Transcription of EOB Description Rejection Group Reason Remark Code
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EOB Description Rejection Group Reason Remark Code
EOB CodeDescriptionRejection CodeGroup CodeReason CodeRemark Code001 Denied. Care beyond first 20 visits or 60 days requires , 45N54, M62002 Denied. Report of Accident (ROA) payable once per claim. Previous payment has been , A1, 23N117003 Initial office visit payable 1 time only for same injured worker/ Physical therapy by the attending doctor is limited to 6 , A1, 45N362005 Denied. Physical therapy beyond the first 12 treatments requires , 45M62, N54006 Rental has extended over 30 days. Only short term rental is , 119, 45 NULL007 Denied. Facet joint injections are limited to 4 per injured , A1, 45N362008 Denied. Chemonucleolysis is allowed once in a lifetime , A1, 45N117009 Maximum 2 service units , P12 NULL010 Maximum 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 , 45 NULL015 Maximum of 2 hours travel wait time you.
Apr 30, 2016 · Reason Code Remark Code 074 Denied. Replacement and repair of this item is not covered by L&I. NULL CO 96, A1 N171 075 Denied. Requested records not rec'd by August(AHS). Injured worker is not to be billed. NULL CO 226, €A1 N463 076 Denied. Claim reopened for provisional time-loss only. If/when reopened for medical, rebill. NULL CO 27, A1 …
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