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[]
["EDIT","EDIT DESC","EOB","EOB DESC","CARC","CARC DESC","RARC","RARC DESC"]
[4059,"REVENUE CODE NOT ON FILE","0136","REVENUE CODE IS INVALID/NOT ON FILE",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","M50","Missing/incomplete/invalid revenue code(s)."]
[264,"THE DATE OF SERVICE IS MISSING","0006","SERVICE FROM DATE IS MISSING OR INVALID",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","M52","Missing/incomplete/invalid from date(s) of service."]
[514,"HEADER THRU DATE OF SERVICE AFTER ICN DATE","0034","SERVICE DATE GREATER THAN DATE OF SYS GEN ICN",110,"Billing date predates service date.","M52","Missing/incomplete/invalid from date(s) of service."]
[574,"SERVICE DATES ARE NOT IN SAME MONTH","2004","SERVICE DATES ARE NOT IN SAME MONTH",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","M52","Missing/incomplete/invalid from date(s) of service."]
[508,"TOTAL CHARGE DOES NOT EQUAL THE SM OF ALL LINE C","0274","TOTAL BILLED NOT EQUAL SUM OF ALL LINE CHARGES",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","M54","Missing/incomplete/invalid total charges."]
[4041,"SECONDARY DIAGNOSIS CODE NOT ON FILE","1325","INVALID SECONDARY/TERTIARY DIAGNOSIS CODE",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","M64","Missing/incomplete/invalid other diagnosis."]
[4252,"DX CODE 10-24 NOT ON FILE","4252","DIAGNOSIS CODE 10-24 NOT ON FILE",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","M64","Missing/incomplete/invalid other diagnosis."]
[546,"TYPE OF BILL INVALID FOR RECIPIENT LEVEL OF CARE","3049","INVALID TYPE OF BILL FOR RECIPIENT LEVEL OF CARE",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","MA30","Missing/incomplete/invalid type of bill."]
[507,"THE \"FROM\" DATE IS AFTER THE \"TO\" DATE","0008","SERVICE \"TO\" DATE LESS THAN SERVICE \"FROM\" DATE",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","MA31","Missing/incomplete/invalid beginning and ending dates of the period billed."]
[282,"COVERED DAYS MISSING OR INVALID","0047","COVERED DAYS ARE MISSING OR INVALID",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","MA32","Missing/incomplete/invalid number of covered days during the billing period."]
[518,"COVERED/NONCOVRED DAYS DO NOT EQUAL DOS BILLED","0046","COVERED DAYS AND FROM/THRU DAYS ARE NOT EQUAL.",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","MA32","Missing/incomplete/invalid number of covered days during the billing period."]
[646,"NON-COVERED DAYS INVALID","0059","INVALID NON-COVERED DAYS",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","MA33","Missing/incomplete/invalid noncovered days during the billing period."]
[513,"RECIPIENT NAME AND NUMBER DISAGREE","0222","RECIPIENT NAME DOES NOT MATCH TENNCARE NUMBER",16,"Claim/service lacks information or has submission/billing error(s). ","MA36","Missing/incomplete/invalid patient name."]
[275,"ADMIT DATE MISSING","0043","ADMISSION DATE INVALID OR MISSING",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","MA40","Missing/incomplete/invalid admission date."]
[276,"ADMIT DATE INVALID","0043","ADMISSION DATE INVALID OR MISSING",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","MA40","Missing/incomplete/invalid admission date."]
[278,"ADMIT TYPE MISSING","0057","TYPE OF ADMISSION IS INVALID OR MISSING",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","MA41","Missing/incomplete/invalid admission type."]
[279,"ADMIT TYPE IS INVALID","0057","TYPE OF ADMISSION IS INVALID OR MISSING",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","MA41","Missing/incomplete/invalid admission type."]
[229,"INVALID SOURCE OF ADMISSION","0049","SOURCE OF ADMISSION IS INVALID OR MISSING",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","MA42","Missing/incomplete/invalid admission source."]
[4040,"PRIMARY DIAGNOSIS CODE NOT ON FILE","0018","DIAGNOSIS CODE IS MISSING OR INVALID",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","MA63","Missing/incomplete/invalid principal diagnosis."]
[5014,"EXACT DUPLICATE - DETAIL","5014","THIS IS A DUPLICATE OF ANOTHER CLAIM",18,"Exact duplicate claim/service ","N112","This claim is excluded from your electronic remittance advice."]
[513,"RECIPIENT NAME AND NUMBER DISAGREE","9999","PROCESSED PER MEDICAID POLICY...",59,"Processed based on multiple or concurrent procedure rules.","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[514,"HEADER THRU DATE OF SERVICE AFTER ICN DATE","9999","PROCESSED PER MEDICAID POLICY...",59,"Processed based on multiple or concurrent procedure rules.","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[558,"SERVICE RESTRICTED TO MONDAY THRU FRIDAY","0558","SERVICE RESTRICTED TO MONDAY THRU FRIDAY","A1","Claim/Service denied. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[1012,"PROV SPECIALTY INELIGIBLE TO RENDER PROC CODE","9999","PROCESSED PER MEDICAID POLICY...",59,"Processed based on multiple or concurrent procedure rules.","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[1020,"ATTENDING PHYSICIAN ID NUMBER NOT ON FILE","9999","PROCESSED PER MEDICAID POLICY...",59,"Processed based on multiple or concurrent procedure rules.","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[2033,"RECIP PGM DOES NOT COVER SVCS BILLED ON CLAIM TYPE","9999","PROCESSED PER MEDICAID POLICY...",59,"Processed based on multiple or concurrent procedure rules.","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[4018,"PROC CODE TYPE SITTER - CONV. CARE - NOT ALLOWED","4018","PROC CODE TYPE SITTER - CONV. CARE - NOT ALLOWED",96,"Non-covered charge(s). ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[5549,"CHOICES HOME SRVS CONFLICT AGAINST HCBS FFS","5549","CHOICES HOME SERVICES CONFLICT AGAINST HCBS FFS",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[5550,"NURSING SVC DURING MEDICAL RES SVC","5550","NURSING SVC DURING MEDICAL RES SVC",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[5551,"IBRS SERVICE DURING BEHAVIORAL SVC","5551","IBRS SVC DURING BEHAVIORAL SVC",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[5552,"SIL VS SPECIFIED SUPPORT SERVICES","5552","SIL VS SPECIFIED SUPPORT SERVICES",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[5556,"IE&CP NOT ALLOWED WITH FBS, MED RES & RESP3 SVCS","5556","IE&CP NOT ALLOWED WITH FBS, MED RES & RESP3 SVCS",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[5557,"RSNA-H & NR-HS NOT ALLOWED WITH EMPLOYMENT SVCS","5557","RSNA-H & NR-HS NOT ALLOWED WITH EMPLOYMENT SVCS",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[5558,"DAILY SIL LIMIT","5558","DAILY SIL LIMIT",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[5610,"CP & SE NOT ALLOWED WITH MED RES & RESP 3 SVCS","5610","CP & SE NOT ALLOWED WITH MED RES & RESP 3 SVCS",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[5611,"SE-IND NOT ALLOWED WITH RESP3 SVCS","5611","SE-IND NOT ALLOWED WITH RESP3 SVCS",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[6712,"SIL ENHANCED TRANSITION DAY LIMIT","6712","SIL ENHANCED TRANSITION DAY LIMIT",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[6713,"SIL TRANSITION INCENTIVE PAYMENT","6713","SIL TRANSITION INCENTIVE PAYMENT",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[6786,"ANNUAL EMPLOYMENT & DAY SERVICES","6786","ANNUAL EMPLOYMENT & DAY SERVICES",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[6787,"SE INDIVIDUAL STABILIZATION & MONITORING EXCEEDED","6787","SE INDIVIDUAL STABILIZATION & MONITORING EXCEEDED",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[6788,"SPECIAL NEEDS ADJ LIMIT EXCEEDED","6788","SPECIAL NEEDS ADJ LIMIT EXCEEDED",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[6789,"SE QUALITY INCENTIVE LIMIT EXCEEDED","6789","SE QUALITY INCENTIVE LIMIT EXCEEDED",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[6790,"JOB DEVELOPMENT SERVICES EXCEEDED","6790","JOB DEVELOPMENT SERVICES EXCEEDED",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[6791,"14-DAY EMPLOYMENT & DAY SERVICES LIMIT EXCEEDED","6791","14-DAY EMPLOYMENT & DAY SERVICES LIMIT EXCEEDED",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[6792,"IE & CP WRAPAROUND ANNUAL LIMIT EXCEEDED","6792","IE & CP WRAPAROUND ANNUAL LIMIT EXCEEDED",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[6793,"14-DAY IE & COMMUNITY PARTICIPATION WRAPAROUND","6793","14-DAY IE & CP PARTICIPATION WRAPAROUND",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. ","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[7500,"BILLING PROVIDER ON REVIEW OR RESTRICTIONS APPLY","9999","PROCESSED PER MEDICAID POLICY...",59,"Processed based on multiple or concurrent procedure rules.","N130","Consult plan benefit documents/guidelines for information about restrictions for this service."]
