Searchable Denial Code Directory

The procedure code is inconsistent with the modifier used. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the procedure. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The authorization number is missing, invalid, or does not apply to the billed services.

Claim/service lacks information or has submission/billing error(s). Usage: Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO)

This is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.

This care may be covered by another payer per coordination of benefits.

The impact of prior payer(s) adjudication including payments and/or adjustments. (Use only with Group Code OA)

Charges are covered under a capitation agreement/managed care plan.

Expenses incurred prior to coverage.

Expenses incurred after coverage terminated.

The time limit for filing has expired.

Patient cannot be identified as our insured.

Our records indicate the patient is not an eligible dependent.

Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. Usage: This adjustment amount cannot equal the total service or claim charge amount; and 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)

This is a non-covered service because it is a routine/preventive exam or a diagnostic/screening procedure done in conjunction with a routine/preventive exam. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

These are non-covered services because this is not deemed a 'medical necessity' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Procedure/treatment/drug is deemed experimental/investigational by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Indirect Medical Education Adjustment.

Plan procedures not followed.

Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.

Benefit maximum for this time period or occurrence has been reached.

Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.

This (these) diagnosis(es) is (are) not covered. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is denied when performed/billed by this type of provider. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Precertification/authorization/notification/pre-treatment absent.

This service/equipment/drug is not covered under the patient's current benefit plan

This procedure is not paid separately. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).

The procedure code/type of bill is inconsistent with the place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure/revenue code is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure code is inconsistent with the provider type/specialty (taxonomy). Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the patient's gender. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the provider type. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The date of death precedes the date of service.

The date of birth follows the date of service.

Service(s) not valid for the provider type.

This injury/illness is covered by the liability carrier.

This injury/illness is the liability of the no-fault carrier.

The charges are a duplicate of a claim previously processed.

Coverage not in effect for the time period of this bill.

Services not provided by network/primary care providers.

Procedure/treatment has not been deemed 'proven to be effective' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Service(s) not covered under this plan.

Submitting provider's NPI is not eligible to receive payment for this service.

Precertification/notification/authorization/pre-treatment exceeded.

Legislated/Regulatory Penalty. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Sequestration - reduction in federal payment

Referral absent

Deductible Amount

Coinsurance Amount

Co-payment Amount

Expenses incurred prior to coverage.

Expenses incurred after coverage terminated.

This is a non-covered service because it is a routine/preventive exam or a diagnostic/screening procedure done in conjunction with a routine/preventive exam. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Benefit maximum for this time period or occurrence has been reached.

This service/equipment/drug is not covered under the patient's current benefit plan

Claim/service lacks information or has submission/billing error(s). Usage: Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO)

The impact of prior payer(s) adjudication including payments and/or adjustments. (Use only with Group Code OA)

Processed in Excess of charges.

Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.

Submission/billing error(s). At least one Remark Code must be provided.

The procedure code is inconsistent with the modifier used. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Deductible Amount

Deductible Amount

Deductible Amount

Coinsurance Amount

Coinsurance Amount

Coinsurance Amount

Co-payment Amount

Co-payment Amount

Co-payment Amount

The procedure code is inconsistent with the modifier used. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure code is inconsistent with the modifier used. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure code/type of bill is inconsistent with the place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure code/type of bill is inconsistent with the place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure code/type of bill is inconsistent with the place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure/revenue code is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure/revenue code is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure/revenue code is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure/revenue code is inconsistent with the patient's gender. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure/revenue code is inconsistent with the patient's gender. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure/revenue code is inconsistent with the patient's gender. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure/revenue code is inconsistent with the patient's gender. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure code is inconsistent with the provider type/specialty (taxonomy). Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure code is inconsistent with the provider type/specialty (taxonomy). Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The procedure code is inconsistent with the provider type/specialty (taxonomy). Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the patient's gender. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the patient's gender. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the patient's gender. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the procedure. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the procedure. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the procedure. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the provider type. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the provider type. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The diagnosis is inconsistent with the provider type. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The date of death precedes the date of service.

The date of death precedes the date of service.

The date of death precedes the date of service.

The date of birth follows the date of service.

The date of birth follows the date of service.

The date of birth follows the date of service.

