12 (68)    ADJUSTMENT REASON (161.91)

Name Value
CODE 12
STATUS EFFECTIVE DATE
  • 2003-06-01 00:00:00
    STATUS:   ACTIVE
    FEE USE:   APPLICABLE
DESCRIPTION EFFECTIVE DATE
  • DESCRIPTION:   
    The diagnosis is inconsistent with the provider type.
    
  • DESCRIPTION:   
    The diagnosis is inconsistent with the provider type. Note: Refer to the 
    835 Healthcare Policy Identification Segment (loop 2110 Service Payment 
    Information REF), if present.
    
  • DESCRIPTION:   
    The diagnosis is inconsistent with the provider type. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
    
ASSOCIATED SUSPEND CODE File: 161.27, IEN: 4
SUSPENSION DESCRIPTION
The diagnosis is inconsistent with the provider type. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
REMITTANCE REMARK
CORE SCENARIO Billed Service Not Covered
ADJUSTMENT GROUP