Denial code guides

The denial card catalog

37 guides. What each code means, why it happens, and how to stop it before the claim goes out.

At billingCO-4Modifier inconsistent with the procedure At billingCO-5Code inconsistent with place of service At billingCO-11Diagnosis inconsistent with the procedure Before the visitCO-15Authorization number missing or invalid At billingCO-16Missing information or billing error At billingCO-18Exact duplicate claim or service At bookingCO-22Another payer should pay first At bookingCO-24Covered by a managed care plan At bookingCO-26Service before coverage started At billingCO-29Timely filing limit expired At bookingCO-31Patient can't be identified as insured After the payer answersCO-45Charge exceeds the allowed amount At billingCO-50Not deemed medically necessary At billingCO-58Inappropriate place of service At bookingCO-96Non-covered charge At billingCO-97Bundled into another service At bookingCO-109Sent to the wrong payer or contractor At bookingCO-119Benefit maximum reached At bookingCO-140Name and ID number don't match At billingCO-146Diagnosis invalid for the date of service At billingCO-151More units than Medicare accepts At billingCO-167The diagnosis is not covered At bookingCO-177Eligibility requirements not met At billingCO-181Procedure code invalid for the date Before the visitCO-197Prior authorization missing At billingCO-236Code combination not compatible At the visitCO-252Attachment or documentation required At bookingCO-B7Provider not eligible on the date At billingKX modifierMedicare's yearly therapy threshold ReferenceMedicare contractor by stateAll 56 states and territories, in one table After the payer answersOA-23Impact of the primary payer's payment After the payer answersPR-1Deductible amount After the payer answersPR-2Coinsurance amount After the payer answersPR-3Co-payment amount At bookingPR-27Coverage ended before the visit At bookingPR-204Not a benefit of the patient's plan At bookingPR-242Not a network or primary care provider

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