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EOB Description Rejection Group Reason Remark Code

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EOB CodeDescriptionRejection CodeGroup CodeReason CodeRemark Code001Denied. Care beyond first 20 visits or 60 days requires , 45N54, M62002Denied. Report of Accident (ROA) payable once per claim. Previous payment has been , A1, 23N117003Initial office visit payable 1 time only for same injured worker/ Physical therapy by the attending doctor is limited to 6 , A1, 45N362005Denied. Physical therapy beyond the first 12 treatments requires , 45M62, N54006Rental has extended over 30 days. Only short term rental is , 119, 45NULL007Denied. Facet joint injections are limited to 4 per injured , A1, 45N362008Denied. Chemonucleolysis is allowed once in a lifetime , A1, 45N117009Maximum 2 service units , P12NULL010Maximum 40 hours payable per vocational 50 hours payable per vocational 2 hours allowed per vocational or level of service does not meet L&I 1 service unit allowed for same , 45NULL015Maximum of 2 hours travel wait time you.

EOB Code Description Rejection Code Group Code Reason Code Remark Code 040 Denied. Place of service is invalid/invalid for date of service. Resubmit with valid code.

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