[5520,"RES HAB INSTATE SRV DURING OUT OF STATE SRV","5520","RESIDENTIAL HABILITATION INSTATE SERVICE CANNOT BILL SAME TIME AS OUT OF STATE",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5521,"MED RES INSTATE SRV DURING OUT OF STATE SRV","5521","MEDICAL RESIDENTIAL INSTATE SERVICE CANNOT BILL SAME TIME AS OUT OF STATE MEDIC",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5522,"FAM RES INSTATE SRV DURING OUT OF STATE SRV","5522","FAMILY RESIDENTIAL INSTATE SERVICE CANNOT BILL SAME TIME AS OUT OF STATE",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5523,"SUPP LV(T2031) INSTATE SRV DURING OUT OF STATE SRV","5523","SUPPORTED LIVING(T2031) INSTATE SERVICE CANNOT BILL SAME TIME AS OUT OF STATE S",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5524,"SUPP LV(T2033) INSTATE SRV DURING OUT OF STATE SRV","5524","SUPPORTED LIVING(T2033) INSTATE SERVICE CANNOT BILL SAME TIME AS OUT OF STATE S",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5525,"PER. ASST(S9122) SRV DURING PER. ASST(T1020) SRV","5525","PERSONAL ASSISTANCE(S9122) SERVICE CANNOT BILL SAME TIME AS PERSONAL ASSISTANCE",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5526,"DAY SERVICES CONFLICT W/SUPPORTED EMPLOYMENT LVL 5","5526","DAY SRVS/FACILITY BASED SERVICES CANNOT BILL DURING DAY SRVS/SUPPORTED EMPLOYME",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5527,"RESPITE IN-HOME SRV DURING RESPITE SITTER SRV","5527","RESPITE(IN THE HOME) SERVICE CANNOT BILL SAME TIME AS RESPITE(SITTER) SERVICE",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5528,"SUPP LIVING SERVICES NOT ALLOWED ON SAME DOS","5528","SUPP LIVING SERVICES NOT ALLOWED ON SAME DOS",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5529,"PER AST INSTATE SRV DURING OUT OF STATE SRV","5529","PERSONAL ASSISTANCE(S9122) INSTATE SERVICE CANNOT BILL SAME TIME AS OUT OF STAT",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5530,"PER AST INSTATE SRV DURING OUT OF STATE SRV","5530","PERSONAL ASSISTANCE(T1020) INSTATE SERVICE CANNOT BILL SAME TIME AS OUT OF STAT",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5531,"RESPITE IN-HOME SRV DURING RESPITE SITTER SRV","5527","RESPITE(IN THE HOME) SERVICE CANNOT BILL SAME TIME AS RESPITE(SITTER) SERVICE",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5532,"PER AST INSTATE STAFF DURING OUT OF STATE STAFF","5532","PERSONAL ASSISTANCE(T1019) INSTATE STAFF SERVICE CANNOT BILL SAME TIME AS OUT O",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5533,"PER. ASST(T1019) SRV DURING PER. ASST(T1020) SRV","5533","PERSONAL ASSISTANCE(T1019) SERVICE CANNOT BILL SAME TIME AS PERSONAL ASSISTANCE",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5534,"DAY SERVICES DURING RESPITE/MED. RES. SRV","5534","DAY SERVICES CANNOT BILL DURING RESPITE/MEDICAL RESIDENTIAL SERVICES",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5535,"NUTRITION RATE SVC DURING OTHER NUTRITION SVCS","5535","NUTRITION RATE(S9470) SERVICE CANNOT BILL SAME TIME AS OTHER NUTRITION ASSESSME",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5536,"OCC THER RATE SVC DURING OTHER  OCC THER SVCS","5536","OCCUPATIONAL THERAPY RATE(G0152) SERVICE CANNOT BILL SAME TIME AS OTHER OCC. TH",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5537,"ORIENTATION MOB. RATE SVC DURING OTHER OR. MOB SVC","5537","ORIENTATION & MOBILITY TRAINING RATE(H2014) SERVICE CANNOT BILL SAME TIME AS OT",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5538,"PHYS THER RATE SVC DURING OTHER  PHYS THER SVCS","5538","PHYSICAL THERAPY RATE(G0151) SERVICE CANNOT BILL SAME TIME AS OTHER PHYSICAL TH",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[5539,"SPEECH LANG HEAR RATE SVC DURING OTHER S, L H  SVC","5539","SPEECH, LANGUAGE & HEARING RATE(G0153) SERVICE CANNOT BILL SAME TIME AS OTHER S",96,"Non-covered charge(s). ","N20","Service not payable with other service rendered on the same date."]
[2036,"RECIP BENEFIT PLAN AND PROV BENEFIT PLAN MISMATCH","2036","RECIP BENEFIT PLAN AND PROVIDER BENEFIT PLAN MISMATCH","A1","Claim/Service denied.","N216","We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package."]
[1214,"TAXONOMY DOES NOT MATCH ATTENDING PROVIDER","1214","TAXONOMY DOES NOT MATCH MATCHED FOR ATTENDING PROVIDER ON HEADER",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","N251","Missing/incomplete/invalid attending provider taxonomy."]
[1216,"TAXONOMY DOES NOT MATCH ATTENDING PROVIDER","1216","TAXONOMY DOES NOT MATCH MATCHED FOR ATTENDING PROVIDER ON DETAIL",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","N251","Missing/incomplete/invalid attending provider taxonomy."]
[382,"ATTENDING PHYSICIAN ID/DMRS FACILITY INVALID","0029","ATTENDING PHYSICIAN/DMRS FACILITY INVALID OR MISSING",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N253","Missing/incomplete/invalid attending provider primary identifier."]
[1020,"ATTENDING PHYSICIAN ID NUMBER NOT ON FILE","0029","ATTENDING PHYSICIAN/DMRS FACILITY INVALID OR MISSING",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N253","Missing/incomplete/invalid attending provider primary identifier."]
[1227,"ATTENDING PROVIDER NPI NOT SUBMITTED - HDR","1227","ATTENDING PROVIDER NPI NOT SUBMITTED ON XOVER-HDR",206,"National Provider Identifier - missing.","N253","Missing/incomplete/invalid attending provider primary identifier."]
[1228,"ATTENDING PROVIDER NPI NOT SUBMITTED - DTL","1228","ATTENDING PROVIDER NPI NOT SUBMITTED - DTL",206,"National Provider Identifier - missing.","N253","Missing/incomplete/invalid attending provider primary identifier."]
[1234,"ATTENDING NPI NOT MATCHED FOR SELECTED PROV","1234","ATTENDING NPI NOT MATCHED FOR SELECTED PROV",208,"National Provider Identifier - Not matched.","N253","Missing/incomplete/invalid attending provider primary identifier."]
[1284,"ATTENDING NPI NOT SUBMITTED/VALID/ON FILE-HDR","1284","ATTENDING NPI NOT SUBMITTED/VALID/ON FILE",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N253","Missing/incomplete/invalid attending provider primary identifier."]
[1209,"TAXONOMY DOES NOT MATCH BILLING PROVIDER","1209","TAXONOMY DOES NOT MATCH MATCHED FOR BILLING PROVIDER ON HEADER",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N255","Missing/incomplete/invalid billing provider taxonomy."]
