Reason Code 109 | Remark Code N104 - JA DME
Reason Code 109 | Remark Code N104
| Code | Description |
|---|---|
| Reason Code: 109 | Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor. |
| Remark Code: N104 | This claim/service is not payable under our claim’s Jurisdiction area. You can identify the correct Medicare contractor to process this claim/service through the CMS website at CMS.gov |
Common Reasons for Denial
- Claim was submitted to incorrect Jurisdiction
- Claim must be submitted to the Jurisdiction listed as the beneficiary’s permanent address with the Social Security Administration
Next Step
- Submit claim to correct Jurisdiction listed as beneficiary’s permanent address with the Social Security Administration. This can be verified in the Noridian Medicare Portal
- Determine which DME MAC jurisdiction the claim is to be submitted to, based on the permanent address or should it be billed to the Part B Mac Jurisdiction
How to Avoid Future Denials
- Check eligibility on the Noridian Medicare Portal to verify the beneficiary’s permanent address on file with the Social Security Administration
- Identify correct DME MAC Medicare contractor to process claim, based on beneficiary’s permanent address
- Ensure claim is submitted to correct jurisdiction, either the DME MAC or the Part B Mac Jurisdiction
- File claims to Jurisdiction where beneficiary’s permanent residence is listed with the Social Security Administration. If changes are required, the beneficiary must contact the Social Security Administration.
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