Claim/service lacks information or has submission/billing error(s). Usage: Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Claim/service lacks information or has submission/billing error(s). Usage: Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO)

Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO)

This is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.

This is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.

This is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.

This injury/illness is covered by the liability carrier.

This injury/illness is covered by the liability carrier.

This injury/illness is covered by the liability carrier.

This injury/illness is the liability of the no-fault carrier.

This injury/illness is the liability of the no-fault carrier.

This injury/illness is the liability of the no-fault carrier.

This care may be covered by another payer per coordination of benefits.

This care may be covered by another payer per coordination of benefits.

This care may be covered by another payer per coordination of benefits.

The impact of prior payer(s) adjudication including payments and/or adjustments. (Use only with Group Code OA)

The impact of prior payer(s) adjudication including payments and/or adjustments. (Use only with Group Code OA)

Charges are covered under a capitation agreement/managed care plan.

Charges are covered under a capitation agreement/managed care plan.

Charges are covered under a capitation agreement/managed care plan.

Expenses incurred prior to coverage.

Expenses incurred prior to coverage.

Expenses incurred after coverage terminated.

Expenses incurred after coverage terminated.

The time limit for filing has expired.

The time limit for filing has expired.

The time limit for filing has expired.

Patient cannot be identified as our insured.

Patient cannot be identified as our insured.

Patient cannot be identified as our insured.

Our records indicate the patient is not an eligible dependent.

Our records indicate the patient is not an eligible dependent.

Our records indicate the patient is not an eligible dependent.

Insured has no dependent coverage.

Insured has no dependent coverage.

Insured has no dependent coverage.

Insured has no dependent coverage.

Insured has no coverage for newborns.

Insured has no coverage for newborns.

Insured has no coverage for newborns.

Insured has no coverage for newborns.

Lifetime benefit maximum has been reached.

Lifetime benefit maximum has been reached.

Lifetime benefit maximum has been reached.

Lifetime benefit maximum has been reached.

Services denied at the time authorization/pre-certification was requested.

Services denied at the time authorization/pre-certification was requested.

Services denied at the time authorization/pre-certification was requested.

Services denied at the time authorization/pre-certification was requested.

Charges do not meet qualifications for emergent/urgent care. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Charges do not meet qualifications for emergent/urgent care. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Charges do not meet qualifications for emergent/urgent care. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Charges do not meet qualifications for emergent/urgent care. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Prompt-pay discount.

Prompt-pay discount.

Prompt-pay discount.

Prompt-pay discount.

Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. Usage: This adjustment amount cannot equal the total service or claim charge amount; and 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)

Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. Usage: This adjustment amount cannot equal the total service or claim charge amount; and 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)

Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. Usage: This adjustment amount cannot equal the total service or claim charge amount; and 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)

This is a non-covered service because it is a routine/preventive exam or a diagnostic/screening procedure done in conjunction with a routine/preventive exam. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

This is a non-covered service because it is a routine/preventive exam or a diagnostic/screening procedure done in conjunction with a routine/preventive exam. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

These are non-covered services because this is not deemed a 'medical necessity' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

These are non-covered services because this is not deemed a 'medical necessity' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

These are non-covered services because this is not deemed a 'medical necessity' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

These are non-covered services because this is a pre-existing condition. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

These are non-covered services because this is a pre-existing condition. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

These are non-covered services because this is a pre-existing condition. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

These are non-covered services because this is a pre-existing condition. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Services by an immediate relative or a member of the same household are not covered.

Services by an immediate relative or a member of the same household are not covered.

Services by an immediate relative or a member of the same household are not covered.

Services by an immediate relative or a member of the same household are not covered.

Multiple physicians/assistants are not covered in this case. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Multiple physicians/assistants are not covered in this case. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Multiple physicians/assistants are not covered in this case. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Multiple physicians/assistants are not covered in this case. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Procedure/treatment/drug is deemed experimental/investigational by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Procedure/treatment/drug is deemed experimental/investigational by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Procedure/treatment/drug is deemed experimental/investigational by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Procedure/treatment has not been deemed 'proven to be effective' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Procedure/treatment has not been deemed 'proven to be effective' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Procedure/treatment has not been deemed 'proven to be effective' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Charges for outpatient services are not covered when performed within a period of time prior to or after inpatient services.

