Medical Practice Assessment, Medical Practice Management, Uncategorized
Aug 30

Top Medicare claim submission/reason code errors for July 2017 by Novitas

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Explanation of Medicare Benefits Message

Description

Resolution

1

96

Non-covered charge.

Prior to performing or billing a service, ensure that the service is covered under Medicare. Please refer to the Centers for Medicare & Medicaid Services Internet Only Manual, 100-02, Chapter 16.

2

109

Claim not covered by this payer/contractor.

This denial indicates that the service is one that is processed or paid by another contractor.

Examples of these types of service are:

Durable Medical Equipment
Hospice related services
Medicare Advantage

You must send the claim to the correct payer/contractor.

3

18

Duplicate claim/service.

Please check claim status through the IVR to see if another claim was paid or is currently being processed. To prevent duplicate denials, allow us sufficient time to process a claim before submitting a second.

4

26

Expenses incurred prior to coverage.

Our records show the patient did not have Part B coverage when you provided this service. If you disagree, please contact us at the customer service notice on this notice.

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