Quick Answer: What Does OA 121 Mean?

What does OA mean on an EOB?

Other AdjustmentsOA (Other Adjustments) is used when CO (Contractual Obligation) nor PR (Patient Responsibility apply.

This can be used when the claim is paid in full and there is no contractual obligation or patient responsibility on the claim..

What does PR 204 mean?

PR-204: This service/equipment/drug is not covered under the patient’s current benefit plan.

What does Reason Code OA 23 mean?

OA-23: Indicates the impact of prior payers(s) adjudication, including payments and/or adjustments. No action required since the amount listed as OA-23 is the allowed amount by the primary payer.

What does indemnification adjustment Medicare?

Indemnification adjustment – compensation for outstanding member responsibility. This denial usually occurs when Medicare is the secondary payer. Information may be missing from the primary payer that is required for payment from Medicare.

What is denial code CO 151?

Description. Reason Code: 151. Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.

What does denial code Co 45 mean?

Charges exceedDenial code CO 45: Charges exceed your contracted/legislated fee arrangement. Kindly note this adjustment amount cannot equal the total service or claim charge amount; and must not duplicate provider adjustment amounts (payments and contractual reductions) that have resulted from prior payer(s) adjudication.

What is denial code Co 59?

CO 59 – Processed based on multiple or concurrent procedure rules. Reason and action: This is Multiple surgeries detected, hence confirm with coding guideliness and take the necessity action.

What is a remark code on a claim?

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.

What does group code OA mean?

Group code OA is used when neither PR nor CO applies, such as with the reason code message that indicates the bill is being paid in full.

What does OA 18 mean?

A: You will receive this reason code when more than one claim has been submitted for the same item or service(s) provided to the same beneficiary on the same date(s) of service.

What is denial code Co 97?

Denial Code CO 97 occurs because the benefit for the service or procedure is included in the allowance or payment for another procedure or service that has already been adjudicated.

What does PR 27 mean?

Expenses incurred after coverage terminatedPR-27: Expenses incurred after coverage terminated. • Claim Adjustment Reason Code (CARC) 26: Expenses incurred prior to coverage.

How do I fix Medicare denials?

Know How to Fix DenialsIncrease number of services or units (without an increase in the billed amount)Add/Change/Delete modifiers.Procedure Codes.Place of service.Add or change a diagnosis.Billed amounts (without an increase in the number of unit billed)Change Rendering Provider National Provider Identifier (NPI)More items…•

What does CR mean in medical billing?

Medicare contractors are permitted to use the following group codes: CO Contractual Obligation (provider is financially liable); CR Correction and Reversal (no financial liability);

What does PR 96 mean?

PR 96 Denial Code: Patient Related Concerns When a patient meets and undergoes treatment from an Out-of-Network provider. Based on Provider’s consent bill patient either for the whole billed amount or the carrier’s allowable.

What does PR 22 mean?

Claim Adjustment Reason CodesClaim Adjustment Reason Codes (CARC) CO-22 or PR-22 This care may be covered by another payer per coordination of benefits. CO-19 This is a work-related injury/illness and thus the liability of the Worker’s Compensation Carrier.