Denial message code CO 140 ma 61
• Patient/insured health identification number and name do not match (140)
• Missing/incomplete/invalid social security number or health insurance claim number (61)
Reason for denial
• Claim was filed for a patient whose Medicare number does not match the SSA records and CWF
How to resolve and avoid future denials
• Review the patient’s file to locate a copy of the Medicare card. If copy has not be obtained:
* Contact the patient for the information
* Call the referring/ordering physician to obtain the information
• File a new claim with the correct name and Health Insurance Claim Number (HIC) as listed on the Medicare card
Denial message co 96 and M117
• Non-covered charge(s) (96)
• Not covered unless submitted via electronic claim (117)
Reason for denial
• Claims were received in hard copy format
How to resolve and avoid future denials
• Submit claims electronically in the HIPAA complaint 837 format
• If you must submit hard copy claims, contact EDI Technology Support Center to appeal your filing status
• EDI Technology Support – 1-866-749- 4301
Denial message CO 16 AND N286
• Claim/service lacks information which is needed of adjudication (16)
• Missing/invalid/incomplete referring provider primary identifier (286)
Reason for denial
• Claim was filed with a invalid or missing NPI in Item 17B of CMS 1500 Claim Form
How to resolve and avoid future denials
• Refile the claim with the valid referring provider NPI in Item 17B of the CMS 1500 Claim Form
Denial message co 16 N234
• Claim/service lacks information needed for adjudication (16)
• Missing/incomplete/invalid last seen visit date (234)
Reason for denial
• Claim was not submitted with a 6-digit or 8-digit date patient was last seen by their attending physician
How to resolve and avoid future denials
• Routine foot care
* Item 19 of CMS 1500 claim form
• Include a 6-digit (mm/dd/yy) or an 8-digit (mm/dd/yyyy) date patient was last seen by his/her attending physician
• Include the NPI of the patient’s attending physician
Tags:
Denial and action