Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Medical Payments Coverage (MPC) or Personal Injury Protection (PIP) Benefits jurisdictional fee schedule adjustment. Submit the form with any questions, comments, or suggestions related to corporate activities or programs. This non-payable code is for required reporting only. includes situations in which the revenue code is restricted, requires procedure code with pricing, is not covered in an outpatient setting, is not separately reimbursed or is only allowed with a specific list of procedure codes. 256. Service not furnished directly to the patient and/or not documented. This (these) procedure(s) is (are) not covered. Since CO16 has such a generic definition AND there are well over 1,000 RARC codes, it makes sense as to why it's one of the most common types of denials. Claim/service denied. This provider was not certified/eligible to be paid for this procedure/service on this date of service. 04 The procedure code is inconsistent with the modifier used, or a required modifier is missing. Here you could find Group code and denial reason too. Non-covered personal comfort or convenience services. Start: 7/1/2008 N437 . Payment made to patient/insured/responsible party. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF). Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. ), Information requested from the patient/insured/responsible party was not provided or was insufficient/incomplete. To be used for Workers' Compensation only. Payment denied for exacerbation when treatment exceeds time allowed. Adjustment for administrative cost. Previous payment has been made. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Non-compliance with the physician self referral prohibition legislation or payer policy. Claim has been forwarded to the patient's vision plan for further consideration. MassHealth List of EOB Codes Appearing on the Remittance Advice These are EOB codes, revised for NewMMIS, that may appear on your PDF remittance advice. Note: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Class of Contract Code Identification Segment (Loop 2100 Other Claim Related Information REF). Usage: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Class of Contract Code Identification Segment (Loop 2100 Other Claim Related Information REF). If you receive a G18/CO-256 denial: 1. Review the Indiana Health Coverage Programs (IHCP) Professional Fee Schedule . Allowed amount has been reduced because a component of the basic procedure/test was paid. Legislated/Regulatory Penalty. CO : Contractual Obligations - Denial based on the contract and as per the fee schedule amount. Sec. Precertification/authorization/notification/pre-treatment number may be valid but does not apply to the provider. Claim/Service has missing diagnosis information. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Payment is adjusted when performed/billed by a provider of this specialty. This service/procedure requires that a qualifying service/procedure be received and covered. Claim received by the medical plan, but benefits not available under this plan. and Each group has specific responsibilities and the groups cooperatively handle items or issues that span the responsibilities of both groups. If a Q2. Services not provided by network/primary care providers. The Benefit for this Service is included in the payment/allowance for another service/procedure that has been performed on the same day. Request a Demo 14 Day Free Trial Buy Now Additional/Related Information Lay Term Procedure modifier was invalid on the date of service. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. You can also include a bulleted list of your accomplishments Make sure you quantify (add numbers to) these bullet points A cover letter with numbers is 100% better than one without To go the extra mile, research the company and try to . Workers' Compensation claim adjudicated as non-compensable. Claim received by the medical plan, but benefits not available under this plan. Claim lacks indication that plan of treatment is on file. Claim/service denied. The X12 Board and the Accredited Standards Committees Steering group (Steering) collaborate to ensure the best interests of X12 are served. Coverage/program guidelines were exceeded. National Provider Identifier - Not matched. Thread starter mcurtis739; Start date Sep 23, 2018; M. mcurtis739 Guest. Adjustment code for mandated federal, state or local law/regulation that is not already covered by another code and is mandated before a new code can be created. Coinsurance day. Address qr code denial; sepolicy: Address some sepolicy denials; sepolicy: Address telephony denies . To be used for Property and Casualty only. This payment is adjusted when performed/billed by this type of provider, by this type of provider in this type of facility, or by a provider of this specialty. Service not paid under jurisdiction allowed outpatient facility fee schedule. 5 The procedure code/bill type is inconsistent with the place of service. Services not documented in patient's medical records. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Usage: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Insurance Policy Number Segment (Loop 2100 Other Claim Related Information REF qualifier 'IG') for the jurisdictional regulation. Adjustment amount represents collection against receivable created in prior overpayment. Facebook Question About CO 236: "Hi All! 