New Codes – RARC Code Modified Narrative Effective Date
N753 Missing/Incomplete/Invalid Attachment Control Number. 07/01/2015
N754 Missing/Incomplete/Invalid Referring Provider or Other Source Qualifier on the 1500 Claim Form. 07/01/2015
N755 Missing/Incomplete/Invalid ICD Indicator on the 1500 Claim Form. 07/01/2015
N756 Missing/Incomplete/Invalid point of drop-off address, 07/01/2015
N757 Adjusted based on the Federal Indian Fees schedule (MLR). 07/01/2015
N758 Adjusted based on the prior authorization decision. 07/01/2015
N759 Payment adjusted based on the National Electrical Manufacturers Association (NEMA) Standard XR-29-2013. 07/01/2015
M47 Missing/Incomplete/Invalid Payer Claim Control Number. Other terms exist for this element including, but not limited to, Internal Control Number (ICN), Claim Control Number (CCN), Document Control Number (DCN). 07/01/2015
MA74 ALERT: This payment replaces an earlier payment for this claim that was either lost, damaged or returned. 07/01/2015
N432 ALERT: Adjustment based on a Recovery Audit. 07/01/2015
N22 ALERT: This procedure code was added/changed because it more accurately describes the services rendered. 07/01/2015
M39 ALERT: The patient is not liable for payment of this service as the advance notice of non-coverage you provided the patient did not comply with program requirements. 07/01/2015
M109 ALERT: This claim/service was chosen for complex review. 07/01/2015
M38 ALERT: The patient is liable for the charges for this service as they were informed in writing before the service was furnished that we would not pay for it and the patient agreed to be responsible for the charges. 07/01/2015
N381 ALERT: Consult our contractual agreement for restrictions/billing/payment information related to these charges. 07/01/2015
MA91 ALERT: This determination is the result of the appeal you filed. 07/01/2015
270 Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient’s dental plan for further consideration. 07/01/2015
45 Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. Note: This must not duplicate provider adjustment amounts (payments and contractual reductions) that have resulted from prior payer(s) adjudication. (Use only with Group Codes PR or CO depending upon liability.) 11/01/15
Medicare Guideline posts
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
Top Medicare billing tips
Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee...
This post has Most used J code list and we are constantly updating with example . If you are looking particular J code, use search button. ...
CPT CODES and Description 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitr...
Flow Cytometry is a highly complex process by which blood, body fluids, bone marrow and tissue can be examined. It provides important immun...
Procedure code and description 93015 (cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous ele...
Coverage Indications, Limitations, and/or Medical Necessity This LCD describes conditions under which the coverage of nail avulsion/ex...
Procedure Codes and Definitions 36415 Collection of venous blood by venipuncture - Fee schedule amount $3.10 36416 Collection of capi...
Molecular diagnostic testing, which includes DNA- or RNA-based analysis, with or without amplification/quantification, provides sensitive, ...
Procedure code and description 95004 Percut Tests w/ Extrac Immed React # Allergy testing - Percut allergy skin tests - Percutaneous ...
procedure code and description 93922 LIMITED BILATERAL NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, (EG, FOR LOW...