Remittance Advice Codes for Screening Pelvic Examinations (Rev. 440, 07-05-05)

by  Jared Staheli
June 29th, 2015

If high risk factors are not present, and the screening Pap smear and/or screening pelvic examination is being denied because the procedure/examination is performed more frequently than allowed, use existing ANSI X12N 835:

• Claim adjustment reason code 119 - “Benefit maximum for this time period has been reached” at the line level, and

Remark code M83 - “Service is not covered unless the patient is classified as at high risk.” At the line item level.

References:

Remittance Advice Codes for Screening Pelvic Examinations (Rev. 440, 07-05-05). (2015, June 29). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/remittance-advice-codes-for-screening-pelvic-examinations-rev-440-07-05-05-26969.html

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