[720,"BILLING NPI INVALID - HDR","1720","BILLING NPI INVALID - HDR",207,"National Provider identifier - Invalid format","N257","Missing/incomplete/invalid billing provider/supplier primary identifier."]
[1222,"NPI NUMBER EXPECTED FOR BILLING PROVIDER","1222","BILLING PROVIDER NPI NOT SUBMITTED ON XOVER",206,"National Provider Identifier - missing.","N257","Missing/incomplete/invalid billing provider/supplier primary identifier."]
[1231,"NPI NOT MATCH BILLING","1231","NPI NOT MATCH BILLING",208,"National Provider Identifier - Not matched.","N257","Missing/incomplete/invalid billing provider/supplier primary identifier."]
[1221,"ZIPCODE DOES NOT MATCH FOR BILLING PROVIDER","1221","ZIPCODE DOES NOT MATCH THE BILLING PROVIDER",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N258","Missing/incomplete/invalid billing provider/supplier address."]
[1226,"MULTIPLE BILLING PROVIDERS MATCH","1226","MULTIPLE BILLING PROVIDERS MATCH",226,"Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete.","N259","Missing/incomplete/invalid billing provider/supplier secondary identifier."]
[4014,"NO PRICING SEGMENT ON FILE","0241","PRICING FILE HAS NO VALID PRICE OR PERCENTAGE OR PER DIEM FOR DOS",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N261","Missing/incomplete/invalid operating provider name."]
[1248,"OTHER PROVIDER NPI NOT SUBMITTED","1248","OTHER PROVIDER NPI NOT SUBMITTED",206,"National Provider Identifier - missing.","N270","Missing/incomplete/invalid other provider primary identifier."]
[1218,"TAXONOMY DOES NOT MATCH OTHER PROVIDER","1218","TAXONOMY DOES NOT MATCH FOUND OTHER PROV ON DETAIL",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N271","Missing/incomplete/invalid other provider secondary identifier."]
[1219,"TAXONOMY DOES NOT MATCH OTHER PROVIDER","1219","TAXONOMY DOES NOT MATCH FOUND OTHER PROV ON DETAIL",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N271","Missing/incomplete/invalid other provider secondary identifier."]
[255,"BILLING PROVIDER LOCATION CODE INVALID","0244","INVALID PAY-TO PROVIDER NUMBER",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","N280","Missing/incomplete/invalid pay-to provider primary identifier."]
[1212,"TAXONOMY DOES NOT MATCH REFERRING PROVIDER","1212","TAXONOMY DOES NOT MATCH MATCHED FOR REFERRING PROVIDER ON HEADER",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N284","Missing/incomplete/invalid referring provider taxonomy."]
[1213,"TAXONOMY DOES NOT MATCH REFERRING PROVIDER","1213","TAXONOMY DOES NOT MATCH MATCHED FOR REFERRING PROVIDER ON DETAIL",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N284","Missing/incomplete/invalid referring provider taxonomy."]
[1233,"ATTENDING NPI NOT MATCHED FOR SELECTED PROV","1233","ATTENDING NPI NOT MATCHED FOR SELECTED PROV",208,"National Provider Identifier - Not matched.","N286","Missing/incomplete/invalid referring provider primary identifier."]
[1095,"RENDERING PROVIDER TAXONOMY DOES NOT MATCH CLAIM H","1095","RENDERING PROVIDER TAXONOMY DOES NOT MATCH CLAIM HDR",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N288","Missing/incomplete/invalid rendering provider taxonomy."]
[1210,"TAXONOMY DOES NOT MATCH RENDERING PROVIDER","1210","TAXONOMY DOES NOT MATCH MATCHED FOR RENDERING PROVIDER ON HEADER",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N288","Missing/incomplete/invalid rendering provider taxonomy."]
[1211,"TAXONOMY DOES NOT MATCH RENDERING PROVIDER","1211","TAXONOMY DOES NOT MATCH MATCHED FOR RENDERING PROVIDER ON DETAIL",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","N288","Missing/incomplete/invalid rendering provider taxonomy."]
[1093,"RENDERING PROVIDER MEDICAID ID DOES NOT MATCH CLAI","1093","RENDERING PROVIDER MEDICAID ID DOES NOT MATCH CLAIM HD",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N290","Missing/incomplete/invalid rendering provider primary identifier."]
[1223,"RENDERING PROVIDER NPI NOT SUBMITTED - HDR","1223","RENDERING PROVIDER NPI NOT SUBMITTED ON XOVER-HDR",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","N290","Missing/incomplete/invalid rendering provider primary identifier."]
[1225,"RENDERING PROVIDER NPI NOT SUBMITTED - DTL","1225","RENDERING PROVIDER NPI NOT SUBMITTED ON XOVER-DTL",206,"National Provider Identifier - missing.","N290","Missing/incomplete/invalid rendering provider primary identifier."]
[1232,"RENDERING NPI NOT MATCHED FOR SELECTED PROV","1232","RENDERING NPI NOT MATCHED FOR SELECTED PROV",208,"National Provider Identifier - Not matched.","N290","Missing/incomplete/invalid rendering provider primary identifier."]
[1224,"FACILITY PROVIDER NPI NOT SUBMITTED - HDR","1224","FACILITY PROVIDER NPI NOT SUBMITTED ON XOVER-HDR",206,"National Provider Identifier - missing.","N293","Missing/incomplete/invalid service facility primary identifier."]
[1019,"MULTIPLE LEVELS OF CARE ON FILE","1019","RECIPIENT HAS MULTIPLE LEVELS OF CARE ON FILE",96,"Non-covered charge(s). ","N30","Patient ineligible for this service."]
[2008,"NO PAE AVAILABLE FOR TENNCARE PAYMENT","0331","NO PAE AVAILABLE FOR RECIPIENT ADMISSION",96,"Non-covered charge(s). ","N30","Patient ineligible for this service."]
[2020,"RECIPIENT NOT ELIG FOR DTES OF SVC-NO FIN BENEFIT","0218","RECIPIENT NOT ELIGIBLE FOR MEDICAID ON DATE(S) OF SERVICE",96,"Non-covered charge(s).","N30","Patient ineligible for this service."]
[2021,"RECIPIENT NOT ELIG FOR DATES OF SVC-NO FIN BENE","0218","RECIPIENT NOT ELIGIBLE FOR MEDICAID ON DATE(S) OF SERVICE",96,"Non-covered charge(s).","N30","Patient ineligible for this service."]
[2033,"RECIP PGM DOES NOT COVER SVCS BILLED ON CLAIM TYPE","0074","SERVICES NOT COVERED FOR QMB/SLMB RECIPIENTS",96,"Non-covered charge(s). ","N30","Patient ineligible for this service."]
[523,"DISCHARGE DATE GREATER THAN ICN DATE","0053","DATE OF DISCHARGE IS INVALID OR MISSING",110,"Billing date predates service date.","N318","Missing/incomplete/invalid discharge or end of care date."]
[2110,"PHYS VISIT DATE - OCCUR CODE INVALID OR MISSING","0172","PHYSICIAN VISIT DATE IS INVALID OR MISSING",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N324","Missing/incomplete/invalid last seen/visit date."]
[2112,"PHYSICIAN VISIT DATE MORE THAN 120 DAYS OLD","0629","PHYSICIAN VISIT DATE DOES NOT MEET FEDERAL REQUIREMENTS",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N324","Missing/incomplete/invalid last seen/visit date."]
[2113,"PHYSICIAN VISIT DATE MORE THAN 365 DAYS","0346","PHYSICIAN VISIT MUST NOT BE MORE THAN 365 DAYS NO GRACE PERIOD IS GIVEN ON THES",16,"Claim/service lacks information or has submission/billing error(s). ","N324","Missing/incomplete/invalid last seen/visit date."]
[652,"TIME OF DEATH MISSING OR INVALID","0907","TIME OF DEATH MISSING OR INVALID",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N330","Missing/incomplete/invalid patient death date."]
[4020,"UNITS BILLED EXCEED ALLOWABLE UNITS FOR PROCEDURE","0131","UNITS EXCEED PROGRAM MAXIMUM FOR HCBS CODE",273,"Coverage/program guidelines were exceeded.","N362","The number of Days or Units of Service exceeds our acceptable maximum."]