Charges for outpatient services are not covered when performed within a period of time prior to or after inpatient services.

Charges for outpatient services are not covered when performed within a period of time prior to or after inpatient services.

Charges for outpatient services are not covered when performed within a period of time prior to or after inpatient services.

Adjusted for failure to obtain second surgical opinion

Adjusted for failure to obtain second surgical opinion

Adjusted for failure to obtain second surgical opinion

Adjusted for failure to obtain second surgical opinion

Blood Deductible.

Blood Deductible.

Blood Deductible.

Blood Deductible.

Day outlier amount.

Day outlier amount.

Day outlier amount.

Day outlier amount.

Cost outlier - Adjustment to compensate for additional costs.

Cost outlier - Adjustment to compensate for additional costs.

Cost outlier - Adjustment to compensate for additional costs.

Cost outlier - Adjustment to compensate for additional costs.

Indirect Medical Education Adjustment.

Indirect Medical Education Adjustment.

Indirect Medical Education Adjustment.

Direct Medical Education Adjustment.

Direct Medical Education Adjustment.

Direct Medical Education Adjustment.

Direct Medical Education Adjustment.

Disproportionate Share Adjustment.

Disproportionate Share Adjustment.

Disproportionate Share Adjustment.

Disproportionate Share Adjustment.

Non-Covered days/Room charge adjustment.

Non-Covered days/Room charge adjustment.

Non-Covered days/Room charge adjustment.

Non-Covered days/Room charge adjustment.

Patient Interest Adjustment (Use Only Group code PR)

Patient Interest Adjustment (Use Only Group code PR)

Patient Interest Adjustment (Use Only Group code PR)

Patient Interest Adjustment (Use Only Group code PR)

Professional fees removed from charges.

Professional fees removed from charges.

Professional fees removed from charges.

Professional fees removed from charges.

Ingredient cost adjustment. Usage: To be used for pharmaceuticals only.

Ingredient cost adjustment. Usage: To be used for pharmaceuticals only.

Ingredient cost adjustment. Usage: To be used for pharmaceuticals only.

Ingredient cost adjustment. Usage: To be used for pharmaceuticals only.

Dispensing fee adjustment.

Dispensing fee adjustment.

Dispensing fee adjustment.

Dispensing fee adjustment.

Processed in Excess of charges.

Processed in Excess of charges.

Processed in Excess of charges.

Plan procedures not followed.

Plan procedures not followed.

Plan procedures not followed.

Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment made to patient/insured/responsible party.

Payment made to patient/insured/responsible party.

Payment made to patient/insured/responsible party.

Payment made to patient/insured/responsible party.

Predetermination: anticipated payment upon completion of services or claim adjudication.

Predetermination: anticipated payment upon completion of services or claim adjudication.

Predetermination: anticipated payment upon completion of services or claim adjudication.

Predetermination: anticipated payment upon completion of services or claim adjudication.

Major Medical Adjustment.

Major Medical Adjustment.

Major Medical Adjustment.

Major Medical Adjustment.

Provider promotional discount (e.g., Senior citizen discount).

Provider promotional discount (e.g., Senior citizen discount).

Provider promotional discount (e.g., Senior citizen discount).

Provider promotional discount (e.g., Senior citizen discount).

Managed care withholding.

Managed care withholding.

Managed care withholding.

Managed care withholding.

Tax withholding.

Tax withholding.

Tax withholding.

Tax withholding.

Patient payment option/election not in effect.

Patient payment option/election not in effect.

Patient payment option/election not in effect.

Patient payment option/election not in effect.

The related or qualifying claim/service was not identified on this claim. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The related or qualifying claim/service was not identified on this claim. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The related or qualifying claim/service was not identified on this claim. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The related or qualifying claim/service was not identified on this claim. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Rent/purchase guidelines were not met. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Rent/purchase guidelines were not met. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Rent/purchase guidelines were not met. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Rent/purchase guidelines were not met. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.

Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.

Billing date predates service date.

Billing date predates service date.

Billing date predates service date.

Billing date predates service date.

Not covered unless the provider accepts assignment.

Not covered unless the provider accepts assignment.

Not covered unless the provider accepts assignment.

Not covered unless the provider accepts assignment.

Service not furnished directly to the patient and/or not documented.

