Claim Adjustment Reason Codes and Remittance Advice Remark ...

Claim Adjustment Reason Codes and Remittance Advice Remark Codes (CARC and RARC)--Effective 01/01/2020

EOB CODE 0201 0202 0203 0204 0205 0206

0208 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0227

0228 0229 0231 0233 0234 0235

EOB CODE DESCRIPTION

ADJUSTMENT REASON CODE

ADJUSTMENT REASON CODE DESCRIPTION

REMARK CODE

BILLING PROVIDER ID NUMBER

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

N280

MISSING

SUBMISSION/BILLING ERROR(S).

BILLING PROVIDER ID IN INVALID

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

N280

FORMAT

SUBMISSION/BILLING ERROR(S).

MEMBER I.D. NUMBER

31

PATIENT CANNOT BE IDENTIFIED AS OUR INSURED.

-

MISSING/INVALID

HOSPITAL DISCHARGE DATE INVALID 16

CLAIM/SERVICE LACKS INFORMATION OR HAS

N318

SUBMISSION/BILLING ERROR(S).

PRESCRIBING PRACTITIONERS

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

N31

LICENSE NO. MISSING

SUBMISSION/BILLING ERROR(S).

PRESCRIBING PRACTITIONER

184

THE PRESCRIBING/ORDERING PROVIDER IS NOT ELIGIBLE TO N574

LICENSE NO. FORMAT INVALID

PRESCRIBE/ORDER THE SERVICE BILLED.

PREGNANCY INDICATOR INVALID

16

BRAND MEDICALLY NECESSARY

96

INDICATOR INVALID

REFILL INDICATOR INVALID

16

PRESCRIPTION NUMBER IS MISSING 16

DATE PRESCRIBED IS MISSING

16

DATE PRESCRIBED IS INVALID

16

DATE DISPENSED IS MISSING

16

DATE DISPENSED IS INVALID

16

NDC MISSING

16

NDC INVALID FORMAT

16

QUANTITY DISPENSED IS MISSING 16

QUANTITY DISPENSED IS INVALID 16

DAYS SUPPLY MISSING

16

DAYS SUPPLY INVALID

16

PROC CODE REQUIRES DIAGNOSIS 16 CODE, NONE FOUND ON CLAIM DIAGNOSIS TREATMENT INDICATOR 16 INVALID MISSING PRESCRIBING PROVIDER 16 NUMBER REFERRAL PROV ID REQUIRED FOR 16 PROCEDURE GROUP THIRD PARTY PAYMENT AMOUNT 16 INVALID

BILLING PROVIDER SIGNATURE

16

MISSING

SOURCE OF ADMISSION MISSING 16

RENDERING PROVIDER NUMBER IS 16

MISSING

UNITS OF SERVICE MISSING

16

PROCEDURE CODE MISSING

16

PROCEDURE CODE NOT IN VALID 181 FORMAT

CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). NON-COVERED CHARGE(S).

M76 N130

CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S).

N657 N388 N57 N57 N304 N304 M119 M119 N378 N378 M53 M53 M64 M64 N318 N286 MA04

CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). PROCEDURE CODE WAS INVALID ON THE DATE OF SERVICE.

MA70 MA42 N290 M53 M51 N56

REMARK CODE DESCRIPTION MISSING/INCOMPLETE/INVALID PAY-TO PROVIDER PRIMARY IDENTIFIER.

MISSING/INCOMPLETE/INVALID PAY-TO PROVIDER PRIMARY IDENTIFIER.

-

MISSING/INCOMPLETE/INVALID DISCHARGE OR END OF CARE DATE.

MISSING/INCOMPLETE/INVALID PRESCRIBING PROVIDER IDENTIFIER.