[4255,"INST UNITS OF SRV EXCEED MEDICALLY UNLIKELY EDITS","4255","INSTITUTIONAL UNITS OF SERVICE EXCEED MEDICALLY UNLIKELY EDIT",273,"Coverage/program guidelines were exceeded.","N362","The number of Days or Units of Service exceeds our acceptable maximum."]
[6018,"COMMUNITY PARTICIPATION","6018","EXCEEDED COMMUNITY PARTICIPATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached.","N362","The number of Days or Units of Service exceeds our acceptable maximum."]
[6726,"DAY SERVICES","6726","EXCEEDED DAY SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached.","N362","The number of Days or Units of Service exceeds our acceptable maximum."]
[618,"TIME OF DEATH IS INVALID OR MISSING","0173","TIME OF DEATH IS INVALID OR MISSING",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N443","Missing/incomplete/invalid total time or begin/end time."]
[640,"INVALID DISCHARGE HOUR","0055","TIME OF DISCHARGE IS INVALID OR MISSING",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","N50","Missing/incomplete/invalid discharge information."]
[654,"LATE DISCHARGE REQS PATIENT STATUS 20, 41 OR 42","1328","LATE DISCHARGE REQUIRES PATIENT STATUS 20, 41 OR 42",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","N50","Missing/incomplete/invalid discharge information."]
[657,"INVALID DISCHARGE HOUR OR CODE FOR SAME DAY XFER","1012","INVALID DISCHARGE HOUR OR PATIENT STATUS FOR SAME DAY TRANSFER",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N50","Missing/incomplete/invalid discharge information."]
[1270,"HCBS SUBMITTER ID/BILLING PROV ELIGIBILITY MISMATC","1270","HCBS SUBMITTER ID/BILLING PROV ELIGIBILITY MISMATCH",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. ","N521","Mismatch between the submitted provider information and the provider information stored in our system."]
[1024,"PROVIDER NOT LISTED AS RECIPIENT PROVIDER","1024","PROVIDER DOES NOT MATCH THE PROVIDER SPECIFIED ON PAE FOR THIS RECIPIENT",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","N54","Claim information is inconsistent with pre-certified/authorized services."]
[2033,"RECIP PGM DOES NOT COVER SVCS BILLED ON CLAIM TYPE","0294","SERVICE NOT COVERED BY MEDICAID",96,"Non-covered charge(s). ","N56","Procedure code billed is not correct/valid for the services billed or the date of service billed."]
[4013,"PROCEDURE CODE IS NOT COVERED FOR DATE OF SERVICE","0233","PROCEDURE/NDC NOT COVERED BY MEDICAID FOR DATE OF SERVICE",96,"Non-covered charge(s).","N56","Procedure code billed is not correct/valid for the services billed or the date of service billed."]
[4021,"PROCEDURE CODE VS PROGRAM INDICATOR","0288","PROCEDURE NOT COVERED BY MEDICAID",96,"Non-covered charge(s). ","N56","Procedure code billed is not correct/valid for the services billed or the date of service billed."]
[2100,"PHYS CERT DATE - OCCUR CODE INVALID/MISSING","0171","PHYSICIAN CERTIFICATION DATE IS MISSING OR INVALID","B7","This provider was not certified/eligible to be paid for this procedure/service on this date of service.","N570","Missing/incomplete/invalid credentialing data."]
[2101,"PHYSICIAN CERT DATE EXCEEDS ALLOWABLE DAYS","0347","PHYSICIAN CERTIFICATION DATE EXCEEDS ALLOWABLE DAYS","B7","This provider was not certified/eligible to be paid for this procedure/service on this date of service. ","N570","Missing/incomplete/invalid credentialing data."]
[2102,"PHYS CERT DATE MUST MEET FEDERAL GUIDELINES","0348","PHYSICIAN CERTIFICATION DATE MUST MEET FEDERAL GUIDELINES","B7","This provider was not certified/eligible to be paid for this procedure/service on this date of service. ","N570","Missing/incomplete/invalid credentialing data."]
[2103,"PHYS RECERT DATE EXCEEDS ALLOWABLE DAYS","0349","PHYSICIAN RECERTIFICATION DATE EXCEEDS ALLOWABLE DAYS","B7","This provider was not certified/eligible to be paid for this procedure/service on this date of service. ","N570","Missing/incomplete/invalid credentialing data."]
[635,"NO PATIENT LIABILITY IN EFFECT FOR DATE OF SERVICE","0334","NO PATIENT LIABILITY IN EFFECT FOR DATE OF SERVICE",142,"Monthly Medicaid patient liability amount.","N58","Missing/incomplete/invalid patient liability amount."]
[636,"PATIENT LIABILITY CHANGE DURING DOS","0338","PATIENT LIABILITY CHANGED DURING MONTH",142,"Monthly Medicaid patient liability amount.","N58","Missing/incomplete/invalid patient liability amount."]
[637,"NO PATIENT LIABILITY IN EFFECT FOR DOS - RCY","0280","NO PATIENT LIABILITY IN EFFECT FOR DOS - RCY",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.","N58","Missing/incomplete/invalid patient liability amount."]
[5540,"PYMT LIMITED TO ONE CASE MGMT UNIT PER MONTH","5540","PAYMENT LIMITED TO ONE CASE MANAGEMENT UNIT PER MONTH",119,"Benefit maximum for this time period or occurrence has been reached.","N640","Exceeds number/frequency approved/allowed within time period."]
[1012,"PROV SPECIALTY INELIGIBLE TO RENDER PROC CODE","0237","PROCEDURE/FORMULARY PROVIDER SPECIALTY RESTRICTION",8,"The procedure code is inconsistent with the provider type/specialty (taxonomy).","N95","This provider type/provider specialty may not bill this service."]
[429,"HOMEBOUND SNA & SUPPORT DAILY LIMIT","0429","HOMEBOUND SNA & SUPPORT DAILY LIMIT",272,"Coverage/program guidelines were not met."]
[506,"ICN DATE PRIOR TO DATE BILLED","0475","DATE BILLED AFTER ICN DATE",110,"Billing date predates service date."]
[513,"RECIPIENT NAME AND NUMBER DISAGREE","0468","NAME ON CLAIM MUST MATCH DHS IDENTIFICATION",140,"Patient/Insured health identification number and name do not match."]
[545,"TIMELY FILING LIMIT EXCEEDED (HDR)","0268","CLAIM EXCEEDS FILING TIME LIMIT- RESUBMIT WITH PROOF OF TIMELY FILING",29,"The time limit for filing has expired."]
[556,"CLAIM PAST 24 MONTH FILING - HDR","0946","CLAIM PAST 24 MONTH FILING - HDR",29,"The time limit for filing has expired."]
[604,"NO ATTACHMENT RECEIVED","9663","ATTACHMENT BEING SENT BY PROVIDER WAS NOT RECEIVED.",163,"Attachment/other documentation referenced on the claim was not received."]
[608,"NO ATTACHMENT RECEIVED","9663","ATTACHMENT BEING SENT BY PROVIDER WAS NOT RECEIVED.",163,"Attachment/other documentation referenced on the claim was not received."]
[1001,"BILLING PROV NOT ENROLLED AT SVC LOC FOR PGM BILLD","0388","SERVICES OF THIS PROVIDER NOT COVERED BY MEDICAID","B7","This provider was not certified/eligible to be paid for this procedure/service on this date of service. "]
[1066,"DMRS FACILITY INVALID/MISSING/NOT ELIGIBLE ON DOS","0107","DMRS FACILITY INVALID/MISSING/NOT ELIGIBLE ON DOS",16,"Claim/service lacks information or has submission/billing error(s) which is needed for adjudication."]
[1085,"BILLING PROVIDER IS AN OUT OF STATE PROVIDER","0208","BILLING PROVIDER IS AN OUT OF STATE PROVIDER","B7","This provider was not certified/eligible to be paid for this procedure/service on this date of service."]
[2007,"QMB RECIPIENT- BILL MEDICARE FIRST.","2016","QMB RECIPIENT ELIGIBLE FOR CROSSOVER ONLY",31,"Patient cannot be identified as our insured."]
