Reason Code 16 | Remark Code MA27 N382

Code Description
Reason Code: 16 Claim/service lacks information or has submission/billing error(s). Usage: Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Remark Codes: MA27 and N382
  • Missing/incomplete/invalid entitlement number or name shown on the claim.
  • Missing/incomplete/invalid patient identifier.

 

Common Reasons for Denial

  • Beneficiary name/Medicare number do not match.

Next Step

  • Correct and resubmit as a new claim.

How to Avoid Future Denials

  • If the record on file is incorrect, the patient's family/estate must contact Social Security to have records corrected.

 

Last Updated Nov 29, 2018