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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 057 Submit charges for rehab DRG 462 under your facilities separate rehab unit provider number.

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