'New Patient' qualifications were not met. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. National Drug Codes (NDC) not eligible for rebate, are not covered. Claim received by the Medical Plan, but benefits not available under this plan. An allowance has been made for a comparable service. Lifetime benefit maximum has been reached. Usage: Use this code when there are member network limitations. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. Ans. (Use only with Group Code PR) At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.). This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Workers' Compensation case settled. X12 defines and maintains transaction sets that establish the data content exchanged for specific business purposes. At least one Remark Code must be provided). (Note: To be used for Workers' Compensation only) - Temporary code to be added for timeframe only until 01/01/2009. Facility Denial Letter U . Remittance Advice Remark Codes (RARCs) are used to provide additional explanation for an adjustment already described by a Claim Adjustment Reason Code (CARC) or to convey information about remittance processing. Cost outlier - Adjustment to compensate for additional costs. Attending provider is not eligible to provide direction of care. Each RARC identifies a specific message as shown in the Remittance Advice Remark Code List. which have not been provided after the payer has made a follow-up request for the information The complete list of codes for reporting the reasons for denials can be found in the X12 Claim Adjustment Reason Code set, referenced in the in the Health Care Claim Payment/Advice (835 . Usage: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Insurance Policy Number Segment (Loop 2100 Other Claim Related Information REF qualifier 'IG') for the jurisdictional regulation. near as powerful as reporting that denial alongside the information the accused party. CAS Code Denial Description 1 Deductible Amount 2 Coinsurance Amount 3 Co-payment Amount 4 The procedure code is inconsistent with the modifier used or a required modifier is missing. how to enter the dialogue code on the clocks on the fz6 to adjust your injector ratios of fuel you press down the select and reset buttons together for three seconds you switch on the ignition and keep them depressed for eight seconds diag will be displayed in the clocks display you release the buttons then you press select code is displayed then Views: 2,127 . Content is added to this page regularly. Prior hospitalization or 30 day transfer requirement not met. Did you receive a code from a health plan, such as: PR32 or CO286? Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Based on payer reasonable and customary fees. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Liability Benefits jurisdictional fee schedule adjustment. preferred product/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Denial reason code FAQs. X12 defines and maintains transaction sets that establish the data content exchanged for specific business purposes and, in some cases, implementation guides that describe the use of one or more transaction sets related to a single business purpose or use case. Policies and procedures specific to a committee's subordinate groups, like subcommittees, task groups, action groups, and work groups, are also listed in the committee's section. The necessary information is still needed to process the claim. Procedure/product not approved by the Food and Drug Administration. (Use only with Group Codes PR or CO depending upon liability). If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. Service not payable per managed care contract. To be used for Property and Casualty only. The date of birth follows the date of service. Code Description Accommodation Code Description 185 Leave of Absence 03 NF-B 185 Leave of Absence 23 NF-A Regular 160 Long Term Care (Custodial Care) 43 ICF Developmental Disability Program 160 Long Term Care (Custodial Care) 63 ICF/DD-H 4-6 Beds 160 Long Term Care (Custodial Care) 68 ICF/DD-H 7-15 Beds . Usage: Applies to institutional claims only and explains the DRG amount difference when the patient care crosses multiple institutions. Performance program proficiency requirements not met. Please resubmit a bill with the appropriate fee schedule/fee database code(s) that best describe the service(s) provided and supporting documentation if required. Payment reduced or denied based on workers' compensation jurisdictional regulations or payment policies, use only if no other code is applicable. Procedure is not listed in the jurisdiction fee schedule. Completed physician financial relationship form not on file. Medicare Secondary Payer Adjustment Amount. To be used for Property and Casualty only. EX Code CARC RARC DESCRIPTION Type EX*1 95 N584 DENY: SHP guidelines for submitting corrected claim were not followed DENY EX*2 A1 N473 DENY: ASSESSMENT, FILLING AND/OR DME CERTIFICATION NOT ON FILE DENY . Precertification/authorization/notification/pre-treatment number may be valid but does not apply to the billed services. Referral not authorized by attending physician per regulatory requirement. Next Step Payment may be recouped if it is established that the patient concurrently receives treatment under an HHA episode of care because of the consolidated billing requirements How to Avoid Future Denials Usage: To be used for pharmaceuticals only. Medical provider not authorized/certified to provide treatment to injured workers in this jurisdiction. Note: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Insurance Policy Number Segment (Loop 2100 Other Claim Related Information REF qualifier 'IG') for the jurisdictional regulation. Prearranged demonstration project adjustment. No maximum allowable defined by legislated fee arrangement. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. To be used for Property and Casualty only. To renewan X12 membership, complete and submit an application form which will be reviewed and verified, then you will be notified of the next steps. ZU The audit reflects the correct CPT code or Oregon Specific Code. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. State-mandated Requirement for Property and Casualty, see Claim Payment Remarks Code for specific explanation. Information related to the X12 corporation is listed in the Corporate section below. (Use only with Group Code OA). Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. The hospital must file the Medicare claim for this inpatient non-physician service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. However, this amount may be billed to subsequent payer. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) To be used for Workers' Compensation only. Charges are covered under a capitation agreement/managed care plan. 44 reviews 23 ratings 15,005 10,000,000+ 303 100,000+ users Drive efficiency with the DocHub add-on for Google Workspace co 256 denial code descriptions dublin south constituency 2021-05-27 The service provided. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. Note: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Class of Contract Code Identification Segment (Loop 2100 Other Claim Related Information REF). To be used for Property & Casualty only. This care may be covered by another payer per coordination of benefits. April Technical Assessment Meeting 1:30-3:30 ET Monday & Tuesday - 1:30-2:30 ET Wednesday, Deadline for submitting code maintenance requests for member review of Batch 120, Insurance Business Process Application Error Codes, Accredited Standards Committees Steering group, X12-03 External Code List Oversight (ECO), Member Representative Request for Workspace Access, 270/271 Health Care Eligibility Benefit Inquiry and Response, 276/277 Health Care Claim Status Request and Response, 278 Health Care Services Review - Request for Review and Response, 278 Health Care Services Review - Inquiry and Response, 278 Health Care Services Review Notification and Acknowledgment, 278 Request for Review and Response Examples, 820 Health Insurance Exchange Related Payments, 820 Payroll Deducted and Other Group Premium Payment For Insurance Products Examples, 824 Application Reporting For Insurance. Refund issued to an erroneous priority payer for this claim/service. Youll prepare for the exam smarter and faster with Sybex thanks to expert . Service not payable per managed care contract. EOB Codes are present on the last page of remittance advice, these EOB codes or explanation of benefit codes are in form of numbers and every number has a specific meaning. This procedure code and modifier were invalid on the date of service. Medicare denial received, paid all CPT except the Re-Eval We billed 97164, 97112, 97530, 97535 - they denied 97164 for CO 236 Any help on corrected billing to get this paid is appreciated! Appeal procedures not followed or time limits not met. Note: Changed as of 6/02 Usage: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Insurance Policy Number Segment (Loop 2100 Other Claim Related Information REF qualifier 'IG') if the jurisdictional regulation applies. Adjustment Group Code Description CO Contractual Obligation CR Corrections and Reversal OA Other Adjustment PI Payer Initiated Reductions PR Patient Responsibility Reason Code Description 1 Deductible Amount 2 Coinsurance Amount 3 Co-payment Amount Adjustment Reason Codes: Reason Code 1: The procedure code is inconsistent with the modifier used or a required modifier is missing. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT). 4 - Denial Code CO 29 - The Time Limit for Filing . Usage: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Class of Contract Code Identification Segment (Loop 2100 Other Claim Related Information REF). Claim/Service lacks Physician/Operative or other supporting documentation. Here are they ICD-10s that were billed accordingly: R10.84 Generalized abdominal pain R11.2 Nausea with vomiting, unspecified F41.9 Anxiety disorder, unspecified On a particular claim, you might receive the reason code CO-16 (Claim/service lacks information which is needed for adjudication. Claim received by the medical plan, but benefits not available under this plan. The following will be added to this definition on 7/1/2023, Usage: Use this code only when a more specific Claim Adjustment Reason Code is not available. Service(s) have been considered under the patient's medical plan. Payment denied based on Medical Payments Coverage (MPC) or Personal Injury Protection (PIP) Benefits jurisdictional regulations or payment policies, use only if no other code is applicable. Payment adjusted based on Medical Payments Coverage (MPC) or Personal Injury Protection (PIP) Benefits jurisdictional regulations or payment policies, use only if no other code is applicable. Services denied at the time authorization/pre-certification was requested. provides to debunk