What does denial code N479 mean?
Missing Explanation of Benefits
N479. Missing Explanation of Benefits (Coordination of Benefits or Medicare. Secondary Payer).
What does denial code OA 133 mean?
The disposition of the claim/service is
133 The disposition of the claim/service is pending further review. (Use only with Group Code OA). Note: Use of this code requires a reversal and correction when the service line is finalized ( use only in Loop 2110 CAS segment of the 835 or Loop 2430 of the 837). 134 Technical fees removed from charges.
What is a PR denial?
What does the denial code PR mean? PR Meaning: Patient Responsibility (patient is financially liable). A provider is prohibited from billing a Medicare beneficiary for any adjustment amount identified with a CO group code, but may bill a beneficiary for an adjustment amount identified with a PR group code.
What is remark code N30?
N30. Patient ineligible for this service. (Modified 6/30/03) N32. Claim must be submitted by the provider who rendered the.
What does N479 mean?
Remittance Advice Remark Code Changes
| Code | Current Narrative |
|---|---|
| N479 | Missing Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer). Start: 7/1/2008 |
| N480 | Incomplete/invalid Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer). Start: 7/1/2008 |
How is the total allowed amount calculated?
If you used a provider that’s in-network with your health plan, the allowed amount is the discounted price your managed care health plan negotiated in advance for that service. Usually, an in-network provider will bill more than the allowed amount, but he or she will only get paid the allowed amount.
What is CO16?
The CO16 denial code alerts you that there is information that is missing in order for Medicare to process the claim. Due to the CO (Contractual Obligation) Group Code, the omitted information is the responsibility of the provider and, therefore, the patient cannot be billed for these claims.