What does OA 121 mean?
Q4: What does the denial code OA-121 mean? A4: OA-121 has to do with an outstanding balance owed by the patient.
What does co A1 denial mean?
A1 Claim/Service denied. 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.)
What does denial code Co 97 mean?
The benefit for this service is
CO 97 Denial Code: The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.
What does co A1 mean?
� CO-A1 — Claim/services denied.
What does PR 204 mean?
PR-204: This service/equipment/drug is not covered under the patient’s current benefit plan.
What does PR 187 mean?
187 Consumer Spending Account payments (includes but is not limited to Flexible Spending Account, Health Savings Account, Health Reimbursement Account, etc.) 188 This product/procedure is only covered when used according to FDA recommendations.
What is co18 in healthcare?
CO -18 – refers to Duplicate claim/service. It means that claim has been submitted in the past. CO – 97 – occurs when the procedure or service is not paid separately and is rather inclusive with another procedure code that was performed by the provider on the same day.
What is Medicare adjustment code CO 237?
Group Code: CO. This group code is used when a contractual agreement between the payer and payee, or a regulatory requirement, resulted in an adjustment. Claims Adjustment Reason Code (CARC) 237: “Legislated/Regulatory Penalty.
How do I resolve a Co 97 denial code?
Potential Solutions for Denial Code CO 97
- Start out by checking to see which procedure code is mutually exclusive, included, or bundled.
- Once you know which procedure code is in question, talk to the coding team to see if there is an appropriate modifier that can be used so you can resubmit the claim.
What does PR 242 mean?
242 Services not provided by network/primary care providers. Reason for this denial PR 242: If your Provider is Not Contracted for this member’s plan. Supplies or DME codes are only payable to Authorized DME Providers.
What is reason code A1?
Reason Code: A1. Claim/Service denied. 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.)
What is modifier 76 medical billing?
What you need to know. Modifier 76 is used to report a repeat procedure or service by the same physician and is appended to the procedure to report: Repeat procedures performed on the same day. Indicate that a procedure or service was repeated subsequent to the original procedure or service.