Service not furnished directly to the patient and/or not documented.

Service not furnished directly to the patient and/or not documented.

Service not furnished directly to the patient and/or not documented.

Procedure/product not approved by the Food and Drug Administration.

Procedure/product not approved by the Food and Drug Administration.

Procedure/product not approved by the Food and Drug Administration.

Procedure/product not approved by the Food and Drug Administration.

Procedure postponed, canceled, or delayed.

Procedure postponed, canceled, or delayed.

Procedure postponed, canceled, or delayed.

Procedure postponed, canceled, or delayed.

The advance indemnification notice signed by the patient did not comply with requirements.

The advance indemnification notice signed by the patient did not comply with requirements.

The advance indemnification notice signed by the patient did not comply with requirements.

The advance indemnification notice signed by the patient did not comply with requirements.

Transportation is only covered to the closest facility that can provide the necessary care.

Transportation is only covered to the closest facility that can provide the necessary care.

Transportation is only covered to the closest facility that can provide the necessary care.

Transportation is only covered to the closest facility that can provide the necessary care.

ESRD network support adjustment.

ESRD network support adjustment.

ESRD network support adjustment.

ESRD network support adjustment.

Benefit maximum for this time period or occurrence has been reached.

Benefit maximum for this time period or occurrence has been reached.

Indemnification adjustment - compensation for outstanding member responsibility.

Indemnification adjustment - compensation for outstanding member responsibility.

Indemnification adjustment - compensation for outstanding member responsibility.

Indemnification adjustment - compensation for outstanding member responsibility.

Psychiatric reduction.

Psychiatric reduction.

Psychiatric reduction.

Psychiatric reduction.

Newborn's services are covered in the mother's Allowance.

Newborn's services are covered in the mother's Allowance.

Newborn's services are covered in the mother's Allowance.

Newborn's services are covered in the mother's Allowance.

Prior processing information appears incorrect. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Prior processing information appears incorrect. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Prior processing information appears incorrect. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Prior processing information appears incorrect. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Claim submission fee.

Claim submission fee.

Claim submission fee.

Claim submission fee.

Claim specific negotiated discount.

Claim specific negotiated discount.

Claim specific negotiated discount.

Claim specific negotiated discount.

Prearranged demonstration project adjustment.

Prearranged demonstration project adjustment.

Prearranged demonstration project adjustment.

Prearranged demonstration project adjustment.

The disposition of this service line is pending further review. (Use only with Group Code OA). Usage: Use of this code requires a reversal and correction when the service line is finalized (use only in Loop 2110 CAS segment of the 835 or Loop 2430 of the 837).

The disposition of this service line is pending further review. (Use only with Group Code OA). Usage: Use of this code requires a reversal and correction when the service line is finalized (use only in Loop 2110 CAS segment of the 835 or Loop 2430 of the 837).

The disposition of this service line is pending further review. (Use only with Group Code OA). Usage: Use of this code requires a reversal and correction when the service line is finalized (use only in Loop 2110 CAS segment of the 835 or Loop 2430 of the 837).

The disposition of this service line is pending further review. (Use only with Group Code OA). Usage: Use of this code requires a reversal and correction when the service line is finalized (use only in Loop 2110 CAS segment of the 835 or Loop 2430 of the 837).

Technical fees removed from charges.

Technical fees removed from charges.

Technical fees removed from charges.

Technical fees removed from charges.

Interim bills cannot be processed.

Interim bills cannot be processed.

Interim bills cannot be processed.

Interim bills cannot be processed.

Failure to follow prior payer's coverage rules. (Use only with Group Code OA)

Failure to follow prior payer's coverage rules. (Use only with Group Code OA)

Failure to follow prior payer's coverage rules. (Use only with Group Code OA)

Failure to follow prior payer's coverage rules. (Use only with Group Code OA)

Regulatory Surcharges, Assessments, Allowances or Health Related Taxes.

Regulatory Surcharges, Assessments, Allowances or Health Related Taxes.

Regulatory Surcharges, Assessments, Allowances or Health Related Taxes.

Regulatory Surcharges, Assessments, Allowances or Health Related Taxes.

Contracted funding agreement - Subscriber is employed by the provider of services. Use only with Group Code CO.

