if(pathArray[4]){document.getElementById("usprov").href="/web/"+pathArray[4]+"/help/us-government-rights";} 25 Payment denied. Claim lacks indicator that x-ray is available for review.. 129 Prior processing information appears incorrect. 153 Payer deems the information submitted does not support this dosage. 5 The procedure code/bill type is inconsistent with the place of service. W2 Payment reduced or denied based on workers compensation jurisdictional regulations or payment policies, use only if no other code is applicable. 62 Payment denied/reduced for absence of, or exceeded, pre-certification/authorization. 2023 Noridian Healthcare Solutions, LLC Terms & Privacy. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. P17 Referral not authorized by attending physician per regulatory requirement. 201 Workers Compensation case settled. 98 The hospital must file the Medicare claim for this inpatient non-physician service. Denial Code - 5 is "Px code/ bill type is inconsistent with the POS", The procedure code/ revenue code is inconsistent with the patient's age, The procedure code/ revenue code is inconsistent with the Patient's gender, The procedure code is inconsistent with the provider type/speciality (Taxonomy), The Diagnosis Code is inconsistent with the patient's age, The Diagnosis Code is inconsistent with the patient's gender, The Diagnosis code is inconsistent with the provider type, The Date of Death Precedes Date of Service. 224 Patient identification compromised by identity theft. 132 Prearranged demonstration project adjustment. Resubmit claim with a valid ordering physician NPI registered in PECOS. Based on payer reasonable and customary fees. Claim did not include patients medical record for the service. PR Patient Responsibility. 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. 64 Denial reversed per Medical Review. PR 168 Payment denied as Service(s) have been considered under the patients medical plan. 16 Claim/service lacks information which is needed for adjudication. 2023 Noridian Healthcare Solutions, LLC Terms & Privacy. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT.
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