[2024,"DCS CHILD RUNAWAY/YOUTH DEVELOP CTR-NO PAYMENT DUE","2075","DCS CHILD RUNAWAY/YOUTH DEVELOP CTR-NO PAYMENT DUE",133,"The disposition of this service line is pending further review. "]
[2026,"DCS CHLD MED SURG HOSP/INPAT PSYCH-NO PMT DUE","2077","DCS CHILD MED SURG HOSP/INPAT PSYCH-NO PAYMENT DUE",133,"The disposition of this service line is pending further review. "]
[2026,"DCS CHLD MED SURG HOSP/INPAT PSYCH-NO PMT DUE","2078","DCS CHILD MED SURG HOSP/INPAT PSYCH-NO PAYMENT DUE",133,"The disposition of this service line is pending further review. "]
[2028,"RECIP BENEFIT PLAN NOT ELIG FOR LTC & HCBS SVCS","0388","SERVICES OF THIS PROVIDER NOT COVERED BY MEDICAID","B7","This provider was not certified/eligible to be paid for this procedure/service on this date of service. "]
[2063,"RECIP ELIGIBLE FOR CHOICES-RESUBMIT CLAIM TO MCO","2063","RECIPIENT ELIGIBLE FOR CHOICES - RESUBMIT CLAIM TO RECIPIENT'S MCO",24,"Charges are covered under a capitation agreement/managed care plan."]
[2065,"RECIP PARTIALLY ELIG FOR CHOICES-SPLIT BILL CLAIM","2065","RECIPIENT PARTIALLY ELIGIBLE FOR CHOICES - SPLIT BILL CLAIM",24,"Charges are covered under a capitation agreement/managed care plan."]
[2504,"RECIPIENT COVERED BY PRIVATE INSURANCE","0263","TPL - RECIPIENT HAS THIRD PARTY RESOURCES",22,"This care may be covered by another payer per coordination of benefits."]
[2507,"THIS PATIENT HAS TWO COVERAGE TYPES","0510","THIS PATIENT HAS TWO COVERAGE TYPES",22,"This care may be covered by another payer per coordination of benefits."]
[4020,"UNITS BILLED EXCEED ALLOWABLE UNITS FOR PROCEDURE","4020","UNITS BILLED EXCEED ALLOWABLE UNITS FOR THIS PROCEDURE CODE",119,"Benefit maximum for this time period or occurrence has been reached."]
[4027,"DIAGNOSIS CODE NOT COVERED FOR DATE OF SERVICE","0188","DIAGNOSIS CODE NOT COVERED BY MEDICAID FOR DATE OF SERVICE",167,"This (these) diagnosis(es) is (are) not covered. "]
[4034,"PROCEDURE CODE VS AGE RESTRICTION","0234","PROCEDURE/FORMULARY AGE RESTRICTION",6,"The procedure/revenue code is inconsistent with the patients age. "]
[4045,"PROCEDURE CODE VS AGE RESTRICTION","0234","PROCEDURE/FORMULARY AGE RESTRICTION",6,"The procedure/revenue code is inconsistent with the patients age. "]
[4127,"CANNOT PRIORITIZE RECIPIENT'S PROGRAMS- RECYCLE","4127","CANNOT PRIORITIZE RECIPIENT'S PROGRAMS (INTERNET USERS, TRY TO RESUBMIT IN 24 H",133,"The disposition of this service line is pending further review. "]
[4209,"NO PRICING SEGMENT FOR PROCEDURE/MODIFIER COMBINAT","4209","NO MATCHING PRICING SEGMENT FOR THE PROCEDURE/MODIFIER COMBINATION BILLED",4,"The procedure code is inconsistent with the modifier used or a required modifier is missing. "]
[4227,"REVENUE CODE NOT COVERED BY PROGRAM","4227","REVENUE CODE NOT COVERED BY PROGRAM",109,"Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor."]
[5005,"SUSPECT DUPLICATE - DETAIL","5000","POSSIBLE DUPLICATE OF ANOTHER CLAIM.",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. "]
[5513,"HCBS - ICF/SNF POSSIBLE CONFLICT","5513","HCBS- ICF/SNF POSSIBLE CONFLICT",97,"The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. "]
[5554,"PRIOR RES SVC NOT MET FOR SIL TRANSITION RATE","5554","PRIOR RES SVC NOT MET FOR SIL TRANSITION ENHANCE RATE",180,"Patient has not met the required residency requirements."]
[5555,"PRIOR SIL SVC NOT MET FOR SIL TRANSITION INCENTIVE","5555","PRIOR SIL SVC NOT MET FOR SIL TRANSITION INCENTIVE PAYMENT",180,"Patient has not met the required residency requirements."]
[6000,"MANUAL PRICING REQUIRED","0281","PEND FOR MANUAL PRICING",133,"The disposition of this service line is pending further review."]
[6007,"SUPPORT COORDINATION","6007","EXCEEDED SUPPORT COORDINATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6008,"HCBS MR DAY HABITATION LEVEL B LIMIT EXCEEDED","6008","EXCEEDED DAY HABITATION/LEVEL B LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6009,"HCBS MR DAY HABITATION LEVEL C LIMIT EXCEEDED","6009","EXCEEDED DAY HABITATION/LEVEL C LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6010,"HCBS-MR RESIDENTIAL HABITATION LIMIT EXCEEDED","6010","EXCEEDED RESIDENTIAL HABITATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6011,"FAMILY BASED LIVING","6011","EXCEEDED FAMILY BASED LIVING LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6012,"HOME HEALTH AIDE","6012","EXCEEDED HOME HEALTH AIDE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6013,"RESPITE/OVER NIGHT","6013","EXCEEDED RESPITE/OVER NIGHT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6014,"ENVIRONMENT ACCESS ADAPTATION","6014","EXCEEDED ENVIRONMENT ACCESS ADAPTATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6015,"PERSONAL ASSISTANCE","6015","EXCEEDED PERSONAL ASSISTANCE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6016,"NURSING SERVICES","6016","EXCEEDED NURSING SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6017,"SUPPORTED EMPLOYMENT","6017","EXCEEDED SUPPORTED EMPLOYMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6019,"RESPITE/SITTER SERVICE","6019","EXCEEDED RESPITE/SITTER SERVICE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6020,"TRANSPORTATION","6020","EXCEEDED TRANSPORTATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6021,"BEHAVIOR SUPPORT/PSYCHIATRIST","6021","EXCEEDED BEHAVIOR SUPPORT/PSYCHIATRIST LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6022,"BEHAVIOR SUPPORT/PSYCHOLOGIST","6022","EXCEEDED BEHAVIOR SUPPORT/PSYCHOLOGIST",119,"Benefit maximum for this time period or occurrence has been reached."]
