N151 Telephone contact services will not be paid until the face-to-face contact requirement
has been met.
Note: (New Code 10/31/02)
N152 Missing/incomplete/invalid replacement claim information.
Note: (New Code 10/31/02)
N153 Missing/incomplete/invalid room and board rate.
Note: (New Code 10/31/02)
N154 This payment was delayed for correction of provider's mailing address.
Note: (New Code 10/31/02)
N155 Our records do not indicate that other insurance is on file. Please submit other
insurance information for our records.
Note: (New Code 10/31/02)
N156 The patient is responsible for the difference between the approved treatment and the
elective treatment.
Note: (New Code 10/31/02)
N157 Transportation to/from this destination is not covered.
Note: (New Code 2/28/03, Modified 2/1/04)
N158 Transportation in a vehicle other than an ambulance is not covered.
Note: (New Code 2/28/03)
N159 Payment denied/reduced because mileage is not covered when the patient is not in the
ambulance.
Note: (New Code 2/28/03)
N160 The patient must choose an option before a payment can be made for this procedure/
equipment/ supply/ service.
Note: (New Code 2/28/03, Modified 2/1/04)
N161 This drug/service/supply is covered only when the associated service is covered.
Note: (New Code 2/28/03)
N162 This is an alert. Although your claim was paid, you have billed for a test/specialty not
included in your Laboratory Certification. Your failure to correct the laboratory
certification information will result in a denial of payment in the near future.
Note: (New Code 2/28/03)
N163 Medical record does not support code billed per the code definition.
Note: (New Code 2/28/03)
N164 Transportation to/from this destination is not covered.
Note: (Deactivated eff. 1/31/04) Consider using N157
N165 Transportation in a vehicle other than an ambulance is not covered.
Note: (Deactivated eff. 1/31/04) Consider using N158)
N166 Payment denied/reduced because mileage is not covered when the patient is not in the
ambulance.
Note: (Deactivated eff. 1/31/04) Consider using N159
N167 Charges exceed the post-transplant coverage limit.
Note: (New Code 2/28/03)
N168 The patient must choose an option before a payment can be made for this procedure/
equipment/ supply/ service.
Note: (Deactivated eff. 1/31/04) Consider using N160
N169 This drug/service/supply is covered only when the associated service is covered.
Note: (Deactivated eff. 1/31/04) Consider using N161
N170 A new/revised/renewed certificate of medical necessity is needed.
Note: (New Code 2/28/03)
N171 Payment for repair or replacement is not covered or has exceeded the purchase price.
Note: (New Code 2/28/03)
N172 The patient is not liable for the denied/adjusted charge(s) for receiving any updated
service/item.
Note: (New Code 2/28/03)
N173 No qualifying hospital stay dates were provided for this episode of care.
Note: (New Code 2/28/03)
N174 This is not a covered service/procedure/ equipment/bed, however patient liability is
limited to amounts shown in the adjustments under group "PR".
Note: (New Code 2/28/03)
N175 Missing Review Organization Approval.
Note: (Modified 8/1/04) Related to N241
N176 Services provided aboard a ship are covered only when the ship is of United States
registry and is in United States waters. In addition, a doctor licensed to practice in the
United States must provide the service.
Note: (New Code 2/28/03)
N177 We did not send this claim to patient’s other insurer. They have indicated no additional
payment can be made.
Note: (New Code 2/28/03. Modified 6/30/03)
N178 Missing pre-operative photos or visual field results.
Note: (Modified 8/1/04) Related to N244
N179 Additional information has been requested from the member. The charges will be
reconsidered upon receipt of that information.
Note: (New Code 2/28/03)
N180 This item or service does not meet the criteria for the category under which it was
billed.
Note: (New Code 2/28/03)
N181 Additional information has been requested from another provider involved in the care
of this member. The charges will be reconsidered upon receipt of that information.