OUR RECORDS INDICATE THE ORDERING/REFERRING PROVIDER IS OF A TYPE/SPECIALTY THAT CANNOT ORDER OR REFER. PLEASE VERIFY THAT THE CLAIM ORDERING/REFERRING PROVIDER INFORMATION IS ACCURATE OR CONTACT THE ORDERING/REFERRING PROVIDER. MISSING/INCOMPLETE/INVALID DIAGNOSIS OR CONDITION.

CONSULT PLAN BENEFIT DOCUMENTS/GUIDELINES FOR INFORMATION ABOUT RESTRICTIONS FOR THIS SERVICE. THIS SHOULD BE BILLED WITH THE APPROPRIATE CODE FOR THESE SERVICES.

MISSING/INCOMPLETE/INVALID PRESCRIPTION NUMBER.

MISSING/INCOMPLETE/INVALID PRESCRIBING DATE.

MISSING/INCOMPLETE/INVALID PRESCRIBING DATE.

MISSING/INCOMPLETE/INVALID DISPENSED DATE.

MISSING/INCOMPLETE/INVALID DISPENSED DATE.

MISSING/INCOMPLETE/INVALID/ DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC). MISSING/INCOMPLETE/INVALID/ DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE (NDC). MISSING/INCOMPLETE/INVALID PRESCRIPTION QUANTITY.

MISSING/INCOMPLETE/INVALID PRESCRIPTION QUANTITY.

MISSING/INCOMPLETE/INVALID DAYS OR UNITS OF SERVICE.

MISSING/INCOMPLETE/INVALID DAYS OR UNITS OF SERVICE.

MISSING/INCOMPLETE/INVALID OTHER DIAGNOSIS.

MISSING/INCOMPLETE/INVALID OTHER DIAGNOSIS.

MISSING/INCOMPLETE/INVALID DISCHARGE OR END OF CARE DATE.

MISSING/INCOMPLETE/INVALID REFERRING PROVIDER PRIMARY IDENTIFIER.

SECONDARY PAYMENT CANNOT BE CONSIDERED WITHOUT THE IDENTITY OF OR PAYMENT INFORMATION FROM THE PRIMARY PAYER. THE INFORMATION WAS EITHER NOT REPORTED OR WAS ILLEGIBLE. MISSING/INCOMPLETE/INVALID PROVIDER REPRESENTATIVE SIGNATURE.

MISSING/INCOMPLETE/INVALID ADMISSION SOURCE.

MISSING/INCOMPLETE/INVALID RENDERING PROVIDER PRIMARY IDENTIFIER.

MISSING/INCOMPLETE/INVALID DAYS OR UNITS OF SERVICE.

MISSING/INCOMPLETE/INVALID PROCEDURE CODE(S).

PROCEDURE CODE BILLED IS NOT CORRECT/VALID FOR THE SERVICES BILLED OR THE DATE OF SERVICE BILLED.

Claim Adjustment Reason Codes and Remittance Advice Remark Codes (CARC and RARC)--Effective 01/01/2020

EOB CODE 0236 0237 0238 0239 0240 0241 0242 0243 0244 0245 0246 0248 0249 0250 0251 0252 0253 0254 0255 0256 0257 0258 0259 0260 0261 0262 0263 0264 0265 0266 0268 0269 0270

EOB CODE DESCRIPTION DETAIL DOS DIFFERENT THAN THE HEADER DOS OUTPATIENT CLAIMS CANNOT SPAN DATES MEMBER NAME IS MISSING

THE DETAIL "TO" DATE OF SERVICE IS MISSING THE DETAIL "TO" DATE IS INVALID

ACCIDENT INDICATOR IS INVALID SECONDARY DIAGNOSIS CODE INVALID FORMAT MISSING MEDICARE PAID DATE

THIRD DIAGNOSIS CODE INVALID

MISSING OCCURRENCE CODE

FOURTH DIAGNOSIS CODE INVALID

PLACE OF SERVICE IS MISSING OR BLANK PLACE OF SERVICE IS INVALID

CLAIM HAS NO DETAILS

FIRST MODIFIER NOT COVERED

SECOND MODIFIER NOT COVERED

THIRD MODIFIER NOT COVERED

BILLING PROVIDER LOCATION CODE MISSING BILLING PROVIDER LOCATION CODE INVALID MISSING MEDICARE PAID DATE DETAIL PLACE OF SERVICE IS INVALID DETAIL PRIMARY DIAGNOSIS CODE MISSING

