109 (45) ADJUSTMENT REASON (161.91)

Name	Value
CODE	109
STATUS EFFECTIVE DATE	2003-06-01 00:00:00 STATUS: ACTIVE FEE USE: APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor. DESCRIPTION: Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.
ASSOCIATED SUSPEND CODE	File: 161.27, IEN: 4
SUSPENSION DESCRIPTION	Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.
REMITTANCE REMARK
CORE SCENARIO	Billed Service Not Covered
ADJUSTMENT GROUP