What is denial code PI 16?
16 Claim/service lacks information which is needed for adjudication. 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 co24 denial?
Denial Code CO-24: Charges are covered under a capitation agreement or managed care plan.
What is reason code co24?
CO 24 – charges are covered under a capitation agreement/managed care plan: This reason code is used when the patient is enrolled in a Medicare Advantage (MA) plan or covered under a capitation agreement. This claim should be submitted to the patient’s MA plan.
What does co A1 mean?
CO-A1 — Claim/services denied.
What does N290 mean?
Missing/Incorrect Required NPI Information
|CARC / RARC||Description|
|CO -16||Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.|
|N290||Missing/incomplete/invalid rendering provider primary identifier.|
|N257||Missing/incomplete/invalid billing provider/supplier primary identifier.|
What is MA04?
MA04 means that the claim was submitted with an invalid Medicare Secondary Payer (MSP) code or an MSP code was not included.
What does covered under capitation mean?
A capitated contract is a health care plan that pays a flat fee for each patient it covers. Under a capitation agreement, the doctor is paid a fixed monthly rate in exchange for offering their services to plan members at a reduced or no cost.
What is the denial code for timely filing?
Insurance will deny the claim with denial code CO 29 – the time limit for filing has expired, whenever the claims submitted after the time frame. The time limit is calculated from the date service provided.