DATE BILLED IS MISSING/INVALID

UNITS OF SERVICE NOT IN VALID FORMAT TOOTH NUMBER MISSING

TOOTH NUMBER INVALID

TOOTH SURFACE CODE INVALID

DETAIL FROM DATE OF SERVICE IS MISSING DETAIL FROM DATE OF SERVICE IS INVALID INSUFFICIENT NUMBER OF VALID TOOTH SURFACE CODES BILLED AMOUNT MISSING

DETAIL BILLED AMOUNT INVALID

HEADER TOTAL BILLED AMOUNT MISSING

ADJUSTMENT REASON CODE

ADJUSTMENT REASON CODE DESCRIPTION

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

95

PLAN PROCEDURES NOT FOLLOWED.

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

107

THE RELATED OR QUALIFYING CLAIM/SERVICE WAS NOT

IDENTIFIED ON THIS CLAIM.

182

PROCEDURE MODIFIER WAS INVALID ON THE DATE OF

SERVICE.

182

PROCEDURE MODIFIER WAS INVALID ON THE DATE OF

SERVICE.

182

PROCEDURE MODIFIER WAS INVALID ON THE DATE OF

SERVICE.

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

REMARK CODE

REMARK CODE DESCRIPTION

M52

MISSING/INCOMPLETE/INVALID "FROM" DATE(S) OF SERVICE.

N62 MA36

DATES OF SERVICE SPAN MULTIPLE RATE PERIODS. RESUBMIT SEPARATE CLAIMS. MISSING/INCOMPLETE/INVALID PATIENT NAME.

M59

MISSING/INCOMPLETE/INVALID "TO" DATE(S) OF SERVICE.

M59

MISSING/INCOMPLETE/INVALID "TO" DATE(S) OF SERVICE.

-

-

M64

MISSING/INCOMPLETE/INVALID OTHER DIAGNOSIS.

N307

MISSING/INCOMPLETE/INVALID ADJUDICATION OR PAYMENT DATE.

M64

MISSING/INCOMPLETE/INVALID OTHER DIAGNOSIS.

M45

MISSING/INCOMPLETE/INVALID OCCURRENCE CODE(S).

M64

MISSING/INCOMPLETE/INVALID OTHER DIAGNOSIS.

M77

MISSING/INCOMPLETE/INVALID PLACE OF SERVICE.

M77

MISSING/INCOMPLETE/INVALID PLACE OF SERVICE.

-

-

N517

RESUBMIT A NEW CLAIM WITH THE REQUESTED INFORMATION.

N517

RESUBMIT A NEW CLAIM WITH THE REQUESTED INFORMATION.

N517

RESUBMIT A NEW CLAIM WITH THE REQUESTED INFORMATION.

M77

MISSING/INCOMPLETE/INVALID PLACE OF SERVICE.

M77

MISSING/INCOMPLETE/INVALID PLACE OF SERVICE.

N307

MISSING/INCOMPLETE/INVALID ADJUDICATION OR PAYMENT DATE.

M77

MISSING/INCOMPLETE/INVALID PLACE OF SERVICE.

M64

MISSING/INCOMPLETE/INVALID OTHER DIAGNOSIS.

MA31 M53

MISSING/INCOMPLETE/INVALID BEGINNING AND ENDING DATES OF THE PERIOD BILLED. MISSING/INCOMPLETE/INVALID DAYS OR UNITS OF SERVICE.

N37

MISSING/INCOMPLETE/INVALID TOOTH NUMBER/LETTER.

N37

MISSING/INCOMPLETE/INVALID TOOTH NUMBER/LETTER.