[6023,"BEHAVIOR SUPPORT/BEHAVIOR SPECIALIST","6023","EXCEEDED BEHAVIOR SUPPORT/BEHAVIOR SPECIALIST LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6024,"NUTRITION SERVICES","6024","EXCEEDED NUTRITION SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6025,"PHYSICAL THERAPY","6025","EXCEEDED PHYSICAL THERAPY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6026,"OCCUPATIONAL THERAPY","6026","EXCEEDED OCCUPATIONAL THERAPY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6027,"SPEECH THERAPY","6027","EXCEEDED SPEECH THERAPY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6028,"SPECIAL EQUIPMENT, SUPPLIES & ASSISTIVE TECHNOLOGY","6028","EXCEEDED SPECIAL EQUIPMENT, SUPPLIES & ASSISTIVE TECHNOLOGY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6029,"FAMILY EDUCATION","6029","EXCEEDED FAMILY EDUCATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6030,"ENHANCED DENTAL SERVICES","6030","EXCEEDED ENHANCED DENTAL SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6031,"SUPPORTIVE EMPLOYMENT (MO)","6031","EXCEEDED SUPPORTIVE EMPLOYMENT (MO) LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6032,"COMMUNITY PARTICIPATION (MO)","6032","EXCEEDED COMMUNITY PARTICIPATION (MO) LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6033,"PERSONAL EMERGENCY RESPONSE","6033","EXCEEDED PERSONAL EMERGENCY RESPONSE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6034,"BEHAVIOR SUPPORT/BEHAVIOR ANALYST","6034","EXCEEDED BEHAVIOR SUPPORT/BEHAVIOR ANALYST LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6035,"SUPPORTED LIVING","6035","EXCEEDED SUPPORTED LIVING LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6036,"AUDIOLOGY SERVICES","6036","EXCEEDED AUDIOLOGY SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6037,"NURSING ASSESSMENT","6037","EXCEEDED NURSING ASSESSMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6038,"PHYSICAL THERAPY ASSESSMENT","6038","EXCEEDED PHYSICAL THERAPY ASSESSMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6039,"OCCUPATIONAL THERAPY ASSESSMENT","6039","EXCEEDED OCCUPATIONAL THERAPY ASSESSMENT  LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6040,"SPEECH THERAPY ASSESSMENT","6040","EXCEEDED SPEECH THERAPY ASSESSMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6041,"AUDIOLOGY ASSESSMENT","6041","EXCEEDED AUDIOLOGY ASSESSMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6042,"SUPPORT COORDINATION","6042","EXCEEDED SUPPORT COORDINATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6043,"DAY HABITATION","6043","EXCEEDED DAY HABITATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6044,"TRANSPORTATION, PRIVATE-PUBLIC-CORP","6044","EXCEEDED TRANSPORTATION, PRIVATE-PUBLIC-CORP LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6045,"RESIDENTIAL HABITATION","6045","EXCEEDED RESIDENTIAL HABITATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6048,"RESPITE/OVER NIGHT","6048","EXCEEDED RESPITE/OVER NIGHT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6049,"ENVIRONMENT ACCESS ADAPTATION","6049","EXCEEDED ENVIRONMENT ACCESS ADAPTATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6050,"PERSONAL ASSISTANCE","6050","EXCEEDED PERSONAL ASSISTANCE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6051,"NURSING SERVICES","6051","EXCEEDED NURSING SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6052,"SELF DETERMINATION TRAINING/CONSUMER EDUCATION","6052","EXCEEDED SELF DETERMINATION TRAINING/CONSUMER EDUCATION  LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6053,"TRANSPORTATION/INDIVIDUALS/FAMILY","6053","EXCEEDED TRANSPORTATION/INDIVIDUALS/FAMILY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6054,"SUPPORTED EMPLOYMENT","6054","EXCEEDED SUPPORTED EMPLOYMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6055,"COMMUNITY PARTICIPATION","6055","EXCEEDED COMMUNITY PARTICIPATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6056,"RESPITE/SITTER SERVICE","6056","EXCEEDED RESPITE/SITTER SERVICE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6057,"TRANSPORTATION/SERVICE AGENCY","6057","EXCEEDED TRANSPORTATION/SERVICE AGENCY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6058,"BEHAVIOR SUPPORT/PSYCHIATRIST, EVALUATION","6058","EXCEEDED BEHAVIOR SUPPORT/PSYCHIATRIST, EVALUATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6059,"BEHAVIOR SUPPORT/PSYCHOLOGIST, EVALUATION","6059","EXCEEDED BEHAVIOR SUPPORT/PSYCHOLOGIST, EVALUATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6060,"BEHAVIOR SUPPORT/BEHAVIOR SPECIALIST","6060","EXCEEDED BEHAVIOR SUPPORT/BEHAVIOR SPECIALIST LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6061,"NUTRITION SERVICES","6061","EXCEEDED NUTRITION SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6062,"PHYSICAL THERAPY","6062","EXCEEDED PHYSICAL THERAPY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6063,"OCCUPATIONAL THERAPY","6063","EXCEEDED OCCUPATIONAL THERAPY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6064,"SPEECH THERAPY","6064","EXCEEDED SPEECH THERAPY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6065,"SPECIAL EQUIPMENT, SUPPLIES & ASSISTIVE TECHNOLOGY","6065","EXCEEDED SPECIAL EQUIPMENT, SUPPLIES & ASSISTIVE TECHNOLOGY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6066,"FAMILY EDUCATION","6066","EXCEEDED FAMILY EDUCATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6069,"DENTAL SERVICES","6069","EXCEEDED DENTAL SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6073,"AUDIOLOGY SERVICES","6073","EXCEEDED AUDIOLOGY SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6074,"VISION SERVICES","6074","EXCEEDED VISION SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6075,"NURSING ASSESSMENT","6075","EXCEEDED NURSING ASSESSMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6076,"PHYSICAL THERAPY ASSESSMENT","6076","EXCEEDED PHYSICAL THERAPY ASSESSMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6077,"OCCUPATIONAL THERAPY ASSESSMENT","6077","EXCEEDED  OCCUPATIONAL THERAPY ASSESSMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6078,"SPEECH THERAPY ASSESSMENT","6078","EXCEEDED SPEECH THERAPY ASSESSMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6079,"AUDIOLOGY ASSESSMENT","6079","EXCEEDED AUDIOLOGY ASSESSMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6080,"CASE MANAGEMENT","6080","EXCEEDED CASE MANAGEMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6081,"PERSONAL CARE","6081","EXCEEDED PERSONAL CARE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6082,"HOME DELIVERED MEALS","6082","EXCEEDED HOME DELIVERED MEALS LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6083,"MINOR HOME MODIFICATIONS","6083","EXCEEDED MINOR HOME MODIFICATIONS LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6084,"PERSONAL EMERGENCY RESPONSE SYSTEM","6084","EXCEEDED PERSONAL EMERGENCY RESPONSE SYSTEM LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6087,"HCBS-AD CASE MANAGEMENT LIMIT EXCEEDED","6087","EXCEEDED CASE MANAGEMENT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6088,"HCBS-AD PERSONAL CARE LIMIT EXCEEDED","6088","EXCEEDED PERSONAL CARE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6089,"HCBS-AD RESPITE LIMIT EXCEEDED","6089","EXCEEDED RESPITE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6090,"HCBS-AD MINOR HOME MODIFICATION LIMIT EXCEEDED","6090","EXCEEDED MINOR HOME MODIFICATIONS LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6092,"HCBS-AD PERSONAL EMERG. RESPONSE SYSTEM LIMIT","6092","EXCEEDED PERSONAL EMERGENCY RESPONSE SYSTEM LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6093,"HCBS-AD HOME DELIVERED MEALS LIMIT EXCEEDED","6093","EXCEEDED HOME DELIVERED MEALS LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6094,"HCBS-AD HOME MAKER LIMIT EXCEEDED","6094","EXCEEDED HOME MAKER LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6095,"HCBS-ADAPT HOME MAKER LIMIT EXCEEDED","6095","EXCEEDED HOME MAKER LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6096,"FAMILY BASED LIVING","6096","EXCEEDED FAMILY BASED LIVING LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6097,"PERSONAL EMERGENCY RESPONSE","6097","EXCEEDED PERSONAL EMERGENCY RESPONSE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6098,"BEHAVIOR SUPPORT/BEHAVIOR ANALYST","6098","EXCEEDED BEHAVIOR SUPPORT/BEHAVIOR ANALYST LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6099,"SUPPORTED LIVING","6099","EXCEEDED SUPPORTED LIVING LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6101,"SVC LMTD TO ONE PER RECIP; SUB PAPER CLM W/JUSTIF","6118","SERVICE LIMITED TO ONE PER RECIPIENT; SUBMIT PAPER CLAIM WITH JUSTIFICATION",119,"Benefit maximum for this time period or occurrence has been reached."]
[6102,"PYMT LIMITED TO ONE CASE MGMT UNIT PER MONTH","6102","PAYMENT LIMITED TO ONE CASE MANAGEMENT UNIT PER MONTH",119,"Benefit maximum for this time period or occurrence has been reached."]
[6103,"CASE MGMT RATE PD FOR 1ST MNTHLY FACE-TO-FACE ONLY","6103","MONTHLY CASE MANAGEMENT RATE PAID FOR FACE-TO-FACE VISIT ONLY",119,"Benefit maximum for this time period or occurrence has been reached."]
[6108,"HCBS AD-STATEWIDE ASSISTED LIVING EXCEEDED","6108","ASSISTED LIVING EXCEEDED",45,"Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. "]
[6119,"AD-STATEWIDE CASE MANAGEMENT EXCEEDED","6119","HCBS AD STATEWIDE CASE MANAGEMENT EXCEEDED",119,"Benefit maximum for this time period or occurrence has been reached."]
