Denial and action

Denial Reason, Reason/Remark Code(s) • M-80: Not covered when performed during the same session/date as a previously processed service for the patient • CO-B15: Payment adjusted because this procedure/service requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated. • CPT code: 82565 National Correct Coding InitiativeThe National Correct ... Read More

Code/Modifier Combination Invalid and Modifier Invalid/Missing Remark Code/ Message Number:  • 4: The procedure code is inconsistent with the modifier used or a required modifier is missing • MA130: Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable. Please submit a new claim with the complete/correct ... Read More

Diagnostic Cardiology Services: Medical Necessity DenialsDenial Reason, Reason/Remark Code(s)  • CO-50, CO-57, CO-151, N-115 – Medical Necessity: An ICD-9 code(s) was submitted that is not covered under a LCD/NCD • CPT codes: 93307, 93320, 93325 Resolution/Resources • Refer to the ‘Transthoracic Echocardiography’ Local Coverage Determination • If the service being performed is not covered under the ... Read More