tci Part B Insider - 2003 Issue 15

Denial Reasons: Learn The 10 Deadly Sins Of Claim Submission

Part B carrier AdminaStar Federal recently posted a list of the top ten reasons it denied Indiana physician claims in April. Experts say this list reflects common errors across the country. The ten biggest claims problems were:   1) Duplicate claim to ones already processed (reason code 18). This reason accounted for 51 percent of denied claims.  2) The claim should be sent to another payor first (reason code 22). This accounted for 14 percent of denied claims.  3) Missing or invalid UPIN (reason code MA102)  4) The claim doesn't have an appropriate HCPCS modifier (reason...

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