Cancellation & RNB Code Match

2. did not have insurance on the DOS.
3. services where the coded global code splits into technical & professional codes for billing.
6. LCD edit occurred & no other reasons can be assigned from the documentation.
9. has no insurance that covers OPT services.
14. services not billed.
23. has no insurance that covers MH services.
26. defined timeframe for filing the claim after the date of service has already passed.
27. patient has exhausted all of his benefits for year or lifetime under this policy at the time assigned.
28. plan of care is not certified as required.
29. received TX for a condition related to AO.
30. CBOC/Service provided by RN, PT, OT or other ancillary provider at a non-provider based CBOC cannot be billed due to the facility charge requirement.
31. when 2 encounters for the same service appears on the same DOS, to remove bill for 1 encounter, not both.
32. health insurance coverage is a Health Maintenance Organization policy that will not reimburse.
33. health insurance coverage is no longer active. Used when a claim was authorized and a denial was received. No other insurance to bill.

1. statutorily excluded service.
4. received TX for a condition related to SC.
5. was presumed related to service in combat. SC disability has not been determined.
7. services within the global period & therefore not billable.
8. has no insurance that covers vision coverage.
10. received TX for a condition related to MST.
11. least one CPT is not billed as it is a workload code only & no other more specific reason can be used.
12. services not billed.
13. assigned in encounter has no charge but will be updated during the next reasonable charge update. Temporary RNB & must be changed once update is complete.
15. has no insurance that covers dental TX.
16. assigned by coding will not meet the MED. NEC. REQ. of the payer & no other DX can be assigned. A 2nd review may be appropriate.
17. covered 100% by Medicare. No MRA or bill submitted. No secondary responsibility
18. assigned by coding will not meet the MED. NEC. REQ. of the payer & no other DX can be assigned. A 2nd review may be appropriate.
19. or TAX. ID is not available or completely inactive.
20. cannot submit claims to these types of policies.
21. provided by provider that is not covered by the insurance company.
22. has been contacted for a release of 7332 protected health information. Patient refused to consent.
24. policy will not reimburse for VHA services because we do not participate in their network.
25. 7332 PHI AUTH. is on file at the time of assignment.