Search Denial Types
Value
a tibble
Examples
search_denials()
#> $site
#> # A tibble: 64 × 5
#> adj_code denial_reason common_reasons next_steps claim_submission_tips
#> <chr> <chr> <chr> <chr> <chr>
#> 1 CO-16 Missing/Incorrect R… Information r… Submit ne… Ensure procedure cod…
#> 2 M51 Missing/Incorrect R… Information r… Submit ne… Ensure procedure cod…
#> 3 N56 Missing/Incorrect R… Information r… Submit ne… Ensure procedure cod…
#> 4 CO-16 Code to Highest Lev… Truncated (in… Verify di… To avoid scanning er…
#> 5 M81 Code to Highest Lev… Truncated (in… Verify di… To avoid scanning er…
#> 6 CO-16 Medicare is Seconda… Incorrect pri… Verify wh… Prior to submitting …
#> 7 MA04 Medicare is Seconda… Incorrect pri… Verify wh… Prior to submitting …
#> 8 CO-16 Invalid Patient Name Patient name … Verify th… Obtain patient's ful…
#> 9 MA36 Invalid Patient Name Patient name … Verify th… Obtain patient's ful…
#> 10 N704 Invalid Patient Name Patient name … Verify th… Obtain patient's ful…
#> 11 CO-16 CLIA Certification … CLIA certific… Resubmit … Apply for CLIA Certi…
#> 12 MA120 CLIA Certification … CLIA certific… Resubmit … Apply for CLIA Certi…
#> 13 CO-16 Chiropractic Servic… Initial treat… Resubmit … Paper submitters: Se…
#> 14 MA121 Chiropractic Servic… Initial treat… Resubmit … Paper submitters: Se…
#> 15 MA122 Chiropractic Servic… Initial treat… Resubmit … Paper submitters: Se…
#> 16 N264 Missing or Invalid … NA NA NA
#> 17 N265 Missing or Invalid … NA NA NA
#> 18 CO-16 Missing or Invalid … NA NA NA
#> 19 CO-16 Missing/Incorrect R… Missing or in… Verify su… Rendering NPI must b…
#> 20 N290 Missing/Incorrect R… Missing or in… Verify su… Rendering NPI must b…
#> # ℹ 44 more rows
#>
#> $site2
#> # A tibble: 53 × 5
#> carc rarc claim_type reasons resolutions
#> <chr> <chr> <fct> <chr> <chr>
#> 1 109 NA All The beneficiary was enrolled in… A claim fo…
#> 2 16 MA04 MSP Medicare is the beneficiary's s… Resubmit t…
#> 3 16 MA48, N211 MSP Medicare is the beneficiary's s… Gather acc…
#> 4 16 N245, N211 MSP Medicare is the beneficiary's s… Gather acc…
#> 5 16 N480 MSP Medicare is the beneficiary's s… Submit an …
#> 6 19 NA MSP Medicare is the beneficiary's s… Resubmit t…
#> 7 19 N728 MSP Medicare is the beneficiary's s… Submit an …
#> 8 20 MA04 MSP Medicare is the beneficiary's s… Resubmit t…
#> 9 20 N725 MSP Medicare is the beneficiary's s… Submit an …
#> 10 201 MA01, N722 MSP The beneficiary's primary insur… Submit an …
#> 11 201 N724 MSP The beneficiary's primary insur… Submit an …
#> 12 21 NA MSP Medicare is the beneficiary's s… Resubmit t…
#> 13 21 N727 MSP Medicare is the beneficiary's s… Submit an …
#> 14 22 NA MSP Medicare is the beneficiary's s… Gather acc…
#> 15 22 MA16 MSP The beneficiary is covered unde… Gather acc…
#> 16 246 N620 All The claim was billed with a pro… If it was …
#> 17 26 NA Medicare Part B The beneficiary's did not have … Validate t…
#> 18 50 N115 All The claim was submitted with in… Please ref…
#> 19 96 N56, N211 All The procedure/service that was … Resubmit t…
#> 20 97 M80 All The service billed on the claim… Review all…
#> # ℹ 33 more rows
#>
#> $ext
#> # A tibble: 58 × 3
#> adj_code denial_type denial_category
#> <chr> <chr> <chr>
#> 1 29 Technical Past Timely Filing Limits
#> 2 119 Technical Patient Liability
#> 3 A1 Clinical Informational
#> 4 18 Technical Duplicate Claim
#> 5 50 Clinical Medical Necessity
#> 6 96 Clinical Non-Covered Service
#> 7 129 Technical Billing Error: Invalid Code
#> 8 16 Technical Additional Information Requested
#> 9 B13 Technical Duplicate Claim
#> 10 226 Clinical Additional Information Requested
#> 11 252 Clinical Additional Information Requested
#> 12 4 Clinical Billing Error: Invalid Code
#> 13 146 Clinical Billing Error: Invalid Code
#> 14 197 Clinical Invalid/Missing Authorization
#> 15 236 Clinical Bundling
#> 16 199 Clinical Billing Error: Invalid Code
#> 17 250 Clinical Additional Information Requested
#> 18 6 Clinical Billing Error: Invalid Code
#> 19 96 Technical Non-Covered Service
#> 20 286 Clinical Medical Necessity
#> # ℹ 38 more rows
#>