Common Reasons for Denial

• Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. Missing/incomplete/invalid diagnosis or condition.

Next Step

• Verify the Local Coverage Determination (LCD), LCD Policy Article for the applicable diagnosis codes required for specific policies
• If no diagnosis, add diagnosis and rebill claim
• Suppliers may do a self service reopening in the Noridian Medicare Portal to change the diagnosis.

How to Avoid Future Denials

• Verify the Local Coverage Determination (LCD), LCD Policy Article for the applicable diagnosis codes required for specific policies, prior to billing