[6126,"AD-STATEWIDE ADULT DAY CARE","6126","HCBS AD-STATEWIDE ADULT DAY CARE EXCEEDED",119,"Benefit maximum for this time period or occurrence has been reached."]
[6127,"AD-STATEWIDE ASSISTIVE TECHNOLOGY EXCEEDED","6127","HCBS AD-STATEWIDE ASSISTIVE TECHNOLOGY EXCEEDED",119,"Benefit maximum for this time period or occurrence has been reached."]
[6128,"AD-STATEWIDE PERSONAL CARE ATTENDANT EXCEEDED","6128","HCBS AD-STATEWIDE PERSONAL CARE ATTENDANT EXCEEDED",119,"Benefit maximum for this time period or occurrence has been reached."]
[6129,"AD-STATEWIDE PEST CONTROL EXCEEDED","6129","HCBS AD-STATEWIDE PEST CONTROL EXCEEDED",119,"Benefit maximum for this time period or occurrence has been reached."]
[6130,"AD-STATEWIDE RESPITE EXCEEDED","6130","AD STATEWIDE RESPITE EXCEEDED",119,"Benefit maximum for this time period or occurrence has been reached."]
[6423,"6 TEETH PER VISIT EXCEEDED FOR D1354","6423","6 TEETH PER VISIT EXCEEDED FOR D1354",119,"Benefit maximum for this time period or occurrence has been reached."]
[6669,"HCBS EXCEEDS $26,500","6669","HCBS EXCEEDS $26,000",45,"Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. "]
[6700,"ANNUAL DENTAL LIMIT","6700","ANNUAL DENTAL LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6701,"3-YR DENTAL","6701","3-YR DENTAL LIMIT (EFFECTIVE 2/15/11)",119,"Benefit maximum for this time period or occurrence has been reached."]
[6702,"ENVIRONMENTAL ACCESSIBILITY","6702","ENVIRONMENTAL ACCESSIBILITY (EFFECTIVE 2/15/11)",119,"Benefit maximum for this time period or occurrence has been reached."]
[6703,"ANNUAL NUTRITION ASSESSMENT","6703","ANNUAL NUTRITION ASSESSMENT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6704,"ANNUAL NUTRITION SERVICES","6704","ANNUAL NUTRITION SERVICES",119,"Benefit maximum for this time period or occurrence has been reached."]
[6705,"MR/ARL DAY SERVICES - WEEKLY LIMIT","6705","MR/ARL DAY SERVICES - WEEKLY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6706,"SDW DAY SERVICES - WEEKLY LIMIT","6706","SDW DAY SERVICES - WEEKLY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6707,"HCBS NURSING SERVICES","6707","HCBS NURSING SERVICES",119,"Benefit maximum for this time period or occurrence has been reached."]
[6708,"PERSONAL ASSISTANT SERVICES","6708","PERSONAL ASSISTANT SERVICES",119,"Benefit maximum for this time period or occurrence has been reached."]
[6709,"SEMI-INDEPENDENT LIVING SERVICES","6709","SEMI-INDEPENDENT LIVING SERVICES",119,"Benefit maximum for this time period or occurrence has been reached."]
[6710,"3-YR DENTAL-EFFECTIVE 1/1/2014","6710","3-YR DENTAL EFFECTIVE 1/1/2014",119,"Benefit maximum for this time period or occurrence has been reached."]
[6711,"MR WAIVER SERVICES LIMIT","6711","MR WAIVER SERVICES LIMIT",273,"Coverage/program guidelines were exceeded."]
[6714,"MR WAIVER SERVICE LIMIT - EFFECTIVE 1/1/2016","6714","MR WAIVER SERVICE LIMIT - EFFECTIVE 1/1/2016",273,"Coverage/program guidelines were exceeded."]
[6715,"MR WAIVER SERVICE LIMIT - EFFECTIVE 1/1/2017","6715","MR WAIVER SERVICE LIMIT - EFFECTIVE 1/1/2017",273,"Coverage/program guidelines were exceeded."]
[6716,"MR WAIVER SERVICE LIMIT - EFFECTIVE 1/1/2018","6716","MR WAIVER SERVICE LIMIT - EFFECTIVE 1/1/2018",273,"Coverage/program guidelines were exceeded."]
[6717,"MR WAVIER SERVICE LIMIT","6717","MR WAIVER SERVICE LIMIT",273,"Coverage/program guidelines were exceeded."]
[6721,"DAILY DAY SERVICE LIMIT","6721","DAILY DAY SERVICE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6722,"SDW ENVIRONMENTAL ACCESSIBILITY MOD","6722","SDW ENVIRONMENTAL ACCESSIBILITY MODS",119,"Benefit maximum for this time period or occurrence has been reached."]
[6723,"SDW MONTHLY DAY SERVICES","6723","SDW MONTHLY DAY SERVICES",119,"Benefit maximum for this time period or occurrence has been reached."]
[6724,"SDW ANNUAL DAY SERVICES","6724","SDW ANNUAL DAY SERVICES",119,"Benefit maximum for this time period or occurrence has been reached."]
[6725,"BEHAVIORAL RESPITE SERVICES","6725","EXCEEDED BEHAVIORAL RESPITE SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6727,"ENVIRONMENTAL ACCESSIBILITY MODIFICATIONS","6727","EXCEEDED ENVIRONMENTAL ACCESSIBILITY MODIFICATIONS LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6728,"FAMILY MODEL RESIDENTIAL","6728","EXCEEDED FAMILY MODEL RESIDENTIAL SUPPORT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6729,"INDIVIDUAL TRANSPORTATION SERVICES","6729","EXCEEDED INDIVIDUAL TRANSPORTATION SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6730,"DAY SERVICES(MONTHLY)","6730","EXCEEDED DAY SERVICES LIMIT(MONTHLY)",119,"Benefit maximum for this time period or occurrence has been reached."]
[6731,"NUTRITION ASSESSMENTS/SERVICES","6731","EXCEEDED NUTRITION ASSESSMENTS/SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6732,"OCCUPATIONAL THERAPY ASSESSMENTS","6732","EXCEEDED OCCUPATIONAL THERAPY ASSESSMENTS LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6733,"ORIENTATION AND MOBILITY TRAINING/ASSESSMENTS","6733","EXCEEDED ORIENTATION AND MOBILITY TRAINING/ASSESSMENTS LIMITS",119,"Benefit maximum for this time period or occurrence has been reached."]
[6734,"PERSONAL ASSISTANCE-DAILY RATE","6734","EXCEEDED PERSONAL ASSISTANCE DAILY RATE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6735,"PERSONAL EMERGENCY RESPONSE SYSTEM","6735","EXCEEDED PERSONAL EMERGENCY RESPONSE SYSTEM LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6736,"PHYSICAL THERAPY ASSESSMENTS","6736","EXCEEDED PHYSICAL THERAPY ASSESSMENTS LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6737,"RESIDENTIAL HABILITATION","6737","EXCEEDED RESIDENTIAL HABILITATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6738,"RESPITE/OVERNIGHT","6738","EXCEEDED RESPITE/OVERNIGHT LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6739,"SPECIAL EQUIPMENT, SUPPLIES & ASSISTIVE TECHNOLOGY","6739","EXCEEDED SPECIALIZED MEDICAL EQUIPMENT & SUPPLIES & ASSISTIVE TECHNOLOGY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6740,"SPEECH, LANGUAGE & HEARING SERVICES ASSESSMENT","6740","EXCEEDED SPEECH, LANGUAGE AND HEARING SERVICES ASSESSMENTS LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6741,"SPEECH, LANGUAGE AND HEARING SERVICES","6741","EXCEEDED SPEECH, LANGUAGE AND HEARING SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6742,"SUPPORT COORDINATION","6742","EXCEEDED SUPPORT COORDINATION LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6743,"SUPPORTED LIVING","6743","SUPPORTED LIVING LIMIT EXCEEDED",119,"Benefit maximum for this time period or occurrence has been reached."]
