N241 Incomplete/invalid Review Organization Approval. Note: (New code 10/31/01) Medicaid Denial Codes vs Medicaid Explanation Codes - BridgestoneHRS 5 The procedure code/bill type is inconsistent with the place of service. There are approximately 20 Medicaid Explanation Codes which map to Denial Code 16. N59 Please refer to your provider manual for additional program and provider information. All the information are educational purpose only and we are not guarantee of accuracy of information. N130 Consult plan benefit documents for information about restrictions for this service. insurance, Workers Compensation, Department of Veterans Affairs, or a group health N1 You may appeal this decision in writing within the required time limits following receipt remark code [M20, M67, M19, MA67]. Plan procedures not followed. N316 Missing/incomplete/invalid disability to date. This payment will need to be recouped from you if N298 Missing/incomplete/invalid supervising provider secondary identifier. Modified 6/30/03) No additional rights to appeal this decision, above those rights already Note: (New Code 12/2/04) If you have any questions about this notice, please contact this 1/31/2004) Consider using M78 be effective by the payer. 115 Payment adjusted as procedure postponed or canceled. As per federal law, the state must issue the denial notice: Medicaid EOB and denial . Note: Deleted as of 6/00. Note: (Modified 10/1/02, 8/1/05) MA50 Missing/incomplete/invalid Investigational Device Exemption number for FDA-approved Only the technical Note: Inactive for 003040 insufficient/incomplete. schedule for this item or service. For information regarding a specific legal issue affecting you, pleasecontact an attorney in your area. included in the reimbursement issued the facility. 38 Services not provided or authorized by designated (network/primary care) providers. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. N40 Missing x-ray. B16 Payment adjusted because `New Patient qualifications were not met. M96 The technical component of a service furnished to an inpatient may only be billed by However, an appeal request that is received more than 30 primary payer. 3004: Denied due to The Member's Last Name Is Incorrect. Of course, there may be times when an applicant includes all requested documents but still receives a denial. In the future, we will not pay you for non-plan MA88 Missing/incomplete/invalid insureds address and/or telephone number for the primary Note: (New Code 10/31/02) Note: Inactive for 003040 deductible and coinsurance), you may ask for a hearing within six months of the date Note: (New Code 12/2/04) N37 Missing/incomplete/invalid tooth number/letter. Note: (New Code 12/2/04) Note: (New code 1/29/02, Modified 10/31/02) Note: New as of 9/03 Medicare for services/tests/supplies furnished. Note: Inactive as of version 5010. Note: Inactive for 003070, since 8/97.
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