N75

MISSING/INCOMPLETE/INVALID TOOTH SURFACE INFORMATION.

M52

MISSING/INCOMPLETE/INVALID "FROM" DATE(S) OF SERVICE.

M52

MISSING/INCOMPLETE/INVALID "FROM" DATE(S) OF SERVICE.

N75

MISSING/INCOMPLETE/INVALID TOOTH SURFACE INFORMATION.

M54

MISSING/INCOMPLETE/INVALID TOTAL CHARGES.

M79

MISSING/INCOMPLETE/INVALID CHARGE.

M79

MISSING/INCOMPLETE/INVALID CHARGE.

Claim Adjustment Reason Codes and Remittance Advice Remark Codes (CARC and RARC)--Effective 01/01/2020

EOB CODE 0271 0272 0273 0274 0275 0276 0277 0278 0279 0280 0281 0282 0283 0284 0285 0286 0287 0288 0289 0290 0291 0292 0301

EOB CODE DESCRIPTION HEADER TOTAL BILLED AMOUNT INVALID PRIMARY DIAGNOSIS CODE INVALID

TYPE OF BILL MISSING

TYPE OF BILL CODE INVALID

ADMIT DATE MISSING

ADMIT DATE INVALID

ADMIT HOUR INVALID

ADMIT TYPE MISSING

INVALID TYPE OF ADMISSION

PATIENT STATUS IS MISSING

PATIENT STATUS IS INVALID

COVERED DAYS MISSING

COVERED DAYS INVALID

PRIMARY CONDITION CODE INVALID

SECOND CONDITON CODE INVALID

THIRD CONDITION CODE INVALID

FOURTH CONDITION CODE INVALID

FIFTH CONDITION CODE INVALID

SIXTH CONDITION CODE INVALID

SEVENTH CONDITION CODE INVALID

REVENUE CODE 183 REQUIRES OSC = 74 REVENUE CODE 185 REQUIRES OSC = 71 301 PAYER RESPONSIBILTY/OTHER PAYER COUNT MISMATCH

ADJUSTMENT REASON CODE

ADJUSTMENT REASON CODE DESCRIPTION

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

0302

INSURED GROUP NAME (HSN TYPE) 16 IS MISSING OR INVALID

CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S).

0303 0304

DESTINATION PAYER ID MUST BE 995 16

PYR RESPONSIB AND INSURED GRP 16 NAME NOT COMPATIBLE

CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S). CLAIM/SERVICE LACKS INFORMATION OR HAS SUBMISSION/BILLING ERROR(S).

0305 0308 0309 0310

G1 REF REQUIRED WHEN HSN

96

INSURED GROUP IS CA OR MH

AID CAT MUST BE HB WHEN INSURED 96

GROUP IS BD

AID CAT MUST BE HC OR HD WHEN 96

INSURED GROUP IS CA

AID CAT MUST BE HA WHEN INSURED 96

GROUP IS MH

NON-COVERED CHARGE(S). NON-COVERED CHARGE(S). NON-COVERED CHARGE(S). NON-COVERED CHARGE(S).

REMARK CODE

REMARK CODE DESCRIPTION

M54

MISSING/INCOMPLETE/INVALID TOTAL CHARGES.

MA63

MISSING/INCOMPLETE/INVALID PRINCIPAL DIAGNOSIS.

MA30

MISSING/INCOMPLETE/INVALID TYPE OF BILL.

MA30

MISSING/INCOMPLETE/INVALID TYPE OF BILL.

MA40

MISSING/INCOMPLETE/INVALID ADMISSION DATE.

MA40

MISSING/INCOMPLETE/INVALID ADMISSION DATE.

N46

MISSING/INCOMPLETE/INVALID ADMISSION HOUR.

MA41

MISSING/INCOMPLETE/INVALID ADMISSION TYPE.

MA41

MISSING/INCOMPLETE/INVALID ADMISSION TYPE.

