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.