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 claims jurisdiction area. You can identify the correct Medicare contractor to process this claim/service through the CMS website at http://www.cms.gov.

 

Common Reasons for Denial

  • Claim was submitted to incorrect Jurisdiction

Next Step

  • Submit claim to correct Jurisdiction

How to Avoid Future Denials

  • Identify correct Medicare contractor to process claim on CMS Review Contractor Directory - Interactive Map
  • Verify beneficiary lives in Jurisdiction A. States included are Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, and the District of Columbia
  • File claims to Jurisdiction where beneficiary resides in at time of claim submission

 

Last Updated Apr 18, 2018