MA43

MISSING/INCOMPLETE/INVALID PATIENT STATUS.

MA43

MISSING/INCOMPLETE/INVALID PATIENT STATUS.

MA32 MA32 M44

MISSING/INCOMPLETE/INVALID NUMBER OF COVERED DAYS DURING THE BILLING PERIOD. MISSING/INCOMPLETE/INVALID NUMBER OF COVERED DAYS DURING THE BILLING PERIOD. MISSING/INCOMPLETE/INVALID CONDITION CODE.

M44

MISSING/INCOMPLETE/INVALID CONDITION CODE.

M44

MISSING/INCOMPLETE/INVALID CONDITION CODE.

M44

MISSING/INCOMPLETE/INVALID CONDITION CODE.

M44

MISSING/INCOMPLETE/INVALID CONDITION CODE.

M44

MISSING/INCOMPLETE/INVALID CONDITION CODE.

M44

MISSING/INCOMPLETE/INVALID CONDITION CODE.

M46

MISSING/INCOMPLETE/INVALID OCCURRENCE SPAN CODE(S).

M50

MISSING/INCOMPLETE/INVALID REVENUE CODE(S).

MA04 MA04 M56

SECONDARY PAYMENT CANNOT BE CONSIDERED WITHOUT THE IDENTITY OF OR PAYMENT INFORMATION FROM THE PRIMARY PAYER. THE INFORMATION WAS EITHER NOT REPORTED OR WAS ILLEGIBLE. SECONDARY PAYMENT CANNOT BE CONSIDERED WITHOUT THE IDENTITY OF OR PAYMENT INFORMATION FROM THE PRIMARY PAYER. THE INFORMATION WAS EITHER NOT REPORTED OR WAS ILLEGIBLE. MISSING/INCOMPLETE/INVALID PAYER IDENTIFIER.

MA04

N130 N130 N130 N130

SECONDARY PAYMENT CANNOT BE CONSIDERED WITHOUT THE IDENTITY OF OR PAYMENT INFORMATION FROM THE PRIMARY PAYER. THE INFORMATION WAS EITHER NOT REPORTED OR WAS ILLEGIBLE. CONSULT PLAN BENEFIT DOCUMENTS/GUIDELINES FOR INFORMATION ABOUT RESTRICTIONS FOR THIS SERVICE. CONSULT PLAN BENEFIT DOCUMENTS/GUIDELINES FOR INFORMATION ABOUT RESTRICTIONS FOR THIS SERVICE. CONSULT PLAN BENEFIT DOCUMENTS/GUIDELINES FOR INFORMATION ABOUT RESTRICTIONS FOR THIS SERVICE. CONSULT PLAN BENEFIT DOCUMENTS/GUIDELINES FOR INFORMATION ABOUT RESTRICTIONS FOR THIS SERVICE.

Claim Adjustment Reason Codes and Remittance Advice Remark Codes (CARC and RARC)--Effective 01/01/2020

EOB CODE 0315

EOB CODE DESCRIPTION

HSN PARTIAL CLM PAT RESPONSIBILITY AMT NOT PRESENT

ADJUSTMENT REASON CODE

ADJUSTMENT REASON CODE DESCRIPTION

16

CLAIM/SERVICE LACKS INFORMATION OR HAS

SUBMISSION/BILLING ERROR(S).

REMARK CODE

REMARK CODE DESCRIPTION

N58

MISSING/INCOMPLETE/INVALID PATIENT LIABILITY AMOUNT.

0320 0327 0330 0335 0339 0340 0343 0347

0350 0351 0355 0356 0357 0358 0359 0360 0361 0362 0363 0365 0366 0368 0369 0371 0372 0375 0378 0382 0383 0389

INVALID TOB FOR HSN

16

HSN MH CLAIM SUBMISSION >18

29

MONTHS FROM LDOS

HSN BD CLAIM SUBMISSION ................
................

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