Reason Code C5462 - JE Part A

Reason Code Narrative

ITEM OR SERVICE IS SUBJECT TO PRIOR AUTHORIZATION AND THE UTN ON THE CLAIM DOES NOT MATCH THE UTN ON THE PRAU AUXILLARY FILE FOR THE MATCHING ITEM OR SERVICE OR THE UTN ON THE CLAIM DOES MATCH THE UTN ON FILE BUT DOES NOT MATCH THE ITEM OR SERVICE ON THE PRAU AUXILLARY FILE.

Common Reason Code Errors

• Pending Prior Authorization Request (PAR) at Common Working File (CWF)

Common Reason Code Corrections

• Reject

Resources

• CMS Prior Authorization OPD Guide
• CMS PA OPD FAQ