Contracted funding agreement - Subscriber is employed by the provider of services. Use only with Group Code CO.

Contracted funding agreement - Subscriber is employed by the provider of services. Use only with Group Code CO.

Contracted funding agreement - Subscriber is employed by the provider of services. Use only with Group Code CO.

Patient/Insured health identification number and name do not match.

Patient/Insured health identification number and name do not match.

Patient/Insured health identification number and name do not match.

Patient/Insured health identification number and name do not match.

Monthly Medicaid patient liability amount.

Monthly Medicaid patient liability amount.

Monthly Medicaid patient liability amount.

Monthly Medicaid patient liability amount.

Portion of payment deferred.

Portion of payment deferred.

Portion of payment deferred.

Portion of payment deferred.

Incentive adjustment, e.g. preferred product/service.

Incentive adjustment, e.g. preferred product/service.

Incentive adjustment, e.g. preferred product/service.

Incentive adjustment, e.g. preferred product/service.

Diagnosis was invalid for the date(s) of service reported.

Diagnosis was invalid for the date(s) of service reported.

Diagnosis was invalid for the date(s) of service reported.

Diagnosis was invalid for the date(s) of service reported.

Provider contracted/negotiated rate expired or not on file.

Provider contracted/negotiated rate expired or not on file.

Provider contracted/negotiated rate expired or not on file.

Provider contracted/negotiated rate expired or not on file.

Information from another provider was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Information from another provider was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Information from another provider was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Information from another provider was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Lifetime benefit maximum has been reached for this service/benefit category.

Lifetime benefit maximum has been reached for this service/benefit category.

Lifetime benefit maximum has been reached for this service/benefit category.

Lifetime benefit maximum has been reached for this service/benefit category.

Payer deems the information submitted does not support this level of service.

Payer deems the information submitted does not support this level of service.

Payer deems the information submitted does not support this level of service.

Payer deems the information submitted does not support this level of service.

Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.

Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.

Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.

Payer deems the information submitted does not support this length of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payer deems the information submitted does not support this length of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payer deems the information submitted does not support this length of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payer deems the information submitted does not support this length of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payer deems the information submitted does not support this dosage.

Payer deems the information submitted does not support this dosage.

Payer deems the information submitted does not support this dosage.

Payer deems the information submitted does not support this dosage.

Payer deems the information submitted does not support this day's supply.

Payer deems the information submitted does not support this day's supply.

Payer deems the information submitted does not support this day's supply.

Payer deems the information submitted does not support this day's supply.

Patient refused the service/procedure.

Patient refused the service/procedure.

Patient refused the service/procedure.

Patient refused the service/procedure.

Service/procedure was provided as a result of an act of war.

Service/procedure was provided as a result of an act of war.

Service/procedure was provided as a result of an act of war.

Service/procedure was provided as a result of an act of war.

Service/procedure was provided outside of the United States.

Service/procedure was provided outside of the United States.

Service/procedure was provided outside of the United States.

Service/procedure was provided outside of the United States.

Service/procedure was provided as a result of terrorism.

Service/procedure was provided as a result of terrorism.

Service/procedure was provided as a result of terrorism.

Service/procedure was provided as a result of terrorism.

Injury/illness was the result of an activity that is a benefit exclusion.

Injury/illness was the result of an activity that is a benefit exclusion.

Injury/illness was the result of an activity that is a benefit exclusion.

Injury/illness was the result of an activity that is a benefit exclusion.

Provider performance bonus

Provider performance bonus

Provider performance bonus

Provider performance bonus

Attachment/other documentation referenced on the claim was not received.

Attachment/other documentation referenced on the claim was not received.

Attachment/other documentation referenced on the claim was not received.

Attachment/other documentation referenced on the claim was not received.

Attachment/other documentation referenced on the claim was not received in a timely fashion.

Attachment/other documentation referenced on the claim was not received in a timely fashion.

Attachment/other documentation referenced on the claim was not received in a timely fashion.

Attachment/other documentation referenced on the claim was not received in a timely fashion.

These services were submitted after this payers responsibility for processing claims under this plan ended.

These services were submitted after this payers responsibility for processing claims under this plan ended.

These services were submitted after this payers responsibility for processing claims under this plan ended.

These services were submitted after this payers responsibility for processing claims under this plan ended.

