| 4 | This is a subsequent request for information from the original request.
Start: 01/01/1995 | Last Modified: 01/27/2008 | Stop: 07/01/2008 |
| 5 | This is a final request for information.
Start: 01/01/1995 | Last Modified: 01/27/2008 | Stop: 07/01/2008 |
| 7 | Claim may be reconsidered at a future date.
Start: 01/01/1995 | Last Modified: 01/27/2008 | Stop: 07/01/2008 |
| 8 | No payment due to contract/plan provisions.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 9 | No payment will be made for this claim.
Start: 01/01/1995 | Last Modified: 01/27/2008 | Stop: 07/01/2008 |
| 10 | All originally submitted procedure codes have been combined.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 11 | Some originally submitted procedure codes have been combined.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 13 | All originally submitted procedure codes have been modified.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 14 | Some all originally submitted procedure codes have been modified.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 22 | ... before entering the adjudication system.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 28 | Claim submitted to wrong payer.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 67 | Payment made in full.
Start: 01/01/1995 | Last Modified: 01/27/2008 | Stop: 07/01/2008 |
| 68 | Partial payment made for this claim.
Start: 01/01/1995 | Last Modified: 01/27/2008 | Stop: 07/01/2008 |
| 69 | Payment reflects plan provisions.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 70 | Payment reflects contract provisions.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 71 | Periodic installment released.
Start: 01/01/1995 | Last Modified: 01/27/2008 | Stop: 07/01/2008 |
| 87 | Denied: Entity not found. (Use code 26 with appropriate Claim Status category Code)
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 108 | Coverage has been canceled for this entity. (Use code 27)
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 112 | Policyholder processes their own claims.
Start: 01/01/1995 | Last Modified: 01/27/2008 | Stop: 07/01/2008 |
| 113 | Cannot process individual insurance policy claims.
Start: 01/01/1995 | Last Modified: 01/27/2008 | Stop: 07/01/2008 |
| 115 | Cannot process HMO claims
Start: 01/01/1995 | Last Modified: 01/27/2008 | Stop: 07/01/2008 |
| 118 | TPO rejected claim/line because payer name is missing. (Use status code 21 and status code 125 with entity code IN)
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop:
01/01/2008 |
| 119 | TPO rejected claim/line because certification information is missing. (Use status code 21 and status code 252)
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop:
01/01/2008 |
| 120 | TPO rejected claim/line because claim does not contain enough information. (Use status code 21)
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 122 | Missing/invalid data prevents payer from processing claim. (Use CSC Code 21)
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 169 | Entity's employer id.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 253 | Procedure/revenue code for service(s) rendered. Use codes 454 or 455.
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 02/28/1997 |
| 302 | Refer to codes 300 for lab notes and 311 for pathology notes
Start: 01/01/1995 | Stop: 01/31/1997 |
| 303 | Physical therapy notes. Use code 297:6O (6 'OH' - not zero)
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 02/28/1997 |
| 309 | Code was duplicate of code 299
Start: 01/01/1995 | Stop: 01/31/1997 |
| 328 | Speech therapy notes. Use code 297:6R
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 02/28/1997 |
| 332 | Authorization/certification (include period covered). (Use code 252)
Start: 02/28/1997 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 338 | Home health certification. Use code 332:4Y
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 02/28/1997 |
| 347 | Refer to code 345 for treatment plan and code 282 for prescription
Start: 01/01/1995 | Stop: 01/31/1997 |
| 348 | Chiropractic treatment plan. (Use 345:QL)
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
| 349 | Psychiatric treatment plan. Use codes 345:5I, 5J, 5K, 5L, 5M, 5N, 5O (5 'OH' - not zero), 5P
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 02/28/1997 |
| 350 | Speech pathology treatment plan. Use code 345:6R
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 02/28/1997 |
| 351 | Physical/occupational therapy treatment plan. Use codes 345:6O (6 'OH' - not zero), 6N
Start: 01/01/1995 | Last Modified: 07/09/2007 | Stop: 02/28/1997 |
| 423 | Prognosis
Start: 02/28/1997 | Last Modified: 07/09/2007 | Stop: 01/01/2008 |
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