Note: (New Code 2/28/03)
N182 This claim/service must be billed according to the schedule for this plan.
Note: (New Code 2/28/03)
N183 This is a predetermination advisory message, when this service is submitted for
payment additional documentation as specified in plan documents will be required to
process benefits.
Note: (New Code 2/28/03)
N184 Rebill technical and professional components separately.
Note: (New Code 2/28/03)
N185 Do not resubmit this claim/service.
Note: (New Code 2/28/03)
N186 Non-Availability Statement (NAS) required for this service. Contact the nearest Military
Treatment Facility (MTF) for assistance.
Note: (New Code 2/28/03)
N187 You may request a review in writing within the required time limits following receipt of
this notice by following the instructions included in your contract or plan benefit
documents.
Note: (New Code 2/28/03)
N188 The approved level of care does not match the procedure code submitted.
Note: (New Code 2/28/03)
N189 This service has been paid as a one-time exception to the plan's benefit restrictions.
Note: (New Code 2/28/03)
N190 Missing contract indicator.
Note: (Modified 8/1/04) Related to N229
N191 The provider must update insurance information directly with payer.
Note: (New Code 2/28/03)
N192 Patient is a Medicaid/Qualified Medicare Beneficiary.
Note: (New Code 2/28/03)
N193 Specific federal/state/local program may cover this service through another payer.
Note: (New Code 2/28/03)
N194 Technical component not paid if provider does not own the equipment used.
Note: (New Code 2/28/03)
N195 The technical component must be billed separately.
Note: (New Code 2/28/03)
N196 Patient eligible to apply for other coverage which may be primary.
Note: (New Code 2/28/03)
N197 The subscriber must update insurance information directly with payer.
Note: (New Code 2/28/03)
N198 Rendering provider must be affiliated with the pay-to provider.
Note: (New Code 2/28/03)
N199 Additional payment approved based on payer-initiated review/audit.
Note: (New Code 2/28/03)
N200 The professional component must be billed separately.
Note: (New Code 2/28/03)
Note: (New Code 10/31/02)
N152 Missing/incomplete/invalid replacement claim information.
Note: (New Code 10/31/02)
N153 Missing/incomplete/invalid room and board rate.
Note: (New Code 10/31/02)
N154 This payment was delayed for correction of provider's mailing address.
Note: (New Code 10/31/02)
N155 Our records do not indicate that other insurance is on file. Please submit other
insurance information for our records.
Note: (New Code 10/31/02)
N156 The patient is responsible for the difference between the approved treatment and the
elective treatment.
Note: (New Code 10/31/02)
N157 Transportation to/from this destination is not covered.
Note: (New Code 2/28/03, Modified 2/1/04)
N158 Transportation in a vehicle other than an ambulance is not covered.
Note: (New Code 2/28/03)
N159 Payment denied/reduced because mileage is not covered when the patient is not in the
ambulance.
Note: (New Code 2/28/03)
N160 The patient must choose an option before a payment can be made for this procedure/
equipment/ supply/ service.
Note: (New Code 2/28/03, Modified 2/1/04)
N161 This drug/service/supply is covered only when the associated service is covered.
Note: (New Code 2/28/03)
N162 This is an alert. Although your claim was paid, you have billed for a test/specialty not
included in your Laboratory Certification. Your failure to correct the laboratory
certification information will result in a denial of payment in the near future.
Note: (New Code 2/28/03)
N163 Medical record does not support code billed per the code definition.
Note: (New Code 2/28/03)
N164 Transportation to/from this destination is not covered.
Note: (Deactivated eff. 1/31/04) Consider using N157
N165 Transportation in a vehicle other than an ambulance is not covered.
Note: (Deactivated eff. 1/31/04) Consider using N158)
N166 Payment denied/reduced because mileage is not covered when the patient is not in the
ambulance.
Note: (Deactivated eff. 1/31/04) Consider using N159
N167 Charges exceed the post-transplant coverage limit.
