D12 (278) ADJUSTMENT REASON (161.91)

Name	Value
CODE	D12
STATUS EFFECTIVE DATE	2003-06-01 00:00:00 STATUS: ACTIVE FEE USE: NOT APPLICABLE 2003-10-16 00:00:00 STATUS: INACTIVE FEE USE: APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Claim/service denied. Claim does not identify who performed the purchased diagnostic test or the amount you were charged for the test. DESCRIPTION: Claim/service denied. Claim does not identify who performed the purchased diagnostic test or the amount you were charged for the test.
SUSPENSION DESCRIPTION	Claim/service denied. Claim does not identify who performed the purchased diagnostic test or the amount you were charged for the test.