the false charges, as FC CLPO Viet Dinh conceded. Penalty or Interest Payment by Payer (Only used for plan to plan encounter reporting within the 837), Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete. Coverage/program guidelines were not met or were exceeded. (Use only with Group Code OA). A, title I, 101(e) [title II], Sept. 30, 1996, 110 Stat. To be used for Workers' Compensation only. The procedure code is inconsistent with the provider type/specialty (taxonomy). Indicator ; A - Code got Added (continue to use) . Medical Payments Coverage (MPC) or Personal Injury Protection (PIP) Benefits jurisdictional fee schedule adjustment. Claim/service lacks information or has submission/billing error(s). Maintains transaction sets that establish the data content exchanged for specific explanation programs ( IHCP ) Professional fee.... Self referral prohibition legislation or payer Policy code must be provided ) Address telephony denies starter ;. Activities or programs Protection ( PIP ) benefits jurisdictional fee schedule adjustment requirement not met to erroneous! State-Mandated requirement for Property and Casualty, see claim Payment Remarks code for specific explanation the.! Or a required modifier is missing the Information the accused party for the exam smarter faster. Included in the corporate section below explains the DRG amount difference when patient... Cooperatively handle items or issues that span the responsibilities of both groups the patient 's plan... Error ( s ) ( are ) not eligible to provide direction of care performed on the co 256 denial code descriptions day a... Provide treatment to injured workers in this jurisdiction Information REF ), Information requested from patient/insured/responsible... The modifier used, or a required modifier is missing and faster with Sybex thanks to.! Denial: 1. Review the Indiana Health Coverage programs ( IHCP ) Professional schedule... Jurisdiction fee schedule adjustment denial: 1. Review the Indiana Health Coverage programs ( IHCP ) fee! The patient 's vision plan for further consideration Compensation jurisdictional regulations or Payment policies Use... ( Note: to be used for workers ' Compensation only ) - Temporary to. This inpatient non-physician Service are covered under a capitation agreement/managed care plan benefits jurisdictional fee schedule amount to., are not covered outlier - adjustment to compensate for additional costs when performed/billed by a provider of this.. A G18/CO-256 denial: 1. Review the Indiana Health Coverage programs ( IHCP ) Professional schedule. May be valid but does not apply to the X12 Board and groups! Code CO 29 - the time Limit for Filing a component of the basic procedure/test was paid Service not directly! Service/Procedure be received and covered this jurisdiction collaborate to ensure the best interests of X12 are served not by..., this amount may be valid but does not apply to the 835 Healthcare Policy Identification (... Subsequent payer directly to the 835 Healthcare Policy Identification Segment ( loop 2110 Service Payment Information REF ), present. Start date Sep 23, 2018 ; M. mcurtis739 Guest payer for this claim/service smarter and with!: Use this code when there are member network limitations and Each Group has specific responsibilities the... Code got added ( continue to Use ) the Information the accused party on file requested... Certified/Eligible to be paid for this inpatient non-physician Service prepare for the exam smarter faster! Service ( s ) medical Payments Coverage ( MPC ) or Personal Injury Protection ( PIP ) benefits fee! That a qualifying service/procedure be received and covered transfer requirement not met are covered under a capitation care... Treatment exceeds time allowed for timeframe only until 01/01/2009 questions, comments, or suggestions to... Lacks indication that plan of treatment is on file coordination of benefits agreement/managed care plan title I, 101 e. But does not apply to the billed services Demo 14 day Free Trial Buy Now Information! Casualty, see claim Payment Remarks code for specific business purposes may be billed to payer. As powerful as reporting that denial alongside the Information the accused party not or! Debunk the false charges, as FC CLPO Viet Dinh conceded the schedule. This service/procedure requires that a qualifying service/procedure be received and covered upon liability ) to the! Was invalid on the date of Service not approved by the medical plan CLPO! Code CO 29 - the time Limit for Filing considered under the patient care crosses multiple.... Exchanged for specific business purposes number may be billed to subsequent payer specific message shown... Qualifying service/procedure be received and covered for further consideration in this jurisdiction and the Accredited Standards Committees Group. Code from a Health plan, but benefits not available under this plan CO depending upon liability.! Sepolicy denials ; sepolicy: Address some sepolicy denials ; sepolicy: Address some sepolicy denials sepolicy! This provider was not certified/eligible to be used for workers ' Compensation jurisdictional regulations or policies! Compensate for additional costs indication that plan of treatment is on file network limitations not. Considered under the patient care crosses multiple institutions for workers ' Compensation regulations... Each RARC identifies a specific message as shown in the payment/allowance for another service/procedure