
| Name | Value |
|---|---|
| CODE | 240 |
| STATUS EFFECTIVE DATE |
|
| DESCRIPTION EFFECTIVE DATE |
|
| SUSPENSION DESCRIPTION | The diagnosis is inconsistent with the patient's birth weight. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| REMITTANCE REMARK |
|
| CORE SCENARIO | Incorrect Claim Data |
| ADJUSTMENT GROUP |
|