Reason Code 22 | Remark Codes MA04

Code Description
Reason Code: 22 This care may be covered by another payer per coordination of benefits
Remark Codes: MA04 Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible

Common Reasons for Denial

  • This claim appears to be covered by a primary payer. The primary payer information was either not reported or was illegible on the claim

Next Step

  • Correct claim with the insurance information and resubmit as a new claim

How to Avoid Future Denials

  • Always verify eligibility on the NMP prior to providing items and ask the Medicare Secondary Payer Questions
  • If Medicare is secondary, ensure that primary payer information is included on claim and is legible
  • If the beneficiary believes Medicare should be primary, that may be requested by the beneficiary, by contacting the MSP Contractor at 1-855-798-2627
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