[6744,"VEHICLE ACCESSIBILITY MODIFICATIONS","6744","EXCEEDED VEHICLE ACCESSIBILITY MODIFICATIONS LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6745,"FAMILY MODEL RESIDENTIAL SUPPORT(OUT OF STATE)","6745","EXCEEDED FAMILY MODEL RESIDENTIAL SUPP(OUT OF STATE)LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6746,"MEDICAL RESIDENTIAL SERVICES(OUT OF STATE)","6746","EXCEEDED MEDICAL RESIDENTIAL SVCS(OUT OF STATE) LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6747,"OCCUPATIONAL THERAPY SERVICES","6747","EXCEEDED OCCUPATIONAL THERAPY SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6748,"PHYSICAL THERAPY SERVICES","6748","EXCEEDED PHYSICAL THERAPY SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6749,"RESIDENTIAL HABILITATION(OUT OF STATE)","6749","EXCEEDED RESIDENTIAL HABILITATION(OUT OF STATE) LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6750,"RESPITE-SITTER","6750","EXCEEDED RESPITE-SITTER LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6751,"SPECIAL EQUIPMENT, SUPPLIES & ASSISTIVE TECHNOLOGY","6751","EXCEEDED SPECALIZED MEDICAL EQUIPMENT & SUPPLIES & ASSISTIVE TECHNOLOGY LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6752,"SUPPORTED LIVING (OUT OF STATE)","6752","EXCEEDED SUPPORTED LIVING(OUT OF STATE) LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6753,"SUPPORTED EMPLOYMENT-LEVEL 5","6753","EXCEEDED DAY SERVICES SUPPL EMPLOYMENT LVL 5 LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6754,"SPECIAL NEEDS ADJUSTMENT - IN STATE","6754","EXCEEDED MED RES/RES HABIL/SUPP LVG SPCL NEED ADJ LIM",119,"Benefit maximum for this time period or occurrence has been reached."]
[6755,"SPECIAL NEEDS ADJUSTMENT (OOS)","6755","EXCEEDED MED RES/RES HABIL/SUPP LVG SPCL NEED ADJ LIMIT(OOS)",119,"Benefit maximum for this time period or occurrence has been reached."]
[6756,"PERSONAL ASSISTANCE(S9122 ONLY)","6756","EXCEEDED PERSONAL ASSISTANCE LIMIT(S9122 ONLY)",119,"Benefit maximum for this time period or occurrence has been reached."]
[6757,"MEDICAL RESIDENTIAL SERVICES","6757","MED RES SVCS EXCEEDED - ONLY 1 PER DAY ALLOWED",119,"Benefit maximum for this time period or occurrence has been reached."]
[6766,"EXCEEDED SELF DETERMINATION WAIVER SERVICES LIMIT","6766","EXCEEDED SELF DETERMINATION WAIVER SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6767,"EXCEEDED FINANCIAL ADMINISTRATION SERVICES LIMIT","6767","EXCEEDED FINANCIAL ADMINISTRATION SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6768,"RESPITE-SITTER","6750","EXCEEDED RESPITE-SITTER LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6769,"BEHAVIOR ANALYST MONTHLY ASSESSMENT SERVICES","6769","EXCEEDED MONTHLY BEHAVIOR ANALYST ASSESSMENT SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6770,"BEHAVIOR ANALYST ANNUAL ASSESSMENT SERVICES","6770","EXCEEDED ANNUAL BEHAVIOR ANALYST ASSESSMENT SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6771,"BEHAVIOR ANALYST MONTHLY BEHAVIOR PLAN SERVICES","6771","EXCEEDED BEHAVIOR ANALYST MONTHLY BEHAVIOR PLAN SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6772,"BEHAVIOR ANALYST ANNUAL BEHAVIOR PLAN SERVICES","6772","EXCEEDED BEHAVIOR ANALYST ANNUAL BEHAVIOR PLAN SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6773,"BEHAVIOR ANALYST ANNUAL PRESENTATION SERVICES","6773","EXCEEDED BEHAVIOR ANALYST ANNUAL PRESENTATION SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6774,"MONTHLY NUTRITION ASSESSMENT AND PLAN DEVELOPMENT","6774","EXCEEDED MONTHLY NUTRITION ASSESSMENT/PLAN DEVELOPMENT SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6775,"ANNUAL NUTRITION ASSESSMENT AND PLAN DEVELOPMENT","6775","EXCEEDED ANNUAL NUTRITION ASSESSMENT/PLAN DEVELOPMENT SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6776,"TRANSITIONAL CASE MANAGEMENT","6776","EXCEEDED TRANSITIONAL CASE MANAGEMENT SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6777,"MONTHLY OCC. THERAPY ASSESSMENT AND PLAN DEVELOP","6777","EXCEEDED MONTHLY OCCUPATIONAL THERAPY ASSESSMENT/PLAN DEVELOPMENT SERVICES LIMI",119,"Benefit maximum for this time period or occurrence has been reached."]
[6778,"ANNUAL OCC. THERAPY ASSESSMENT AND PLAN DEVELOP","6778","EXCEEDED ANNUAL OCCUPATIONAL THERAPY ASSESSMENT/PLAN DEVELOPMENT SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6779,"MONTHLY ORIENTATION & MOBILITY TRAINING","6779","EXCEEDED MONTHLY ORIENTATION AND MOBILITY TRAINING ASSESSMENT/PLAN DEVELOPMENT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6780,"ANNUAL ORIENTATION & MOBILITY TRAINING","6780","EXCEEDED ANNUAL ORIENTATION AND MOBILITY TRAINING ASSESSMENT/PLAN DEVELOPMENT S",119,"Benefit maximum for this time period or occurrence has been reached."]
[6781,"PERSONAL ASSISTANCE-STAFF RATE","6781","EXCEEDED PERSONAL ASSISTANCE LIMIT STAFF RATE LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6782,"MONTHLY PHYS THER ASSESSMENT AND PLAN DEVELOPMENT","6782","EXCEEDED MONTHLY PHYSICAL THERAPY ASSESSMENT/PLAN DEVELOPMENT SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6783,"ANNUAL PHYS THER ASSESSMENT AND PLAN DEVELOPMENT","6783","EXCEEDED ANNUAL PHYSICAL THERAPY ASSESSMENT/PLAN DEVELOPMENT SERVICES LIMIT",119,"Benefit maximum for this time period or occurrence has been reached."]
[6784,"MONTHLY SPEECH, LANGUAGE & HEARING SERVICES","6784","EXCEEDED MONTHLY SPEECH, LANGUAGE AND HEARING ASSESSMENT/PLAN DEVELOPMENT SERVI",119,"Benefit maximum for this time period or occurrence has been reached."]
[6785,"ANNUAL SPEECH, LANGUAGE & HEARING SERVICES","6785","EXCEEDED ANNUAL SPEECH, LANGUAGE AND HEARING ASSESSMENT/PLAN DEVELOPMENT SERVIC",119,"Benefit maximum for this time period or occurrence has been reached."]
[7500,"BILLING PROVIDER ON REVIEW OR RESTRICTIONS APPLY","0231","PROVIDER PROCEDURE RESTRICTIONS",170,"Payment is denied when performed/billed by this type of provider. "]
[7500,"BILLING PROVIDER ON REVIEW OR RESTRICTIONS APPLY","0309","REVIEW CLAIM FOR PAY-TO- PROVIDER",133,"The disposition of this service line is pending further review."]
[null,null,"0039","FORMER ICN/SUBMITTER ID IS NOT FOUND FOR VOID/REPLACEMENT   "]
[null,null,"0304","PROVIDER INELIGIBLE ON SERVICE DATE"]
[null,null,"0841","ORIGINAL CLAIM IS IN A DENIED STATUS "]
[null,null,"1056","RECIPIENT SSN AND DATE OF BIRTH AMBIGUOUS    "]
[null,null,"1271","ATTENDING PROVIDER NOT ELIGIBLE ON ALL DOS  "]
[null,null,"1920","DUP SECONDARY PROV RECORD-HIGHEST SAK PROV ASSIGN "]
[null,null,"5002","PREVIOUSLY VOIDED CLAIM      "]
[null,null,"5511","RECORD OF PATIENT EXPIRATION "]
[null,null,"9004","NO EXPLANATION"]
[null,null,"9922","NO EXPLANATION"]