wellcare eob explanation codes

The Reimbursement Code Assigned To This Certification Segment Does Not Authorize a NAT Payment. In addition, duplex scan of extracranial arteries, computed tomographic angiography (CTA) of the neck and magnetic resonance angiography (MRA) of the neck are not medically necessary for evaluation of syncope in patients with no suggestion of seizure and no report of other neurologic symptoms or signs. The Members Gait Is Not Functional And Cannot Be Carried Over To Nursing. Indicated Diagnosis Is Not Applicable To Members Sex. Rendering Provider is not a certified provider for . Pricing Adjustment. Restorative Nursing Can Provide Follow-through, Based On Diagnosis Of Long-standing Nature, And The Amount Of Therapy. Multiple Service Location Found For the Billing Provider NPI. Multiple Providers Of Treatment Are Not Indicated For This Member. Quick Tip: In Microsoft Excel, use the " Ctrl + F " search function to look up specific denial codes. Alternatively, the provider has billed a prior inpatient E&M visit, without an inpatient discharge service (CPT 99238-99239) in the interim. WellCare Known Issues List Please be advised: Claims that have either rejected or denied . Claim/adjustment/reconsideration Request Received After 730 Days From Date(s) of Service. Thank You For Your Assessment Interest Payment. One or more Occurrence Code Date(s) is invalid in positions nine through 24. Handwritten Changes/corrections On The Medicare EOMB Are Not Acceptable. For Newly Certified CNAs, Date Of Inclusion Is T heir Test Date. Previously Denied Claims Are To Be Resubmitted As New-day Claims. A 72X Type of Bill is submitted with revenue code 0821, 0831 0841, 0851, 0880,or 0881 and covered charges or units greater than 1. We Have Determined There Were (are) Several Home Health Agencies Willing To Provide Medically Necessary Skilled Nursing Services To This Member. CPT Code And Service Date For Memberis Identical To Another Claim Detail On File For Another WWWP Provider. Denied. According to the American Association of Neuromuscular & Electro-Diagnostic Medicine and CMS Policy, nerve conduction studies and a needle electromyography (EMG) must both be performed in order to diagnose radiculopathy (pinched nerve in back or neck).

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