This (these) diagnosis(es) is (are) not covered. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

This (these) diagnosis(es) is (are) not covered. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

This (these) diagnosis(es) is (are) not covered. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Alternate benefit has been provided.

Alternate benefit has been provided.

Alternate benefit has been provided.

Alternate benefit has been provided.

Payment is denied when performed/billed by this type of provider. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is denied when performed/billed by this type of provider. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is denied when performed/billed by this type of provider. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is denied when performed/billed by this type of provider in this type of facility. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is denied when performed/billed by this type of provider in this type of facility. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is denied when performed/billed by this type of provider in this type of facility. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is denied when performed/billed by this type of provider in this type of facility. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is adjusted when performed/billed by a provider of this specialty. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is adjusted when performed/billed by a provider of this specialty. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is adjusted when performed/billed by a provider of this specialty. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Payment is adjusted when performed/billed by a provider of this specialty. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Service/equipment was not prescribed by a physician.

Service/equipment was not prescribed by a physician.

Service/equipment was not prescribed by a physician.

Service/equipment was not prescribed by a physician.

Service was not prescribed prior to delivery.

Service was not prescribed prior to delivery.

Service was not prescribed prior to delivery.

Service was not prescribed prior to delivery.

Prescription is incomplete.

Prescription is incomplete.

Prescription is incomplete.

Prescription is incomplete.

Prescription is not current.

Prescription is not current.

Prescription is not current.

Prescription is not current.

Patient has not met the required eligibility requirements.

Patient has not met the required eligibility requirements.

Patient has not met the required eligibility requirements.

Patient has not met the required eligibility requirements.

Patient has not met the required spend down requirements.

Patient has not met the required spend down requirements.

Patient has not met the required spend down requirements.

Patient has not met the required spend down requirements.

Patient has not met the required waiting requirements. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Patient has not met the required waiting requirements. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Patient has not met the required waiting requirements. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Patient has not met the required waiting requirements. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Patient has not met the required residency requirements.

Patient has not met the required residency requirements.

Patient has not met the required residency requirements.

Patient has not met the required residency requirements.

Procedure code was invalid on the date of service.

Procedure code was invalid on the date of service.

Procedure code was invalid on the date of service.

Procedure code was invalid on the date of service.

Procedure modifier was invalid on the date of service.

Procedure modifier was invalid on the date of service.

Procedure modifier was invalid on the date of service.

Procedure modifier was invalid on the date of service.

The referring provider is not eligible to refer the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The referring provider is not eligible to refer the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The referring provider is not eligible to refer the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The referring provider is not eligible to refer the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The prescribing/ordering provider is not eligible to prescribe/order the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The prescribing/ordering provider is not eligible to prescribe/order the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The prescribing/ordering provider is not eligible to prescribe/order the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The prescribing/ordering provider is not eligible to prescribe/order the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The rendering provider is not eligible to perform the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The rendering provider is not eligible to perform the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The rendering provider is not eligible to perform the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The rendering provider is not eligible to perform the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Level of care change adjustment.

Level of care change adjustment.

Level of care change adjustment.

Level of care change adjustment.

Consumer Spending Account payments (includes but is not limited to Flexible Spending Account, Health Savings Account, Health Reimbursement Account, etc.)

Consumer Spending Account payments (includes but is not limited to Flexible Spending Account, Health Savings Account, Health Reimbursement Account, etc.)

Consumer Spending Account payments (includes but is not limited to Flexible Spending Account, Health Savings Account, Health Reimbursement Account, etc.)

Consumer Spending Account payments (includes but is not limited to Flexible Spending Account, Health Savings Account, Health Reimbursement Account, etc.)

This product/procedure is only covered when used according to FDA recommendations.

This product/procedure is only covered when used according to FDA recommendations.

This product/procedure is only covered when used according to FDA recommendations.

This product/procedure is only covered when used according to FDA recommendations.

'Not otherwise classified' or 'unlisted' procedure code (CPT/HCPCS) was billed when there is a specific procedure code for this procedure/service

'Not otherwise classified' or 'unlisted' procedure code (CPT/HCPCS) was billed when there is a specific procedure code for this procedure/service

'Not otherwise classified' or 'unlisted' procedure code (CPT/HCPCS) was billed when there is a specific procedure code for this procedure/service

'Not otherwise classified' or 'unlisted' procedure code (CPT/HCPCS) was billed when there is a specific procedure code for this procedure/service

Payment is included in the allowance for a Skilled Nursing Facility (SNF) qualified stay.

