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At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code.) PI 17 Payment adjusted because requested information was not provided or was insufficient/incomplete. CO 38 Services not provided or authorized by designated (network/primary care) providers.At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code.) OA 18 Duplicate claim/service. CO 39 Services denied at the time authorization/pre-certification was requested.OA 61 Charges adjusted as penalty for failure to obtain second surgical opinion. PI 150 Payment adjusted because the payer deems the information submitted does not support this level of service.PI 151 Payment adjusted because the payer deems the information submitted does not support this many services.Medicare contractors are permitted to use the following group codes: CO Contractual Obligation (provider is financially liable); CR Correction and Reversal (no financial liability); OA Other Adjustment (no financial liability); and PR Patient Responsibility (patient is financially liable).

OA 10 The diagnosis is inconsistent with the patient's gender.PI 152 Payment adjusted because the payer deems the information submitted does not support this length of service.PI 153 Payment adjusted because the payer deems the information submitted does not support this dosage.PI 154 Payment adjusted because the payer deems the information submitted does not support this day's supply.OA 155 This claim is denied because the patient refused the service/procedure.

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