# | 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 | 50 | These are non-covered services because this is not deemed a ‘medical necessity’ by the payer. | Please ensure to follow Medicare guidelines, national and local coverage determinations for the service billed. References: |
Medical Practice Assessment, Medical Practice Management, Uncategorized