Insights and Tips into Medical Billing

Wednesday, September 21, 2005

Medicare Denial Codes That Require Documentation

Most Medicare denials can be resubmitted to the carrier as a new electronic claim. An appeal is not necessary to have the claim reprocessed, despite what it might say on your EOB. Correction of the error or omission and resubmitting the claim will suffice. The only denial codes that require a written redetermination request are the following:

50 (Exception for Chiropractors: if you received reason code 50 due to failing to add the "AT" modifier, you may file a new claim)

57

N115

Reason codes 19, 20, 21, 22, MA04, MA16, MA26 and MA92 are considered Medicare Secondary Payer (MSP) related denials. Contact your local Medicare carrier for a complete list of Remittance Advice codes.

2 Comments:

Blogger Maverick SM said...

are you a doctor? Hope we can read more of your knowledge.

6:33 AM

 
Blogger Puru said...

Here is the website, you can find most of the denial codes and explanation.

http://www.whatismedicalinsurancebilling.org/

Good Work

2:56 AM

 

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