Note: (New Code 2/28/03)
N168 The patient must choose an option before a payment can be made for this procedure/
equipment/ supply/ service.
Note: (Deactivated eff. 1/31/04) Consider using N160
N169 This drug/service/supply is covered only when the associated service is covered.
Note: (Deactivated eff. 1/31/04) Consider using N161
N170 A new/revised/renewed certificate of medical necessity is needed.
Note: (New Code 2/28/03)
N171 Payment for repair or replacement is not covered or has exceeded the purchase price.
Note: (New Code 2/28/03)
N172 The patient is not liable for the denied/adjusted charge(s) for receiving any updated
service/item.
Note: (New Code 2/28/03)
N173 No qualifying hospital stay dates were provided for this episode of care.
Note: (New Code 2/28/03)
N174 This is not a covered service/procedure/ equipment/bed, however patient liability is
limited to amounts shown in the adjustments under group "PR".
Note: (New Code 2/28/03)
N175 Missing Review Organization Approval.
Note: (Modified 8/1/04) Related to N241
N176 Services provided aboard a ship are covered only when the ship is of United States
registry and is in United States waters. In addition, a doctor licensed to practice in the
United States must provide the service.
Note: (New Code 2/28/03)
N177 We did not send this claim to patient’s other insurer. They have indicated no additional
payment can be made.
Note: (New Code 2/28/03. Modified 6/30/03)
N178 Missing pre-operative photos or visual field results.
Note: (Modified 8/1/04) Related to N244
N179 Additional information has been requested from the member. The charges will be
reconsidered upon receipt of that information.
Note: (New Code 2/28/03)
N180 This item or service does not meet the criteria for the category under which it was
billed.
Note: (New Code 2/28/03)
N181 Additional information has been requested from another provider involved in the care
of this member. The charges will be reconsidered upon receipt of that information.
Note: (New Code 2/28/03)
N182 This claim/service must be billed according to the schedule for this plan.
Note: (New Code 2/28/03)
N183 This is a predetermination advisory message, when this service is submitted for
payment additional documentation as specified in plan documents will be required to
process benefits.
Note: (New Code 2/28/03)
N184 Rebill technical and professional components separately.
Note: (New Code 2/28/03)
N185 Do not resubmit this claim/service.
Note: (New Code 2/28/03)
N186 Non-Availability Statement (NAS) required for this service. Contact the nearest Military
Treatment Facility (MTF) for assistance.
Note: (New Code 2/28/03)
N187 You may request a review in writing within the required time limits following receipt of
this notice by following the instructions included in your contract or plan benefit
documents.
Note: (New Code 2/28/03)
N188 The approved level of care does not match the procedure code submitted.
Note: (New Code 2/28/03)
N189 This service has been paid as a one-time exception to the plan's benefit restrictions.
Note: (New Code 2/28/03)
N190 Missing contract indicator.
Note: (Modified 8/1/04) Related to N229
N191 The provider must update insurance information directly with payer.
Note: (New Code 2/28/03)
N192 Patient is a Medicaid/Qualified Medicare Beneficiary.
Note: (New Code 2/28/03)
N193 Specific federal/state/local program may cover this service through another payer.
Note: (New Code 2/28/03)
N194 Technical component not paid if provider does not own the equipment used.
Note: (New Code 2/28/03)
N195 The technical component must be billed separately.
Note: (New Code 2/28/03)
N196 Patient eligible to apply for other coverage which may be primary.
Note: (New Code 2/28/03)
N197 The subscriber must update insurance information directly with payer.
Note: (New Code 2/28/03)
N198 Rendering provider must be affiliated with the pay-to provider.
Note: (New Code 2/28/03)
N199 Additional payment approved based on payer-initiated review/audit.
Note: (New Code 2/28/03)
N200 The professional component must be billed separately.
Note: (New Code 2/28/03)
