Denial list – CMS 1500 data missing in particular field
A claim lacks a valid (or contains an invalid) Health Insurance Claim Number (HICN).
MA61
2
A claim lacks a valid (or contains an invalid) patient’s last name and first name as seen on the patient’s Medicare card.
MA36
11
A claim does not indicate whether or not a primary insurer to Medicare exists.
MA83 or MA92
12
A claim lacks a valid (or contains an invalid) patient or authorized person’s signature.
MA75
24a
A claim lacks a valid (or contains an invalid) “from” date of service.
M52
24b
A claim lacks a valid (or contains an invalid) place of service for each detail.
M77
24d
A claims lacks a valid (or contains an invalid) procedure or HCPCS code.
M20 or M51
24f
A claim lacks a charge for each listed service.
M79
24g
If the claim does not indicate at least one day or unit
M53
31
A claim lacks a signature from a provider of service or supplier, or their representative.
MA70 or MA81
33
A claim does not contain a billing name, address, ZIP code and telephone number of a provider or supplier of service and a valid NPI in Item 33a.
N256, N257, N258 or MA112
33a
A claim lacks the NPI of the billing provider, supplier or group.
N257 or MA112
A claim lacks a valid (or contains an invalid) Health Insurance Claim Number (HICN).
MA61
2
A claim lacks a valid (or contains an invalid) patient’s last name and first name as seen on the patient’s Medicare card.
MA36
11
A claim does not indicate whether or not a primary insurer to Medicare exists.
MA83 or MA92
12
A claim lacks a valid (or contains an invalid) patient or authorized person’s signature.
MA75
24a
A claim lacks a valid (or contains an invalid) “from” date of service.
M52
24b
A claim lacks a valid (or contains an invalid) place of service for each detail.
M77
24d
A claims lacks a valid (or contains an invalid) procedure or HCPCS code.
M20 or M51
24f
A claim lacks a charge for each listed service.
M79
24g
If the claim does not indicate at least one day or unit
M53
31
A claim lacks a signature from a provider of service or supplier, or their representative.
MA70 or MA81
33
A claim does not contain a billing name, address, ZIP code and telephone number of a provider or supplier of service and a valid NPI in Item 33a.
N256, N257, N258 or MA112
33a
A claim lacks the NPI of the billing provider, supplier or group.
N257 or MA112