Name	Value
CODE	M39
STATUS EFFECTIVE DATE	2003-06-01 00:00:00 STATUS: ACTIVE FEE USE: NOT APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: The patient is not liable for payment for this service as the advance notice of non-coverage you provided the patient did not comply with program requirements DESCRIPTION: Alert: The patient is not liable for payment of this service as the advance notice of non-coverage you provided the patient did not comply with program requirements.

Name

Value

CODE

M39

STATUS EFFECTIVE DATE

2003-06-01 00:00:00

STATUS: ACTIVE

FEE USE: NOT APPLICABLE

DESCRIPTION EFFECTIVE DATE

DESCRIPTION:

The patient is not liable for payment for this service as the advance notice of non-coverage you provided the patient did not comply with program requirements

DESCRIPTION:

Alert: The patient is not liable for payment of this service as the 
advance notice of non-coverage you provided the patient did not comply 
with program requirements.

M39 (109) REMITTANCE REMARK (161.93)