Store. The scope of this license is determined by the ADA, the copyright holder. Payment denied because this provider has failed an aspect of a proficiency testing program. The CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. Coverage not in effect at the time the service was provided. Denial Codes in Medical Billing - Lists: CO - Contractual Obligations OA - Other Adjsutments PI - Payer Initiated reductions PR - Patient Responsibility Let us see some of the important denial codes in medical billing with solutions: Show Showing 1 to 50 of 50 entries Previous Next Timely Filing Limit of Insurances Separate payment is not allowed. The scope of this license is determined by the AMA, the copyright holder. Procedure/product not approved by the Food and Drug Administration. PR amounts include deductibles, copays and coinsurance. Missing/incomplete/invalid initial treatment date. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements. SpecialityAllergy & ImmunologyAnesthesiologyChiropracticDurable Medical EquipmentGastroenterologyInternal MedicineMental HealthOccupational HealthOral and MaxilofacialPain ManagementPharmacy BillingPodiatryRadiation OncologyRheumatologySports MedicineWound CareAmbulance TransportationBehavioural HealthDentalEmergency Medicine BillingGeneral SurgeryMassage TherapyNeurologyOncologyOrthopaedicPathologyPhysical TherapyPrimary CareRadiologySkilled Nursing FacilityTeleradiologyAmbulatory Surgical CentersCardiologyDermatologyFamily PracticeHospital BillingMedical BillingOB GYNOptometryOtolaryngologyPaediatricsPlastic SurgeryPulmonologyRehab BillingSleep DisorderUrology, StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhodeIslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming. Denial code - 97 described when "The benefit for this service is included in the payment or allowance for another service/procedure that has already been adjudicated". For U.S. Government and other information systems, information accessed through the computer system is confidential and for authorized users only. Duplicate claim has already been submitted and processed. You can also search for Part A Reason Codes. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Reason Code 16 | Remark Codes MA13 N265 N276 Common Reasons for Denial Item (s) billed did not have a valid ordering physician National Provider Identifier (NPI) registered in Medicare Provider Enrollment, Chain and Ownership System (PECOS) Next Step Resubmit claim with a valid ordering physician NPI registered in PECOS How to Avoid Future Denials The good news is that on average, 63% of denied claims are recoverable and nearly 90% are preventable. 3. 199 Revenue code and Procedure code do not match. Claim lacks the name, strength, or dosage of the drug furnished. Before you can enter the Noridian Medicare site, please read and accept an agreement to abide by the copyright rules regarding the information you find within this site. Claim/service not covered by this payer/processor. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. Contracted funding agreement. A: The denial was received because the service billed is statutorily excluded from coverage under the Medicare program. This care may be covered by another payer per coordination of benefits. PR 1 Denial Code - Deductible Amount; CO 4 Denial Code - The procedure code is inconsistent with the modifier used or a required modifier is missing; . Newborns services are covered in the mothers allowance. You acknowledge that the AMA holds all copyright, trademark, and other rights in CPT. Published 02/23/2023. Coverage not in effect at the time the service was provided, Pre-Certification or Authorization absent, Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. Ask the same questions as denial code - 5, but here need check which procedure code submitted is incompatible with patient's age? Plan procedures not followed. Interim bills cannot be processed. Do not use this code for claims attachment(s)/other documentation. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. Based on Provider's consent bill patient either for the whole billed amount or the carrier's allowable. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. Missing/incomplete/invalid ordering provider primary identifier. Claim/Service denied. Claim/service denied because information to indicate if the patient owns the equipment that requires the part or supply was missing. PR (Patient Responsibility) is used to identify portions of the bill that are the responsibility of the patient. Anticipated payment upon completion of services or claim adjudication. Payment adjusted because new patient qualifications were not met. Charges are reduced based on multiple surgery rules or concurrent anesthesia rules. Examples of EOB Claim Adjustments are CO 45, CO 97, OA 23, PR 1, and PR 2. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). A group code is a code identifying the general category of payment adjustment. BY CLICKING ABOVE ON THE LINK LABELED "I Accept", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THESE AGREEMENTS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. Change the code accordingly. Lett. At any time, and for any lawful Government purpose, the government may monitor, record, and audit your system usage and/or intercept, search and seize any communication or data transiting or stored on this system. 16 Claim/service lacks information which is needed for adjudication. Do not use this code for claims attachment(s)/other documentation. CMS Disclaimer Warning: you are accessing an information system that may be a U.S. Government information system. Procedure code was incorrect. Claim denied. 16 Claim/service lacks information which is needed for adjudication. Therefore, you have no reasonable expectation of privacy. 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 days supply. Payment adjusted because transportation is only covered to the closest facility that can provide the necessary care. Claim denied because this injury/illness is covered by the liability carrier. The procedure code is inconsistent with the modifier used, or a required modifier is missing. Claim/service denied because the related or qualifying claim/service was not paid or identified on the claim. It occurs when provider performed healthcare services to the . 5. 0006 23 . If the denial code you're looking for is not listed below, you can contact VA by using the Inquiry Routing & Information System (IRIS), a tool that allows secure email communications, or you can call our Customer Call Center at one of the sites or centers listed below. This warning banner provides privacy and security notices consistent with applicable federal laws, directives, and other federal guidance for accessing this Government system, which includes all devices/storage media attached to this system. Completed physician financial relationship form not on file. 116689 116500LN Blk 116500LN Wht Sky Dweller 326934-003 126710BLNR 126710BLRO - 126610LV 16520 16523 16610 5513 Birth Year - Patek Philippe 5980/1A-001 - AP 26331ST Panda - Panerai Fiddy 127, Bronzo 671, 687, 111, Speedmaster 1957 Broad Arrow, Daniel Roth Endurer Chronosprint, Cartier Santos XL - Tudor Black Bay 58 Bronze M79012M, Montblanc . Alert: You may not appeal this decision but can resubmit this claim/service with corrected information if warranted. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. About Claim Adjustment Group Codes Maintenance Request Status Maintenance Request Form 11/16/2022 Filter by code: Reset Resubmit the cliaim with corrected information. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. Missing/incomplete/invalid rendering provider primary identifier. A16(27) (2001) 1761-1773 July 20, 2001 arXiv:hep-th/0107167 This denial code generally occurs when the diagnosis is inconsistent with the procedure as long as the procedure code shows an inappropriate diagnostic code. Duplicate of a claim processed, or to be processed, as a crossover claim.