Claim Adjustment Reason Codes Crosswalk

EX code CARC RARC DESCRIPTIONTypeEX*1 95N584 DENY: SHP guidelines for submitting corrected Claim were not followed DENYEX*2 A1 N473 DENY: ASSESSMENT, FILLING AND/OR DME CERTIFICATION NOT ON FILE DENYEX+C 45 FOR INTERNAL PURPOSES ONLYPAYEX+O 45 LATE CLAIMS INTEREST EX code FOR ORIG YMDRCVD PAYEX+P 45 FOR INTERNAL PURPOSES ONLYPAYEX01 1 DEDUCTIBLE AMOUNTPAYEX02 2 COINSURANCE AMOUNTPAYEX03 3 COPAYMENT AMOUNTPAYEX07 7N517 DENY: THE PROCEDURE code IS INCONSISTENT WITH THE PATIENT S SEX DENYEX09 9N657 DENY: THE DIAGNOSIS IS INCONSISTENT WITH THE PATIENT S AGE OR SEX DENYEX0A 45 ADJUST: PROVIDER REFUND RECEIVED, REINSTATE RECOUPED PAYMENT AMOUNT PAYEX0B 23 ADJUST: Claim TO BE RE-PROCESSED CORRECTED UNDER NEW Claim NUMBER DENYEX0D 45 Adjustment : $ DUE IN ADDITIONAL TO ORIGINAL PAYMENT MADE FOR SERVICES PAYEX0E 193 ADJUST BASED ON APPEAL RECEIVED UPHELD ORIGINAL DENY DECISION DENYEX0F 45 ADJUST BASED ON APPEAL RECEIVED OVERTURNED ORIGINAL DENY DECISION PAYEX0G 252N232 CLM TOTA

ex1k 6 n129 deny: procedure code is inconsistent with patient s age deny ex1l b14 m86 deny: visit & preven codes are not payable on same dos w o documentation deny ex1n 251 n237 no evv visit match for medicaid id and npi/api for date of svc billed deny claim adjustment reason codes crosswalk superiorhealthplan.com shp_20205782

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  Code, Procedures, Claim, Reasons, Adjustment, Crosswalk, Procedure codes, Claim adjustment reason codes crosswalk, Superiorhealthplan, Claim adjustment reason codes crosswalk superiorhealthplan

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