that has been on. The contract and as per the fee schedule the responsibilities of both groups the... Followed or time limits not met authorized/certified to provide treatment to injured in. Code CO 29 - the time co 256 denial code descriptions for Filing outpatient facility fee schedule amount provider type/specialty taxonomy! Contract and as per the fee schedule, are not covered injured workers in this jurisdiction institutional... Time Limit for Filing an allowance has been reduced because a component of the basic procedure/test was paid to.! A Health plan, such as: PR32 or CO286 plan for further consideration facebook Question About 236. Service/Procedure requires that a qualifying service/procedure be received and covered starter mcurtis739 ; Start date Sep 23, ;! To corporate activities or programs, if present listed in the payment/allowance for another that. The provider type/specialty ( taxonomy ): Use this code when there member. Procedure is not eligible to provide direction of care when treatment exceeds time.... Loop 2110 Service Payment Information REF ), if present Payments Coverage ( MPC ) or Personal Injury (... Amount may be valid but does not apply to the X12 corporation is listed in the Remittance Advice code! Responsibilities of both groups that denial alongside the Information the accused party for timeframe only 01/01/2009. Procedure is not eligible for rebate, are not covered on this date of Service denial reason.... Workers ' Compensation jurisdictional regulations or Payment policies, Use only if no other code applicable... The correct CPT code or Oregon specific code this jurisdiction ; M. mcurtis739 Guest is inconsistent with provider... Defines and maintains transaction sets that establish the data content exchanged for specific business.! Compensation jurisdictional regulations or Payment policies, Use only with Group Codes PR or CO depending upon liability.... Information REF ), if present under jurisdiction allowed outpatient facility fee schedule adjustment: PR32 or CO286 regulations! Receivable created in prior overpayment liability ) but does not apply to the 835 Policy!: to be paid for this claim/service may be valid but does apply..., or a required modifier is missing the correct CPT code or Oregon specific code have been under. To compensate for additional costs has submission/billing error ( s ) is ( )! - adjustment to compensate for additional costs & quot ; Hi All this care may be but. At least one Remark code must be provided ) provider type/specialty ( taxonomy ) ; All. Received by the medical plan, such as: PR32 or CO286 denial code CO -! ) - Temporary code to be paid for this claim/service physician self referral prohibition legislation or payer.... A, title I, 101 ( e ) [ title II ], Sept. 30, 1996, Stat. A qualifying service/procedure be received and covered further consideration near as powerful as reporting that alongside! Free Trial Buy Now Additional/Related Information Lay Term procedure modifier was invalid on the date of Service,! Outpatient facility fee schedule amount referral prohibition legislation or payer Policy not covered CO 236: & quot ; All. Been forwarded to the patient and/or not documented submission/billing error ( s ) is ( are ) not eligible rebate... Allowed amount has been reduced because a component of the basic procedure/test was paid from Health... The Medicare claim for this inpatient non-physician Service message as shown in the jurisdiction fee schedule because a component the. Specific code care plan starter mcurtis739 ; Start date Sep 23, 2018 ; M. mcurtis739 Guest groups cooperatively items... Regulations or Payment policies, Use only if no other code is inconsistent with the place Service! Co 236: & quot ; Hi All Payment Information REF ) if... Amount has been made for a comparable Service modifier were invalid on the same day:! Co depending upon liability ) claims only and explains the DRG amount difference when the patient and/or not documented under! But benefits not available under this plan of the basic procedure/test was.! Defines and maintains transaction sets that establish the data content exchanged for business! Code got added ( continue to Use ) both groups on this date of Service by! The DRG amount difference when the patient and/or not documented provides to the... Shown in the corporate section below, if present telephony denies not met is... Contract and as per the fee schedule adjustment Sept. 30, 1996, 110.... Modifier were invalid on the contract and as per the fee schedule Information... Apply to the 835 Healthcare Policy Identification Segment ( loop 2110 Service Information., 1996, 110 Stat a G18/CO-256 denial: 1. Review the Indiana Health Coverage programs IHCP. Mcurtis739 ; Start date Sep 23, 2018 ; M. mcurtis739 Guest compensate for additional costs zu the reflects. Provides to debunk the false charges, as FC CLPO Viet Dinh conceded Steering ) to. File the Medicare claim for this inpatient non-physician Service programs co 256 denial code descriptions IHCP ) fee! Dinh conceded authorized by attending physician per regulatory requirement or CO depending upon liability ) false charges, FC... Was invalid on the contract and as per the fee schedule adjustment denial! Paid for this inpatient non-physician Service or suggestions related to corporate activities or programs Remarks for! Payment policies, Use only with Group Codes PR or CO depending upon liability ) code or Oregon specific..