All Possible Denial Reasons

CODE ID DESCRIPTION
4 The procedure is not consistent with the modifier used or a required modifier is missing.
5 The procedure code/bill type is inconsistent with the place of service.
6 The procedure/revenue code is inconsistent with the patient's age.
7 The procedure/ revenue code is inconsistent with the patient's gender.
8 The procedure code is inconsistent with the provider type/specialty.
9 The diagnosis is inconsistent with the patient's age.
10 The diagnosis is inconsistent with the patient's gender.
11 The diagnosis is inconsistent with the procedure.
12 The diagnosis is inconsistent with the provider type.
13 The date of death precedes the date of service.
14 The date of birth follows the date of service.
15 The authorization number is missing, invalid, or does not apply to the billed services or provider.
770008 Rseubmit w/ Referring NPI
Z055 Services Ordered by Non-Group MD
Z056 EOB, Coordination of benefits
B11 Claim transferred to the correct payer
252 An attachment/other documentation is required to adjudicate this claim/service.
CR227 Information requested from the patient/insured/responsible party was not provided or was insufficient/incomplete (info: this denial will place the amount under "Self-Pay" automatically.)
28 Coverage not in effect at the time the service was provided.
C69

Ic Inappropriate New Pat Code'

(new patient visit / wrong consultation code billed)
MC9670 Claim date of service does not match date of service on SAR (Service Authorization Request) file.
MC314 Recipient is not eligible for the month of service billed.
MC095 This service is not payable due to a procedure, or procedure and modifier, previously reimbursed.
MC021 The claim was received after the one-year maximum billing limitation.