Payment is included in the allowance for a Skilled Nursing Facility (SNF) qualified stay.

Payment is included in the allowance for a Skilled Nursing Facility (SNF) qualified stay.

Payment is included in the allowance for a Skilled Nursing Facility (SNF) qualified stay.

Non standard adjustment code from paper remittance. Usage: This code is to be used by providers/payers providing Coordination of Benefits information to another payer in the 837 transaction only. This code is only used when the non-standard code cannot be reasonably mapped to an existing Claims Adjustment Reason Code, specifically Deductible, Coinsurance and Co-payment.

Non standard adjustment code from paper remittance. Usage: This code is to be used by providers/payers providing Coordination of Benefits information to another payer in the 837 transaction only. This code is only used when the non-standard code cannot be reasonably mapped to an existing Claims Adjustment Reason Code, specifically Deductible, Coinsurance and Co-payment.

Non standard adjustment code from paper remittance. Usage: This code is to be used by providers/payers providing Coordination of Benefits information to another payer in the 837 transaction only. This code is only used when the non-standard code cannot be reasonably mapped to an existing Claims Adjustment Reason Code, specifically Deductible, Coinsurance and Co-payment.

Non standard adjustment code from paper remittance. Usage: This code is to be used by providers/payers providing Coordination of Benefits information to another payer in the 837 transaction only. This code is only used when the non-standard code cannot be reasonably mapped to an existing Claims Adjustment Reason Code, specifically Deductible, Coinsurance and Co-payment.

Original payment decision is being maintained. Upon review, it was determined that this claim was processed properly.

Original payment decision is being maintained. Upon review, it was determined that this claim was processed properly.

Original payment decision is being maintained. Upon review, it was determined that this claim was processed properly.

Original payment decision is being maintained. Upon review, it was determined that this claim was processed properly.

Anesthesia performed by the operating physician, the assistant surgeon or the attending physician.

Anesthesia performed by the operating physician, the assistant surgeon or the attending physician.

Anesthesia performed by the operating physician, the assistant surgeon or the attending physician.

Anesthesia performed by the operating physician, the assistant surgeon or the attending physician.

Refund issued to an erroneous priority payer for this claim/service.

Refund issued to an erroneous priority payer for this claim/service.

Refund issued to an erroneous priority payer for this claim/service.

Refund issued to an erroneous priority payer for this claim/service.

Precertification/authorization/notification/pre-treatment absent.

Precertification/authorization/notification/pre-treatment absent.

Precertification/authorization/notification/pre-treatment absent.

Precertification/notification/authorization/pre-treatment exceeded.

Precertification/notification/authorization/pre-treatment exceeded.

Precertification/notification/authorization/pre-treatment exceeded.

Revenue code and Procedure code do not match.

Revenue code and Procedure code do not match.

Revenue code and Procedure code do not match.

Revenue code and Procedure code do not match.

Expenses incurred during lapse in coverage

Expenses incurred during lapse in coverage

Expenses incurred during lapse in coverage

Expenses incurred during lapse in coverage

Patient is responsible for amount of this claim/service through 'set aside arrangement' or other agreement. (Use only with Group Code PR) At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Patient is responsible for amount of this claim/service through 'set aside arrangement' or other agreement. (Use only with Group Code PR) At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Patient is responsible for amount of this claim/service through 'set aside arrangement' or other agreement. (Use only with Group Code PR) At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Patient is responsible for amount of this claim/service through 'set aside arrangement' or other agreement. (Use only with Group Code PR) At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Non-covered personal comfort or convenience services.

Non-covered personal comfort or convenience services.

Non-covered personal comfort or convenience services.

Non-covered personal comfort or convenience services.

Discontinued or reduced service.

Discontinued or reduced service.

Discontinued or reduced service.

Discontinued or reduced service.

This service/equipment/drug is not covered under the patient's current benefit plan

This service/equipment/drug is not covered under the patient's current benefit plan

Pharmacy discount card processing fee

Pharmacy discount card processing fee